Low trough levels of tipranavir in a combination antiretroviral therapy of tipranavir/ritonavir and tenofovir require therapeutic drug monitoring.
The new non-peptidic protease inhibitor tipranavir is used boosted with ritonavir in a 500/200 mg bid scheme. Multiple drug interactions are described for both drugs because of their different action in CYP450 3A4 and p-glycoprotein. In this retrospective analysis of 22 patients during therapy with tipranavir/ritonavir (TPV) 500 mg/200 mg bid, we found significantly decreased TPV-trough levels in combination with tenofovir (15.32+/-5.22 microg/ml) in comparison to TPV trough levels without tenofovir (20.21+/-14.87 microg/ml). Therapeutic drug monitoring of TPV is recommended.
Langmann
P
P
Internist-Gastroenterologie, Am Tiefen Weg 2, 97753 Karlstadt, Germany. p_langmann@yahoo.de
Winzer
R
R
Schirmer
D
D
Heinz
W
W
Leyh
M
M
Guhl
C
C
Weissbrich
B
B
Klinker
H
H
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000097:blood* / Q000493:pharmacokinetics; D023241:Antiretroviral Therapy, Highly Active; D048588:Benzoxazines / Q000008:administration & dosage; D003521:Cyclopropanes; D004347:Drug Interactions; D016903:Drug Monitoring; D000077560:Enfuvirtide; D015700:HIV Envelope Protein gp41 / Q000008:administration & dosage; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D063065:Organophosphonates / Q000008:administration & dosage*; D010446:Peptide Fragments / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage* / Q000097:blood* / Q000493:pharmacokinetics; D011753:Pyrones / Q000008:administration & dosage* / Q000097:blood* / Q000493:pharmacokinetics; D012189:Retrospective Studies; D019438:Ritonavir / Q000008:administration & dosage* / Q000097:blood; D013449:Sulfonamides; D000068698:Tenofovir
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D015700:HIV Envelope Protein gp41; D063065:Organophosphonates; D010446:Peptide Fragments; D011725:Pyridines; D011753:Pyrones; D013449:Sulfonamides; D000077560:Enfuvirtide; D000068698:Tenofovir; D000225:Adenine; C098320:efavirenz; D019438:Ritonavir; C107201:tipranavir