title: Use of lopinavir/ritonavir associated with ergotamine resulting in foot amputation: brief communication.
abstract: A 32-year-old female, was diagnosed in 2004 with a C1 HIV1 infection, using zidovudine/lamivudine 300/150 mg BID and lopinavir/ritonavir 400/100 mg BID, in addition to prophylaxis with trimethoprim-sulfamethoxazole 800/160 mg QD, but no prophylaxis with macrolide antibiotics. The patient presented with a severe headache and was prescribed two capsules of the anti-migraine drug Ormigrein™, which contained ergotamine tartrate 1 mg, caffeine 100 mg, paracetamol 220 mg, hyoscyamine sulfate 87.5 mcg, and atropine sulfate 12.5 mcg. Afterwards she was prescribed one capsule of Ormigrein every 30 minutes for a total of six capsules a day. The patient took the medication as prescribed but developed a pain in her left ankle three days later, which evolved to the need for amputation.
authors.affiliation: UNIRIO, Rio de Janeiro, RJ, Brazil.
authors.forename: Fernando Raphael de Almeida
authors.initials: FR
authors.lastname: Ferry
authors.affiliation: UNIRIO, Rio de Janeiro, RJ, Brazil.
authors.forename: Guilherme Almeida Rosa
authors.initials: GA
authors.lastname: Da Silva
authors.affiliation: UNIRIO, Rio de Janeiro, RJ, Brazil.
authors.forename: Rogerio Neves
authors.initials: RN
authors.lastname: Motta
authors.affiliation: UNIRIO, Rio de Janeiro, RJ, Brazil.
authors.forename: Ricardo de Souza
authors.initials: Rde S
authors.lastname: Carvalho
authors.affiliation: UNIRIO, Rio de Janeiro, RJ, Brazil.
authors.forename: Carlos Alberto Morais
authors.initials: CA
authors.lastname: De Sá
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000379:methods; D004878:Ergotamine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005528:Foot / Q000601:surgery*; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D061466:Lopinavir / Q000008:administration & dosage / Q000009:adverse effects*; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D019380:Anti-HIV Agents; D061466:Lopinavir; D019438:Ritonavir; D004878:Ergotamine