12.3 Interactions and overlapping toxicities between tuberculosis drugs and antiretrovirals

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    Certain combinations of TB drugs and ARVs are contraindicated or should be avoided or require dose adjustments of TB drugs or ARVs. For more information, see Appendix 19.


    Note: drug interactions and overlapping toxicities between TB drugs and drugs other than ARVs are common. For example, rifampicin reduces plasma concentrations of fluconazole by 25%. It may be necessary to increase the dose of fluconazole. Conversely, fluconazole increases plasma concentrations of rifabutin. It is necessary to monitor for signs of rifabutin toxicity [1] Citation 1. European Medical Agency. Fluconazole: Summary of Product Characteristics. 2012.
    . If patients are taking drugs other than ARVs, clinicians should be aware of potential interactions and overlapping toxicities.