Rifampicin stimulates the activity of the cytochrome P450 liver enzyme system, which metabolizes PIs and NNRTIs.This can lead to decreased blood levels of PIs and NNRTIs. PIs and NNRTIs can also enhance or inhibit this same enzyme system, and lead to altered blood levels of rifampicin. The potential drug interactions may result in ineffectiveness of ARV drugs, ineffective treatment of TB or an increased risk of drug toxicity.
Isoniazid can cause peripheral neuropathy. The NsRTIs (didanosine, zalcitabine and stavudine) may also cause peripheral neuropathy.There is a potential added toxicity if isoniazid is added. Isoniazid also has a theoretical interaction with abacavir.
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