pricey twice daily in patients receiving simeprevir 200 Methadone No clinically important effect on methadone pharmacokinetics 1 Dosage adjustments not needed for either drug 1 Methylphenidate Clinically important interactions not expected 1 Milk thistle ( Silybum marianum ) Possible increased simeprevir concentrations 1 Concomitant use not recommended 1 Naloxone Clinically important interactions not expected 1 Nelfinavir Ritonavir-boosted or unboosted nelfinavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted or unboosted nelfinavir: Concomitant use not recommended 1 Nevirapine Possible decreased simeprevir concentrations 1 Concomitant use not recommended 1 200 Proton-pump inhibitors Clinically important interactions not expected 1 Omeprazole: Slightly increased omeprazole concentrations and AUC 1 Omeprazole: Dosage adjustments not needed for either drug 1 Raltegravir No clinically important effect on simeprevir pharmacokinetics 1 Dosage adjustments not needed for either drug 1 Ribavirin In vitro evidence of synergistic activity against HCV; 9 no in vitro evidence of antagonistic anti-HCV effects 1 9 Ribavirin and peginterferon alfa: No effect on simeprevir exposure 1 Rilpivirine No clinically important effect on rilpivirine or simeprevir pharmacokinetics 1 Dosage adjustments not needed for either drug 1 200 Ritonavir Substantially increased simeprevir concentrations and AUC 1 Concomitant use not recommended 1 Saquinavir Ritonavir-boosted or unboosted saquinavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted or unboosted saquinavir: Concomitant use not recommended 1 200 Sildenafil Potential increased sildenafil concentrations 1 Sildenafil for pulmonary arterial hypertension (PAH): Dosage adjustment of sildenafil may be needed; 1 consider using lowest initial dosage and titrate as needed with clinical monitoring 1 Sildenafil for erectile dysfunction: Dosage adjustments not needed 1 Sofosbuvir Slightly increased sofosbuvir concentrations and AUC; 1 no clinically important effect on simeprevir pharmacokinetics 1 No in vitro evidence of antagonistic anti-HCV effects between simeprevir and HCV NS5B polymerase inhibitors 1 Dosage adjustments not needed for either drug 1 St. John's wort ( Hypericum perforatum ) Possible decreased simeprevir concentrations; 1 may lead to loss of therapeutic effect of the HCV antiviral 1 Concomitant use not recommended 1 Stavudine Clinically important interactions not expected 1 Tadalafil Possible increased tadalafil concentrations 1 Tadalafil for PAH: Dosage adjustment of tadalafil may be needed; 1 consider using lowest initial dosage and titrate as needed with clinical monitoring 1 Tadalafil for erectile dysfunction: Dosage adjustments not needed 1 Tenofovir Tenofovir disoproxil fumarate (tenofovir DF): No clinically important effect on tenofovir pharmacokinetics; 1 slightly decreased simeprevir concentrations and AUC 1 Tenofovir DF: Dosage adjustments not needed for either drug 1 Tipranavir Ritonavir-boosted tipranavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted tipranavir: Concomitant use not recommended 1 200 Vardenafil Possible increased vardenafil concentrations 1 Vardenafil for erectile dysfunction: Dosage adjustments not needed 1 Zidovudine Clinically important interactions not expected 1 Simeprevir Pharmacokinetics Absorption Bioavailability Mean absolute bioavailability: 62% following single 150-mg oral dose under fed conditions. 1 Peak plasma concentrations achieved approximately 4 6 hours after an oral dose. 1 Food Administration after high-fat each person
Photo :twice daily in patients receiving simeprevir 200 Methadone No clinically important effect on methadone pharmacokinetics 1 Dosage adjustments not needed for either drug 1 Methylphenidate Clinically important interactions not expected 1 Milk thistle ( Silybum marianum ) Possible increased simeprevir concentrations 1 Concomitant use not recommended 1 Naloxone Clinically important interactions not expected 1 Nelfinavir Ritonavir-boosted or unboosted nelfinavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted or unboosted nelfinavir: Concomitant use not recommended 1 Nevirapine Possible decreased simeprevir concentrations 1 Concomitant use not recommended 1 200 Proton-pump inhibitors Clinically important interactions not expected 1 Omeprazole: Slightly increased omeprazole concentrations and AUC 1 Omeprazole: Dosage adjustments not needed for either drug 1 Raltegravir No clinically important effect on simeprevir pharmacokinetics 1 Dosage adjustments not needed for either drug 1 Ribavirin In vitro evidence of synergistic activity against HCV; 9 no in vitro evidence of antagonistic anti-HCV effects 1 9 Ribavirin and peginterferon alfa: No effect on simeprevir exposure 1 Rilpivirine No clinically important effect on rilpivirine or simeprevir pharmacokinetics 1 Dosage adjustments not needed for either drug 1 200 Ritonavir Substantially increased simeprevir concentrations and AUC 1 Concomitant use not recommended 1 Saquinavir Ritonavir-boosted or unboosted saquinavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted or unboosted saquinavir: Concomitant use not recommended 1 200 Sildenafil Potential increased sildenafil concentrations 1 Sildenafil for pulmonary arterial hypertension (PAH): Dosage adjustment of sildenafil may be needed; 1 consider using lowest initial dosage and titrate as needed with clinical monitoring 1 Sildenafil for erectile dysfunction: