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While small prospective studies have not revealed any significant drug-drug interaction between warfarin and levofloxacin, several case reports have indicated that levofloxacin may significantly potentiate the anticoagulation effect of warfarin. On January 31 the FDA announced that the Sustiva (efavirenz) package insert had been changed "to include drug-drug interaction information regarding coadministration of efavirenz with rifampin, diltiazem, itraconazole, voriconazole, atorvastatin, pravastatin, simvastatin, pimozide and bepridil. The reduced protein binding capacity may lead to a greater potential for drug-drug interaction via competitive displacement from the limited number of serum binding sites (Girgis and Brooks 1994). |
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