Darunavir/DolutegravirACE Inhibitors LisinoprilSafe - No dose adjustment usually needed.
ARBs Losartan Safe - No dose adjustment usually needed.
Diuretics HydrochlorothiazideSafe - No dose adjustment usually needed.
Calcium Channel Blockers Amlodipine Caution - Start at a low dose; monitor BP.
Beta-Blockers Metoprolol Caution - Monitor for increased side effects.
3. Medications to Avoid
Lercanidipine: This specific calcium channel blocker is generally contraindicated with protease inhibitors like darunavir.
Aliskiren: Some guidelines recommend avoiding this when taking boosted protease inhibitors.
2. Use with Caution (May Need Dose Adjustment)
Calcium Channel Blockers (CCBs): Examples include amlodipine, diltiazem, and verapamil.
The Issue: Darunavir can increase the levels of these drugs in your blood.
The Advice: If you use a CCB, your doctor should typically start you at the lowest possible dose and monitor you for symptoms of low blood pressure (dizziness, lightheadedness).
Beta-Blockers: Examples include metoprolol or atenolol.
The Issue: Dolutegravir can sometimes increase levels of certain beta-blockers like atenolol.
The Advice: These can be used, but cautious "start low and go slow" dosing is recommended.
1. Generally "Safe" (Low Interaction Risk)
These medications usually don't have major interactions with your HIV regimen and often don't require dose adjustments:
ACE Inhibitors: Examples include lisinopril, benazepril, and enalapril.
ARBs (Angiotensin II Receptor Blockers): Examples include losartan, valsartan, and candesartan.
Diuretics (Water Pills): Examples include hydrochlorothiazide (HCTZ) or chlorthalidone.
Choosing a blood pressure medication while taking darunavir and dolutegravir requires care because darunavir (especially when "boosted" with ritonavir or cobicistat) can significantly change how other drugs are processed by your liver.
Since you are taking a Protease Inhibitor (darunavir) and an Integrase Inhibitor (dolutegravir), here is the general guidance from clinical resources like the Liverpool HIV Drug Interactions database and the NIH.