Decrease of atazanavir and lopinavir plasma concentrations in a boosted double human immunodeficiency virus protease inhibitor salvage regimen.
The human immunodeficiency virus protease inhibitor combination of atazanavir (ATV)-lopinavir-ritonavir was reported to exhibit a mutual pharmacoenhancement of plasma lopinavir and ATV concentrations which may be beneficial for salvage patients. We identified 17 patients in our pharmacokinetic database taking this combination and found conflicting results. Plasma concentrations of both ATV and lopinavir were modestly, although not significantly, decreased when the drugs were coadministered. Therefore, patients should be selected carefully for this regimen and frequent clinical and therapeutic drug monitoring is strongly advised.
von Hentig
Nils
N
Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Hentig@em.uni-frankfurt.de
Kaykhin
Pavel
P
Stephan
Christoph
C
Babacan
Errol
E
Stürmer
Martin
M
Staszewski
Schlomo
S
Lötsch
Jörn
J
D000069446:Atazanavir Sulfate; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D061466:Lopinavir; D009842:Oligopeptides / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011725:Pyridines / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011744:Pyrimidinones / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D019438:Ritonavir / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D016879:Salvage Therapy; D016896:Treatment Outcome
D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D011744:Pyrimidinones; D061466:Lopinavir; D000069446:Atazanavir Sulfate; D019438:Ritonavir