Over-The-Counter Medications and HIV Antiretroviral Therapy
What are the chances of interaction between Over-The-Counter Medications, Food Supplements, and Other Drugs With HIV Antiretroviral Therapy
@vyoma Over-the-counter medications, food supplements, and other drugs may interact with antiretroviral therapy (ART) in people living with HIV and be harmful, an industry-sponsored clinical survey from Denmark reports.
"Our study confirms that polypharmacy and being on a protease inhibitor-based regimen increase the risk of potential drug-drug interactions (PDDIs) considerably and highlights the importance of questioning people living with HIV (PLWH) about dietary supplement intake," the authors, led by Michaela Tinggaard, MD, Copenhagen University Hospital, write in HIV Medicine.
"Potential drug-drug interactions were common among our study population. Although the clinical significance of the majority of the identified PDDIs may be low, most of them were avoidable through a change or discontinuation of the comedication, a change in ART or by spacing drugs," they add.
Senior author Thomas Benfield, MD, DTMH, DMSc, a professor of infectious diseases at the University of Copenhagen, and colleagues collected information on prescription medication, over-the-counter medication, and dietary supplements from adults living with HIV who received ART from two outpatient clinics.
The researchers estimated the prevalence of non-HIV comedications, and they used the University of Liverpool HIV Drug Interactions database to identify potential drug-drug interactions. They evaluated PDDIs and used logistic regression models to investigate links between PDDIs and relevant variables.
The study included 337 people living with HIV receiving ART. The median age was 53 years, 77% of them were male, and 96% were virally suppressed, with HIV-RNA viral load <50 copies/mL.
Overall, 26% of participants received five or more comedications, and 56% took dietary supplements.
In the medication lists of 52% of patients, the authors identified coadministration of drugs that required dose adjustment or monitoring.
4.5% of patients were taking drugs that should not be coadministered.
The researchers detected several factors that independently predicted PDDIs:
male sex (odds ratio (OR), 1.9; 95% CI, 1.0 - 3.4)
being on a protease inhibitor (OR, 4.3; 95% CI, 1.9 - 9.7)
receiving five or more comedications (OR, 3.3; 95% CI, 1.5 - 7.2)
taking over-the-counter medications (OR, 1.9; 95% CI, 1.1 - 3.3)
taking dietary supplements (OR, 2.0; 95% CI, 1.2 - 3.3)
Comorbidities and OTC Medications Increase in Aging People with HIV
Indira Brar, MD, an infectious diseases senior staff physician and the medical director of HIV services at Henry Ford Health in Detroit, Michigan, called the study and important resource for educating providers and patients about over-the-counter drugs.