Prezista (Darunavir) + Antibiotics

Interaction between Prezista and antibiotics may occur. Do not co-administer antibiotics with any ARV medicine without a recommendation from a doctor.

What Is Prezista (Darunavir)?

Darunavir is sold under various brand names. It’s a highly potent antiretroviral medicine prescribed and approved to treat and prevent HIV/AIDS. Darunavir is Prezista’s active ingredient [1].

This drug is recommended for use in combination with other antiretrovirals. Commonly, it is administered with low doses of cobicistat or ritonavir to boost darunavir levels.

Used with the right combination, Prezista is highly effective against HIV. Its mechanism of action inhibits the virus protease enzyme, suppressing its viral load and boosting the CD4+ cell count. The effect results in a stronger immune function making the HIV-infected individuals live healthier and longer lives.

Can Prezista Be Used with Antibiotics?

Macrolide antibiotics are extremely potent in preventing major bacterial infections in patients living with HIV. Mostly, co-trimoxazole or a combination of azithromycin and atovaquone including other potent macrolides are prescribed to HIV-infected persons across the globe due to their tolerability and effectiveness.

Although antibiotics are effective in reducing HIV-related mortality, if administered together with antiretroviral drugs, these medicines can cause potentially serious negative effects, particularly liver injury and related problems. Moreover, long-term use of these antibiotics can lead to bacterial resistance [2].

Since there is a limited study on how ARVs interact with antibiotics, there are most known interactions including rifabutin, rifampin, and clarithromycin. These antibiotics interact with darunavir.

Do not combine rifampin antibiotics and darunavir since co-administering may lower darunavir levels, making the drug less effective. Darunavir mixed with clarithromycin requires monitoring. This combination raises clarithromycin AUC levels by 57% and lowers darunavir Cmax by 17%. In this case, a medical specialist must monitor clarithromycin-related toxicities. Furthermore, a reduction of clarithromycin dosage by 50% is needed in HIV-infected individuals having CrCl 30– 60 mL/min or a reduction of clarithromycin dosage by 75% if CrCl is <30 mL/min [3].


  1. What is PREZISTA®?
  2. Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort. Dr AS Walker, PhD D Ford, PhD Prof CF Gilks, FRCP P Munderi, MBChB F Ssali, MBChB A Reid, MBChB et al. Retrieved March 29, 2010.
  3. Database of Antiretroviral Drug Interactions. Interactions between Antibiotics (including antimycobacterials) and Antiretrovirals.
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