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Related Experiment Video

Updated: Jun 25, 2026

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors

Published on: April 9, 2014

Warfarin-antiretroviral interactions.

Michelle D Liedtke¹, R Chris Rathbun

¹Department of Pharmacy, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA. michelle-liedtke@ouhsc.edu

The Annals of Pharmacotherapy

|February 7, 2009

Summary

This summary is machine-generated.

Warfarin drug interactions with antiretrovirals, particularly protease inhibitors (PIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs), can alter warfarin metabolism. Close international normalized ratio (INR) monitoring is crucial when these medications are used together.

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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors

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Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors

Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors

Published on: May 9, 2025

Area of Science:

Pharmacology
Drug Interactions
HIV Therapeutics

Background:

Warfarin is a widely used anticoagulant.
Antiretroviral agents are crucial for HIV management.
Potential drug interactions between these classes require careful evaluation.

Purpose of the Study:

To review and evaluate literature on interactions between warfarin and antiretroviral agents.
To assess the clinical significance of these drug interactions.

Main Methods:

Comprehensive literature search of MEDLINE and International Pharmaceutical Abstracts.
Inclusion of conference abstracts and manufacturer information.
Evaluation of case reports and studies on CYP2C9 metabolism and interactions.

Main Results:

Twelve case reports identified interactions primarily with protease inhibitors (PIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs).
Interactions are mediated via CYP2C9 metabolism, leading to either over-anticoagulation (e.g., with efavirenz, saquinavir) or subtherapeutic anticoagulation (e.g., with lopinavir/ritonavir, nevirapine).
Interactions with other antiretroviral classes are not anticipated.

Conclusions:

Drug interactions between warfarin and antiretrovirals are probable, especially with PIs and NNRTIs.
Specific antiretroviral agents can induce or inhibit warfarin metabolism.
Close international normalized ratio (INR) monitoring is recommended over empiric dose adjustments due to limited evidence.