Concomitant use of salmeterol and the combinationmasteron propionate ritonavir is not recommended because may increase the risk of side effects of salmeterol on the part of the cardiovascular system, including lengthening the interval QT, palpitations and sinus tachycardia.
Immunosuppressants (cyclosporin, tacrolimus, sirolimus)
Plasma concentrations of cyclosporine, sirolimus and tacrolimus may increase in the case of these combination preparations together with ritonavir. In these situations, it is recommended to control the concentration of immunosuppressive agents in plasma. The simultaneous use of a combination ritonavir and everolimus is not recommended.
Ketoconazole, itraconazole, posaconazole, clotrimazole and voriconazole
Ketoconazole, itraconazole, posaconazole, voriconazole, clotrimazole, and are potent inhibitors and some of them as its substrates. Systemic antifungal drugs data at the same time with a combination ritonavir may result in increased plasma concentrations of darunavir. On the other hand, this combination can increase the plasma concentration of some of these antifungal agents. This was confirmed by the study of the interaction between ketoconazole (200 mg twice daily) and a combination of darunavir / ritonavir (400 mg / 100 mg twice a day), wherein the concentration of ketoconazole and darunavir increased by 212% and 42% respectively. If necessary, use the combination of darunavir / ritonavir simultaneously with ketoconazole or itraconazole daily dose of the latter should not exceed 200 mg. With simultaneous use of a combination ritonavir and posaconazole is recommended clinical monitoring of the patient. Voriconazole concentrations in plasma may be reduced when combined with darunavir / ritonavir. Voriconazole should not be used in conjunction with darunavir / ritonavir, simultaneous use is possible only if the potential benefits from the use of voriconazole outweighs the potential risk.
In a joint application clotrimazole, and combinations of darunavir / ritonavir should be careful and also recommended continuous clinical observation of the patient.
Beta-blockers (carvedilol, metoprolol, timolol)
Combined use of beta-blockers and combinations ritonavir may result in increased concentrations of beta-blockers due to inhibition of isozyme . With the simultaneous use of these drugs and the combination ritonavir should be careful and conduct a careful clinical monitoring may also be necessary to decrease the dose of beta-blockers.
In a study of the effect of the combination ritonavir (600/100 mg 2 times a day) on a stable methadone maintenance therapy has been shown to decrease by 16% the concentration of R-methadone plasma. Based on the pharmacokinetic and clinical results, methadone dose correction at the beginning of therapy masteron propionate r is not required. However, clinical monitoring is recommended, as some patients require maintenance therapy correction.