CALCIUM-CHANNEL BLOCKERS AND PROTEASE INHIBITORS

Nelfinavir, ritonavir, and saquinavir are predicted to increase the levels of calcium- channel blockers that are substrates of CYP3A4. The manufacturers of amprenavir similarly predict that it will increase the levels of diltiazem, nicardipine, nifedipine and nisoldipine. Atazanavir has been seen to raise diltiazem levels (2- to 3-fold) and is therefore predicted to raise verapamil levels.
Undertake concurrent use with caution. Monitor for toxicity, such as hypotension, dizziness, flushing and palpitations.
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