title: A patient with HIV and tuberculosis with diminished clopidogrel response.
abstract: Patients with HIV are at an increased risk for cardiovascular disease, both as a result of treatment with protease inhibitors and from the disease itself. The medication regimens of patients with HIV and cardiovascular comorbidities are complex and require careful assessment for potentially serious drug-drug interactions. We report a case of clopidogrel non-responsiveness in a patient with HIV, latent tuberculosis and cardiovascular disease with a history of myocardial infarction. To our knowledge, this is the first report of significant drug interactions between clopidogrel, isoniazid and ritonavir. This case underscores the importance of a detailed drug interaction screening in infectious disease patients taking complex medication regimens, including clopidogrel.
authors.affiliation: Department of Pharmacy Practice, Mercer University College of Pharmacy, Atlanta, GA, USA Momary_km@mercer.edu.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Metzger
authors.affiliation: Department of Pharmacy Practice, Mercer University College of Pharmacy, Atlanta, GA, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Momary
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D000077144:Clopidogrel; D004347:Drug Interactions; D004351:Drug Resistance; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D019438:Ritonavir / Q000494:pharmacology / Q000627:therapeutic use; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D017320:HIV Protease Inhibitors; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D019438:Ritonavir; D013988:Ticlopidine; D007538:Isoniazid
keywords: AIDS; Antibiotic; HIV; antiviral; clopidogrel; drug--drug interactions; highly active antiretroviral therapy; isoniazid ritonavir