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primobolan depot

Primobolan depot patients co-infected with hepatitis B and / or hepatitis C virus
in HIV-positive patients co-infected with hepatitis B and / or hepatitis C treatment is a combination ritonavir is not accompanied by a higher incidence of adverse events and changes in laboratory parameters ( compared to HIV-infected patients without hepatitis B and / or hepatitis C). The pharmacokinetics of darunavir and ritonavir in patients with opportunistic infections Hepatitis B and / or C was similar to that of patients with  monoinfection, except for increasing the activity of liver enzymes.

Overdose
Information on acute overdose of the drug while taking in combination with ritonavir is limited in humans. Healthy volunteers received one dose of up to 3200 mg of darunavir in solution form and up to 1600 mg in tablets in combination with ritonavir, wherein the adverse effects were observed.
The specific antidote is unknown. In case of overdose should be general supportive therapy with monitoring of vital signs. For removing nevsosavsheysya drug shows gastric lavage or enema. Activated carbon can be used. Darunavir is primarily bound to plasma proteins, therefore, a significant removal of the active substance by dialysis is unlikely.

Interaction with other drugs
darunavir and ritonavir are inhibitors of isoenzyme. Simultaneous use of a combination  ritonavir and drugs that are metabolized mainly isoenzyme , can cause increased concentrations of these drugs in the plasma, which in turn may be the cause of enhancing or prolonging the therapeutic effect, but also cause the occurrence of side effects.
The combination primobolan depotritonavir should not be used in conjunction with drugs, clearance of which is largely determined by the CYP3A4 isoenzyme and elevated concentrations of plasma which may cause serious and / or life-threatening adverse events (narrow therapeutic index). Such drugs include amiodarone, bepridil, quinidine, systemic lidocaine, astemizole, alfuzosin, sildenafil (when used for the treatment of pulmonary arterial hypertension), terfenadine, oral midazolam, triazolam, cisapride, primozid, sertindole, simvastatin, lovastatin and ergot alkaloids (e.g. , ergotamine, dihydroergotamine, ergometrine and metilergometrin).
Rifampicin is a potent inducer of the  isoenzymes of cytochrome. The combination  ritonavir should not be used concurrently with rifampicin because in such cases can significantly reduce the concentration of darunavir in the plasma. The consequence may be a loss of therapeutic effect .
Combination can not be used simultaneously with the preparations containing the extract of Hypericum perforatum (Hypericum perforatum), as this may be accompanied by a significant decrease darunavir plasma concentration, thereby may disappear therapeutic effect of the drug Prezista ® .

Recommendations for simultaneous use with other antiretroviral agents Nucleoside / nucleotide reverse transcriptase inhibitors didanosine combination of ritonavir (600/100 mg 2 times a day) simultaneously with didanosine can be used without dose adjustment. Since didanosine is recommended on an empty stomach, it can be taken for 1 hour before or 2 hours after taking a combination of primobolan depot ritonavir, which is taken with food. tenofovir The results of studies of the interaction between tenofovir (tenofovir disoproxil fumarate 300 mg per day) and the combination of darunavir / ritonavir (300 mg / 100 mg twice day) showed that the plasma concentration of tenofovir increased by 22%. This change is not clinically significant. With simultaneous use of tenofovir and darunavir renal excretion of both drugs did not change. Tenofovir did not have a significant effect on the concentration of darunavir in the plasma. With simultaneous  ritonavir and tenofovir dose adjustment is required.

Other nucleoside reverse transcriptase inhibitors
other nucleoside reverse transcriptase inhibitors (zidovudine, zalcitabine, emtricitabine, stavudine, lamivudine, and abacavir) are eliminated primarily by the kidneys, and therefore the likelihood of interaction with the combination of darunavir / ritonavir is negligible.

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