NNRTIS AND SSRIS
A case of serotonin syndrome, occurred in a woman taking fluoxetine when efavirenz was added; this resolved when the dose of fluoxetine was halved. Efavirenz decreases sertraline levels, and nevirapine decreases fluoxetine levels, whereas fluvoxamine increases nevirapine levels.
Monitor for fluoxetine efficacy if nevirapine is given, and sertraline efficacy if efavirenz is given; adjust the SSRI dose as required. Monitor for signs of nevirapine adverse effects in patients also taking fluvoxamine. Bear the case of serotonin syndrome in mind if efavirenz and fluoxetine are both given.
Monitor for fluoxetine efficacy if nevirapine is given, and sertraline efficacy if efavirenz is given; adjust the SSRI dose as required. Monitor for signs of nevirapine adverse effects in patients also taking fluvoxamine. Bear the case of serotonin syndrome in mind if efavirenz and fluoxetine are both given.