{"id":15558,"date":"2011-08-01T11:00:26","date_gmt":"2011-08-01T11:00:26","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=15558"},"modified":"2011-08-01T11:00:26","modified_gmt":"2011-08-01T11:00:26","slug":"lopinavir-and-rifampicin-interaction-in-hiv-positive-patients","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/15558","title":{"rendered":"Lopinavir and rifampicin interaction in HIV-positive patients"},"content":{"rendered":"<p><strong>hiv-druginteractions.org<\/strong><\/p>\n<p>Coadministration of rifampicin dramatically reduces plasma lopinavir (LPV) concentrations. In healthy volunteers, doubling the dose of lopinavir-ritonavir (LPV\/r) capsules overcame this interaction, but a subsequent study of double doses of the tablets was stopped early owing to hepatotoxicity. However, healthy-volunteer study findings may not apply to HIV-positive adults.<\/p>\n<p>This study evaluated the steady-state pharmacokinetics of LPV in HIV-infected adults stable on LPV\/r tablets (400\/100 mg twice daily) who were given rifampicin (600 mg daily), and the dose of the LPV\/r gradually increased over a period of two weeks (first to 600\/150 twice daily and then to 800\/200 mg twice daily). Twenty-one subjects started the study, but two were withdrawn due to grade 3\/4 transaminitis.<\/p>\n<p>The median [IQR) pre-dose LPV concentrations were 8.1 (6.2 to 9.8) mg\/L at baseline, 1.7 (0.3 to 3.0) mg\/L after 7 days of rifampicin, 5.9 (2.1 to 9.9) mg\/L with 1.5 times the dose of LPV\/r, and 10.8 (7.0 to 13.1) mg\/L with double-dose LPV\/r. There were no significant differences in the LPV AUC, Cmax, pre-dose concentrations, 12-hour concentration, or half-life between the baseline and double-dose LPV\/r time points.<\/p>\n<p>Doubling the dose of the tablet formulation of LPV\/r overcame induction by rifampicin, with less hepatotoxicity occurring in this cohort of HIV-infected participants than reported in healthy-volunteer studies.\u00a0 The cohort consisted of HIV-infected patients who were virologically suppress with high CD4 counts \u0096 the risk of hepatotoxicity may be different in HIV-infected individuals with TB and\/or with different CD4 counts.<\/p>\n<p>Source: <a href=\"http:\/\/www.hiv-druginteractions.org\">hiv-druginteractions.org<\/a> (28 June 2011).<\/p>\n<p>Ref: Decloedt EH et al. Pharmacokinetics of lopinavir in HIV-infected adults receiving rifampin with adjusted doses of lopinavir-ritonavir tablets. Antimicrob Agents Chemother,\u00a0 2011, 55(7): 3195-3200.<\/p>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21537021\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21537021<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>hiv-druginteractions.org Coadministration of rifampicin dramatically reduces plasma lopinavir (LPV) concentrations. In healthy volunteers, doubling the dose of lopinavir-ritonavir (LPV\/r) capsules overcame this interaction, but a subsequent study of double doses of the tablets was stopped early owing to hepatotoxicity. However, &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[],"class_list":["post-15558","post","type-post","status-publish","format-standard","hentry","category-pk-and-drug-interactions"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/15558","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=15558"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/15558\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=15558"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=15558"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=15558"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}