Fosamprenavir: drug development for adherence.
OBJECTIVE
To review the pharmacology, pharmacokinetics, virology, safety, efficacy, and clinical use of fosamprenavir.


METHODS
A MEDLINE (1966-July 2005) search was conducted using fosamprenavir, Lexiva, amprenavir, and GW433908 as key words. Abstracts from infectious diseases and HIV scientific meetings were identified. Bibliographies of cited articles were reviewed.


METHODS
All publications, meeting abstracts, and unpublished information were reviewed and relevant items included. Information from in vitro, preclinical, and Phase II and III clinical trials was included.


RESULTS
Fosamprenavir is a protease inhibitor (PI) prodrug used for the treatment of HIV-1 infection. The active moiety, amprenavir, is extensively metabolized by CYP3A4. In clinical trials, fosamprenavir was at least as effective as amprenavir, with a reduced pill burden. Fosamprenavir was developed with the intention of reducing the pill burden associated with amprenavir. It has demonstrated comparable safety and efficacy with comparator PIs and is associated with limited cross-resistance to other PIs.


CONCLUSIONS
Fosamprenavir is a promising antiretroviral agent with favorable efficacy and tolerability. At this time, data indicate the utility of fosamprenavir in treatment-naïve and PI-experienced HIV-infected patients.
Hester
E Kelly
EK
Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, AL 36849, USA. hesteek@auburn.edu
Chandler
Haley V
HV
Sims
Kelli M
KM
D002219:Carbamates / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D024882:Drug Resistance, Viral; D005663:Furans; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism / Q000821:virology; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D010755:Organophosphates / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010349:Patient Compliance; D013449:Sulfonamides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
D002219:Carbamates; D005663:Furans; D017320:HIV Protease Inhibitors; D010755:Organophosphates; D013449:Sulfonamides; C426859:fosamprenavir