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Influence of tenofovir, nevirapine and efavirenz on ritonavir-boosted atazanavir pharmacokinetics in HIV-infected patients

  • Pharmacokinetics and Disposition
  • Published:
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Abstract

Objective

The influence of nevirapine, efavirenz and tenofovir co-administration on ritonavir-boosted atazanavir pharmacokinetics was investigated in HIV (human immunodeficiency virus)-infected patients.

Methods

A population pharmacokinetic analysis was performed in the context of therapeutic drug monitoring (87 patients, 121 samples).

Results

A significant increase of atazanavir clearance (Cl/F) was found when either tenofovir (group B), efavirenz (group C), or nevirapine (group D) were co administered with atazanavir/ritonavir in comparison with patients treated with atazanavir/ritonavir and nucleoside reverse transcriptase inhibitors (group A): 6.24±0.36 l h−1 (group A) versus 7.42±0.25 l h−1 (group B) versus 9.60±0.27 l h−1 (group C) versus 17.53±0.57 l h−1 (group D) (P<0.001). However, the decrease of the mean trough plasma concentration of atazanavir was significant only in group D: 1.02±0.86 mg/l (group A) versus 0.21±013 mg/l (group D) (P<0.001).

Conclusion

The increase in atazanavir clearance when it is used in combination with nevirapine, efavirenz and/or tenofovir suggests that therapeutic drug monitoring of atazanavir should be performed in such circumstances.

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Authors and Affiliations

  1. Clinical Pharmacology Department, Hôtel Dieu, 9 Quai Moncousu, 44093, Nantes, Cedex, France

    Eric Dailly & Pascale Jolliet

  2. Clinical Pharmacology Department, Hôpital de Pontchaillou, Rennes, France

    Olivier Tribut

  3. Infectious Diseases Department, Hôpital de Pontchaillou, Rennes, France

    Pierre Tattevin & Cédric Arvieux

  4. Department of Medicine, Centre hospitalier de La Roche sur Yon, La Roche sur Yon, France

    Philippe Perré

  5. Infectious Diseases Department, Hôtel Dieu, Nantes, France

    François Raffi

Authors
  1. Eric Dailly
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  2. Olivier Tribut
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  3. Pierre Tattevin
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  4. Cédric Arvieux
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  5. Philippe Perré
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  6. François Raffi
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  7. Pascale Jolliet
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Corresponding author

Correspondence to Eric Dailly.

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Dailly, E., Tribut, O., Tattevin, P. et al. Influence of tenofovir, nevirapine and efavirenz on ritonavir-boosted atazanavir pharmacokinetics in HIV-infected patients. Eur J Clin Pharmacol 62, 523–526 (2006). https://doi.org/10.1007/s00228-006-0122-2

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  • DOI: https://doi.org/10.1007/s00228-006-0122-2

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