Dosage adjustments not needed 1 Sofosbuvir Slightly increased sofosbuvir concentrations and AUC; 1 no clinically important effect on simeprevir pharmacokinetics 1 No in vitro evidence of antagonistic anti-HCV effects between simeprevir and HCV NS5B polymerase inhibitors 1 Dosage adjustments not needed for either drug 1 St. John's wort ( Hypericum perforatum ) Possible decreased simeprevir concentrations; 1 may lead to loss of therapeutic effect of the HCV antiviral 1 Concomitant use not recommended 1 Stavudine Clinically important interactions not expected 1 Tadalafil Possible increased tadalafil concentrations 1 Tadalafil for PAH: Dosage adjustment of tadalafil may be needed; 1 consider using lowest initial dosage and titrate as needed with clinical monitoring 1 Tadalafil for erectile dysfunction: Dosage adjustments not needed 1 Tenofovir Tenofovir disoproxil fumarate (tenofovir DF): No clinically important effect on tenofovir pharmacokinetics; 1 slightly decreased simeprevir concentrations and AUC 1 Tenofovir DF: Dosage adjustments not needed for either drug 1 Tipranavir Ritonavir-boosted tipranavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted tipranavir: Concomitant use not recommended 1 200 Vardenafil Possible increased vardenafil concentrations 1 Vardenafil for erectile dysfunction: Dosage adjustments not needed 1 Zidovudine Clinically important interactions not expected 1 Simeprevir Pharmacokinetics Absorption Bioavailability Mean absolute bioavailability: 62% following single 150-mg oral dose under fed conditions. 1 Peak plasma concentrations achieved approximately 4 6 hours after an oral dose. 1 Food Administration after high-fat splendid high-caloric (928 kcal) or normal-caloric (533 kcal) breakfast in healthy individuals increased AUC by 61 or 69% can probably
important twice daily in patients receiving simeprevir 200 Methadone No clinically important effect on methadone pharmacokinetics 1 Dosage adjustments not needed for either drug 1 Methylphenidate Clinically important interactions not expected 1 Milk thistle ( Silybum marianum ) Possible increased simeprevir concentrations 1 Concomitant use not recommended 1 Naloxone Clinically important interactions not expected 1 Nelfinavir Ritonavir-boosted or unboosted nelfinavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted or unboosted nelfinavir: Concomitant use not recommended 1 Nevirapine Possible decreased simeprevir concentrations 1 Concomitant use not recommended 1 200 Proton-pump inhibitors Clinically important interactions not expected 1 Omeprazole: Slightly increased omeprazole concentrations and AUC 1 Omeprazole: Dosage adjustments not needed for either drug 1 Raltegravir No clinically important effect on simeprevir pharmacokinetics 1 Dosage adjustments not needed for either drug 1 Ribavirin In vitro evidence of synergistic activity against HCV; 9 no in vitro evidence of antagonistic anti-HCV effects 1 9 Ribavirin and peginterferon alfa: No effect on simeprevir exposure 1 Rilpivirine No clinically important effect on rilpivirine or simeprevir pharmacokinetics 1 Dosage adjustments not needed for either drug 1 200 Ritonavir Substantially increased simeprevir concentrations and AUC 1 Concomitant use not recommended 1 Saquinavir Ritonavir-boosted or unboosted saquinavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted or unboosted saquinavir: Concomitant use not recommended 1 200 Sildenafil Potential increased sildenafil concentrations 1 Sildenafil for pulmonary arterial hypertension (PAH): Dosage adjustment of sildenafil may be needed; 1 consider using lowest initial dosage and titrate as needed with clinical monitoring 1 Sildenafil for erectile dysfunction: Dosage adjustments not needed 1 Sofosbuvir Slightly increased sofosbuvir concentrations and AUC; 1 no clinically important effect on simeprevir pharmacokinetics 1 No in vitro evidence of antagonistic anti-HCV effects between simeprevir and HCV NS5B polymerase inhibitors 1 Dosage adjustments not needed for either drug 1 St. John's wort ( Hypericum perforatum ) Possible decreased simeprevir concentrations; 1 may lead to loss of therapeutic effect of the HCV antiviral 1 Concomitant use not recommended 1 Stavudine Clinically important interactions not expected 1 Tadalafil Possible increased tadalafil concentrations 1 Tadalafil for PAH: Dosage adjustment of tadalafil may be needed; 1 consider using lowest initial dosage and titrate as needed with clinical monitoring 1 Tadalafil for erectile dysfunction: Dosage adjustments not needed 1 Tenofovir Tenofovir disoproxil fumarate (tenofovir DF): No clinically important effect on tenofovir pharmacokinetics; 1 slightly decreased simeprevir concentrations and AUC 1 Tenofovir DF: Dosage adjustments not needed for either drug 1 Tipranavir Ritonavir-boosted tipranavir: Possible altered (increased or decreased) simeprevir concentrations 1 Ritonavir-boosted tipranavir: Concomitant use not recommended 1 200 Vardenafil Possible increased vardenafil concentrations 1 Vardenafil for erectile dysfunction: Dosage adjustments not needed 1 Zidovudine Clinically important interactions not expected 1 Simeprevir Pharmacokinetics Absorption Bioavailability Mean absolute bioavailability: 62% following single 150-mg oral dose under fed conditions. 1 Peak plasma concentrations achieved approximately 4 6 hours after an oral dose. 1 Food Administration after high-fat motivated
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