Edurant Drug Interactions

Medicinal Products that Affect Rilpivirine Exposure: Rilpivirine is primarily metabolised by CYP450 3A. Medicinal products that induce or inhibit CYP3A may thus affect the clearance of rilpivirine (see Pharmacology: Pharmacokinetics under Actions). Co-administration of Edurant and medicinal products that induce CYP3A has been observed to decrease the plasma concentrations of rilpivirine, which could reduce the therapeutic effect of Edurant.
Co-administration of Edurant and medicinal products that inhibit CYP3A has been observed to increase the plasma concentrations of rilpivirine.
Co-administration of Edurant with medicinal products that increase gastric pH may result in decreased plasma concentrations of rilpivirine which could potentially reduce the therapeutic effect of Edurant.
Medicinal Products that are Affected by the Use of Rilpivirine: Edurant at a dose of 25 mg once daily is not likely to have a clinically relevant effect on the exposure of medicinal products metabolised by CYP enzymes.
Rilpivirine inhibits P-glycoprotein in vitro (IC₅₀ is 9.2 micromolar). In a clinical study rilpivirine did not significantly affect the pharmacokinetics of digoxin. However, it may not be completely excluded that rilpivirine can increase the exposure to other drugs transported by P-glycoprotein that are more sensitive to intestinal P-gp inhibition eg, dabigatran etexilate.
Rilpivirine inhibits the active renal tubular secretion of creatinine. Via the same mechanism exposure to metformin may be increased. Patients should be carefully monitored when initiating or stopping the concomitant administration of rilpivirine and metformin.
Established and theoretical interactions with selected antiretrovirals and non-antiretroviral medicinal products are listed in Tables 4a, 4b and 4c.

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QT Prolonging Medicinal Products: There is limited information available on the potential for a pharmacodynamic interaction between rilpivirine and medicinal products that prolong the QTc interval of the ECG. In a study of healthy subjects, supratherapeutic doses of rilpivirine (75 mg once daily and 300 mg once daily) have been shown to prolong the QTc interval of the ECG (see Pharmacology: Pharmacodynamics under Actions). Edurant should be used with caution when co-administered with a medicinal product with a known risk of Torsade de Pointes.
Incompatibilities: Not applicable.