title: Lack of a significant drug interaction between raltegravir and tenofovir.
abstract: Raltegravir is a novel human immunodeficiency virus type 1 (HIV-1) integrase inhibitor with potent in vitro activity (95% inhibitory concentration of 31 nM in 50% human serum). This article reports the results of an open-label, sequential, three-period study of healthy subjects. Period 1 involved raltegravir at 400 mg twice daily for 4 days, period 2 involved tenofovir disoproxil fumarate (TDF) at 300 mg once daily for 7 days, and period 3 involved raltegravir at 400 mg twice daily plus TDF at 300 mg once daily for 4 days. Pharmacokinetic profiles were also determined in HIV-1-infected patients dosed with raltegravir monotherapy versus raltegravir in combination with TDF and lamivudine. There was no clinically significant effect of TDF on raltegravir. The raltegravir area under the concentration time curve from 0 to 12 h (AUC(0-12)) and peak plasma drug concentration (C(max)) were modestly increased in healthy subjects (geometric mean ratios [GMRs], 1.49 and 1.64, respectively). There was no substantial effect of TDF on raltegravir concentration at 12 h postdose (C(12)) in healthy subjects (GMR [TDF plus raltegravir-raltegravir alone], 1.03; 90% confidence interval [CI], 0.73 to 1.45), while a modest increase (GMR, 1.42; 90% CI, 0.89 to 2.28) was seen in HIV-1-infected patients. Raltegravir had no substantial effect on tenofovir pharmacokinetics: C(24), AUC, and C(max) GMRs were 0.87, 0.90, and 0.77, respectively. Coadministration of raltegravir and TDF does not change the pharmacokinetics of either drug to a clinically meaningful degree. Raltegravir and TDF may be coadministered without dose adjustments.
authors.affiliation: Merck & Co, Inc, Whitehouse Station, New Jersey, USA. Larissa_Wenning@merck.com
authors.forename: Larissa A
authors.initials: LA
authors.lastname: Wenning
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Friedman
authors.forename: James T
authors.initials: JT
authors.lastname: Kost
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Breidinger
authors.forename: Jon E
authors.initials: JE
authors.lastname: Stek
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Lasseter
authors.forename: Keith M
authors.initials: KM
authors.lastname: Gottesdiener
authors.forename: Joshua
authors.initials: J
authors.lastname: Chen
authors.forename: Hedy
authors.initials: H
authors.lastname: Teppler
authors.forename: John A
authors.initials: JA
authors.lastname: Wagner
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stone
authors.forename: Marian
authors.initials: M
authors.lastname: Iwamoto
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D048588:Benzoxazines / Q000008:administration & dosage / Q000627:therapeutic use; D003521:Cyclopropanes; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D019428:HIV Integrase Inhibitors / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011760:Pyrrolidinones / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000068898:Raltegravir Potassium; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000068698:Tenofovir; D016896:Treatment Outcome
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D019428:HIV Integrase Inhibitors; D063065:Organophosphonates; D011760:Pyrrolidinones; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000068898:Raltegravir Potassium; D000068698:Tenofovir; D000225:Adenine; C098320:efavirenz