Drug-drug interaction between itraconazole and the protease inhibitor lopinavir/ritonavir

The Annals of Pharmacotherapy
Cara Hills-NieminenStephen D Shafran

Abstract

To report the results of therapeutic drug monitoring of lopinavir/ritonavir and itraconazole concentrations in an HIV-infected male who was treated for histoplasmosis. A 34-year-old HIV-infected man who had recently initiated efavirenz-based antiretroviral therapy was diagnosed with disseminated Histoplasma capsulatum infection. In the hospital, lopinavir/ritonavir 400 mg/100 mg twice daily replaced efavirenz to avoid efavirenz-itraconazole interactions. After 14 days of liposomal amphotericin B therapy, itraconazole solution was initiated at 150 mg twice daily for 3 days, followed by 200 mg daily. Prior to itraconazole initiation, lopinavir trough concentration was 7.4 mg/L. The lopinavir trough concentration 15 days later, after 14 days of itraconazole, was 6.8 mg/L. An itraconazole concentration measured 2 hours post-dose on day 15 of oral therapy was 1.9 microg/mL. After 2 weeks of liposomal amphotericin, urine Histoplasma antigen was 27.23 ng/mL; after 5 months of oral itraconazole therapy, it decreased to 5.24 ng/mL. Plasma HIV RNA decreased 4.26 log(10) in 5 months to less than 40 copies/mL. The patient has demonstrated marked clinical improvement. In this case, dosing recommendations of itraconazole 200 mg daily with lo...Continue Reading

References

Apr 1, 1991·Antimicrobial Agents and Chemotherapy·P K SharkeyJ R Graybill
Feb 24, 2001·Drugs·K De Beule, J Van Gestel
Apr 20, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kristel M L CrommentuynJos H Beijnen
Aug 23, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Hoonmo L KooRoberto A Andrade
Sep 7, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·L Joseph WheatUNKNOWN Infectious Diseases Society of America
Nov 16, 2007·Expert Opinion on Pharmacotherapy·Sarah M RobertsonAlice Pau
Oct 29, 2008·Antimicrobial Agents and Chemotherapy·David AndesOscar Marchetti
Apr 18, 2009·Current Opinion in HIV and AIDS·Matthijs van LuinDavid M Burger

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Citations

Mar 30, 2010·Expert Opinion on Drug Safety·Christine A HughesAlice Tseng
Feb 12, 2014·Antimicrobial Agents and Chemotherapy·Rossana de Aguiar CordeiroJosé Júlio Costa Sidrim

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