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Protease inhibitors (PIs), which are the foundation of many HIV treatment regimens, interact with numerous other drugs. They are metabolized by cytochrome P450 (CYP) isoenzymes, and their serum levels can be affected by drugs that induce or inhibit these isoenzymes. In addition, PIs are potent CYP inhibitors (most notably affecting CYP3A4) and can thus substantially increase blood levels of other drugs metabolized via this route.
On April 27, 2010, the FDA notified healthcare professionals and consumers that more information on drug–drug interactions had been added to the labels of all approved PIs:
Sildenafil (when used for pulmonary arterial hypertension) and alfuzosin are contraindicated in combination with PIs.
Salmeterol should not be coa…