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COC-ARV drug interactions.

COC-ARV Drug Interactions

Non-nucleoside reverse    Effect of ARV Use on   Effect of COC Use on
transcriptase             COC Blood Levels       ARV Blood Levels
inhibitors (NNRTIs)

Delavirdine               Possibly increases     No data
Efavirenz *               Increases              No change
Nevirapine                Decreases              No change

Protease inhibitors
Amprenavir                Increases              Decreases
Atazanavir                Increases              No data
Indinavir                 Increases              No data
Lopinavir + ritonavir     Decreases              No data
Nelfinavir                Decreases              No data
Ritonavir                 Decreases              No data
Saquinavir                No change              No change

Nucleoside reverse
inhibitors (NsRTIs)

Zidovudine, stavudine,    None expected          None expected
and lamivudine

Nucleotide reverse
inhibitors (NtRTIs)

Tenofovir                 No change              No change

Fusion inhibitors

Enfurvitide               None expected          None expected

* Should not be given to women of childbearing potential unless
effective contraception can be ensured.

Note: The ARV combinations recommended by the World Health Organization
consist of two NsRTIs and either one NNRTI or one protease inhibitor.
Each of the pharmacokinetic studies that produced these data assessed
interactions between contraceptive hormones and a single ARV drug,
rather than the two- or three-drug combinations taken by the vast
majority of HIV-infected patients. In most cases, only one study has
been conducted for each drug, and most of the studies have not been
published in a peer-reviewed journal.

Sources: World Health Organization (WHO). Improving Access to Quality
Care in Family Planning: Medical Eligibility Criteria for Contraceptive
Use. Third Edition. Geneva, Switzerland: WHO, 2004. Available:;WHO. Scaling
Up Antiretroviral Therapy in Resource-Limited Settings: Treatment
Guidelines for a Public Health Approach. Geneva, Switzerland: WHO,
2004; Center for HIV Information, University of California San
Francisco, School of Medicine. Interactions between ethinyl estradiol/
norethindrone acetate (Ortho-Novum, others) and antiretrovirals.
Database of Antiretroviral Drug Interactions,August 2005. Available:
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Date:Jun 22, 2007
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