Effects of esomeprazole on the pharmacokinetics of atazanavir and fosamprenavir in a patient with human immunodeficiency virus infection.
The effects of proton pump inhibitors on the pharmacokinetics of atazanavir and amprenavir (administered as fosamprenavir) were rigorously evaluated in healthy volunteers in two studies, but formal studies in persons infected with human immunodeficiency virus (HIV) are lacking. We describe a 65-year-old man with HIV who underwent a 12-hour intensive pharmacokinetic study while receiving esomeprazole with atazanavir-ritonavir and subsequently, an 8-hour study while receiving esomeprazole with fosamprenavir-ritonavir. Consistent with the data in healthy volunteers, a major interaction between esomeprazole and atazanavir-ritonavir was observed in this patient-marked reductions in atazanavir trough plasma concentration and in the area under the concentration-time curve from 0-24 hours-whereas an interaction between esomeprazole and fosamprenavir-ritonavir was not apparent in this patient.
Kiser
Jennifer J
JJ
Department of Clinical Pharmacy, School of Pharmacy, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
Lichtenstein
Kenneth A
KA
Anderson
Peter L
PL
Fletcher
Courtney V
CV
D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D000897:Anti-Ulcer Agents / Q000493:pharmacokinetics*; D000069446:Atazanavir Sulfate; D002219:Carbamates / Q000493:pharmacokinetics*; D004347:Drug Interactions; D064098:Esomeprazole / Q000009:adverse effects / Q000493:pharmacokinetics*; D005663:Furans; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D009842:Oligopeptides / Q000187:drug effects / Q000493:pharmacokinetics*; D010755:Organophosphates / Q000493:pharmacokinetics*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011725:Pyridines / Q000493:pharmacokinetics*; D013449:Sulfonamides / Q000493:pharmacokinetics*
D019380:Anti-HIV Agents; D000897:Anti-Ulcer Agents; D002219:Carbamates; D005663:Furans; D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D010755:Organophosphates; D054328:Proton Pump Inhibitors; D011725:Pyridines; D013449:Sulfonamides; D000069446:Atazanavir Sulfate; D064098:Esomeprazole; C426859:fosamprenavir