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Notes:
- Many antidepressants have narrow therapeutic windows, so careful attention to dosing is required.
- Many agents in this class are primarily substrates of CYP2D6
- e.g., TCAs: amitriptyline, nortriptyline, desipramine, imipramine
- e.g., SSRIs: fluoxetine, fluvoxamine, paroxetine
- However, bupropion is a substrate of CYP2B6
- In vitro experiments have shown that ritonavir, efavirenz, and nelfinavir can inhibit CYP2B6; therefore, the potential exists for interactions with bupropion. Indinavir, saquinavir and amprenavir were only weakly inhibitory of bupropion; hence no or only minor increase in bupropion levels anticipated.
- Hesse LM, von Moltke LL, Shader RI, Greenblatt DJ. Ritonavir, efavirenz, and nelfinavir inhibit CYP2B6 activity in vitro: potential drug interactions with bupropion. Drug Metab Dispos 2001;29:100-102
- Similar caution should be used when giving bupropion with lopinavir/ritonavir.
