TABLE 418-3 -SELECTED DRUGS THAT SHOULD NOT BE USED WITH PROTEASE INHIBITORS*

Note: Based on theoretical considerations of pharmacokinetic interactions, the following should not be used with the noted protease inhibitors. This table is not intended as an exhaustive list, and physicians should consult the package inserts and more complete pharmacology reference works when using protease inhibitors with other drugs.
DRUG CATEGORY	INDINAVIR	RITONAVIR	SAQUINAVIR	NELFINAVIR
Analgesics		Meperidine Piroxicam Propoxyphene
Cardiac		Amiodrone Encainide Flecainide Propafenone Quinidine
Antimycobacterial	Rifampin	Rifabutin	Rifampin Rifabutin	Rifampin
Calcium channel blocker		Bepridil
Antihistamine	Astemizole Terfenadine	Astemizole Terfenadine	Astemizole Terfenadine	Astemizole Terfenadine
Gastrointestinal	Cisapride	Cisapride	Cisapride	Cisapride
Antidepressant		Bupropion
Neuroleptic	Clozapine Pimozide
Psychotropic	Midazolam Triazolam	Midazolam Triazolam Clorazepate Diazepam Estazolam Flurazepam Zolpidem	Midazolam Triazolam	Midazolam Triazolam
Ergot alkaloids	Ergotamines D.H.E. 45	Ergotamines D.H.E. 45	Ergotamines D.H.E. 45	Ergotamines D.H.E. 45

* Based on recommendations of the panel convened by the Department of Health and Human Services and the Henry J. Kaiser Family Foundation.

The combination of ritonavir and rifabutin is generally not recommended. If they must be used together, however, the dose of rifabutin should be reduced to one fourth of its standard dose.