Acid reducing agents and protese inhibitors
There have been two publications in Octobers HIV Medicine on this important topic.
Beique et al have provided a systematic review of all the available pharmacokinetic and clinical data on drug interactions between protease inhibitors and acid-reducing agents and their clinical consequences. The table documenting the interactions is a particularly valuable resource. 
However, new data are constantly emerging and Luber et al have documented their findings on once daily fosamprenavir/ritonavir and atazanavir/ritonavir alone and in combination with 20 mg omeprazole in healthy volunteers.
This paper is an update of reference 12 cited by Beique et al data initially presented at the Lisbon HIV Pharmacology Workshop in 2006. The major findings were:
- No impact of omeprazole on amprenavir exposure.
- Atazanavir AUC and Cmin reduced by 27%.
- 4/19 subjects experienced greater than 50% decline in both AUC and Cmin.
- Beique L, Giguere P, la Porte C, Angel J. Interactions between protease inhibitors and acid-reducing agents: a systematic review. HIV Med, 2007, 8(6):335-345.
- Luber A, Brower R, Kim D, et al. Steady-state pharmacokinetics of once-daily fosamprenavir/ritonavir and atazanavir/ritonavir alone and in combination with 20 mg omeprazole in healthy volunteers. HIV Med, 2007, 8(7):457-464.