LOPERAMIDE AND PROTEASE INHIBITORS

Loperamide reduces the bioavailability of saquinavir by about 50%, and saquinavir increases the bioavailability of loperamide by about 40%. Tipranavir alone, and in combination with ritonavir, reduces the bioavailability and plasma levels of loperamide and its metabolites.
Monitor patients to ensure that saquinavir remains effective. The increase in loperamide bioavailability is not expected to be clinically significant in the case of saquinavir, but the decrease with tipranavir may be of relevance, and loperamide may become less effective.
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