Dose escalation or immediate full dose when switching from efavirenz to nevirapine-based highly active antiretroviral therapy in HIV-1-infected individuals?
Efavirenz induces the metabolism of co-administered drugs through the induction of CYP A4. It is often necessary to switch fron efavirenz to nevirapine because of intolerance or toxicity. In a pharmacokinetic study we determined whether to dose-escalate nevirapine or start the full dose when switching from efavirenz. It was found that when changing from efavirenz to nevirapine individuals should commence on 200 mg twice a day, as this dose is associated with therapeutic plasma drug levels.
Winston
Alan
A
Department of Genitourinary and HIV Medicine, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
Pozniak
Anton
A
Smith
Nicola
N
Fletcher
Carl
C
Mandalia
Sundhiya
S
Parmar
Darmishta
D
Gibbons
Sarah
S
Back
David
D
Gazzard
Brian
B
Nelson
Mark
M
D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D048588:Benzoxazines; D003521:Cyclopropanes; D004334:Drug Administration Schedule; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000008:administration & dosage*; D010078:Oxazines / Q000008:administration & dosage; D019562:Viral Load
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D010078:Oxazines; D019829:Nevirapine; C098320:efavirenz