Depo-medroxyprogesterone in women on antiretroviral therapy: effective contraception and lack of clinically significant interactions.
We conducted an open-label, steady-state pharmacokinetic (PK) study of drug interactions among HIV-infected women treated with depo-medroxyprogesterone acetate (DMPA) while on nucleoside analogues plus nelfinavir (N=21), efavirenz (N=17), or nevirapine (N=16); or nucleosides only or no antiretroviral therapy as a control group (N=16). PK parameters were estimated using non-compartmental analysis, with between-group comparisons of medroxyprogesterone acetate (MPA) PKs and within-subject comparisons of ARV PKs before and 4 weeks after DMPA dosing. Plasma progesterone levels were measured at baseline and at 2, 4, 6, 8, 10, and 12 weeks after DMPA dosing. There were no significant changes in MPA area under the concentration curve, peak or trough concentrations, or apparent clearance in the nelfinavir, efavirenz, or nevirapine groups compared to the control group. Minor changes in nelfinavir and nevirapine drug exposure were seen after DMPA, but were not considered clinically significant. Suppression of ovulation was maintained.
Cohn
S E
SE
Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. Susan_Cohn@urmc.rochester.edu
Park
J-G
JG
Watts
D H
DH
Stek
A
A
Hitti
J
J
Clax
P A
PA
Yu
S
S
Lertora
J J L
JJ
D000328:Adult; D000480:Alkynes; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D019540:Area Under Curve; D048588:Benzoxazines; D018791:CD4 Lymphocyte Count; D002853:Chromatography, Liquid; D003521:Cyclopropanes; D004334:Drug Administration Schedule; D004347:Drug Interactions; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D006207:Half-Life; D006801:Humans; D007267:Injections; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008875:Middle Aged; D019888:Nelfinavir / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D019829:Nevirapine / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D034445:Ovulation Inhibition / Q000187:drug effects*; D010078:Oxazines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D011374:Progesterone / Q000097:blood; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000493:pharmacokinetics / Q000627:therapeutic use; D013997:Time Factors
D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D017320:HIV Protease Inhibitors; D010078:Oxazines; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D011374:Progesterone; D019829:Nevirapine; D017258:Medroxyprogesterone Acetate; D019888:Nelfinavir; C098320:efavirenz