Iatrogenic Cushing's syndrome in an HIV-infected patient treated with inhaled corticosteroids (fluticasone propionate) and low dose ritonavir enhanced PI containing regimen.
In HIV-infected patients, ritonavir, a potent cytochrome P450 inhibitor, is increasingly used to improve the pharmacokinetic profile of the associated protease inhibitor. HIV physicians are often faced with potential drug-drug interaction while treating associated diseases. We report the case of an HIV-infected patient with clinical features of Cushing's syndrome due to the interaction of low dose ritonavir with inhaled fluticasone propionate (FP). Safety of life-long CYP450 inhibition has still to be demonstrated.
Clevenbergh
P
P
Department of Infectious Diseases, Nice University Hospital, France. clevenberghph@hotmail.com
Corcostegui
M
M
Gérard
D
D
Hieronimus
S
S
Mondain
V
V
Chichmanian
R M
RM
Sadoul
J L
JL
Dellamonica
P
P
D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy; D003480:Cushing Syndrome / Q000139:chemically induced* / Q000150:complications*; D004347:Drug Interactions; D000068298:Fluticasone; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D000730:Androstadienes; D019380:Anti-HIV Agents; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone; D019438:Ritonavir