Journal Article

Antiviral Effect and Pharmacokinetic Interaction between Nevirapine and Indinavir in Persons Infected with Human Immunodeficiency Virus Type 1

Murphy, Robert L., Hall, David B., Myers, Maureen, Lamson, Michael, Dusek, Alex, Sommadossi, Jean-Pierre

1999

Overview

Nevirapine and indinavir have the potential of affecting the pharmacokinetics of each other. In a prospective trial, 24 human immunodeficiency virus (HIV)—infected subjects on stable nucleoside or no therapy were treated with 800 mg of indinavir every 8 h. After 7 days, 200 mg of nevirapine a day was added for 14 days and then increased to 200 mg twice a day. At day 7 (before nevirapine), there was a sevenfold difference among the subjects in indinavir area under the curve (AUC), and there was a significant correlation between indinavir AUC (r2 = 0.378, P = .019), minimum plasma concentration (Cmin; r2 = 0.359, P = .023), maximum plasma concentration (Cmax; r2 = 0.340, P = .028), and plasma HIV RNA decline. Nevirapine significantly reduced median indinavir Cmin (47.5%) and AUC (27.4%) and, to a lesser extent, Cmax (11%). Plasma HIV RNA values were ⩾20 copies/mL in 10 of 17 (58.8%) subjects at 58 weeks or last visit. These data suggest that indinavir dosing should be dependent on drug exposure and not on cotherapy with nevirapine.

• Publisher: The University of Chicago Press,University of Chicago Press,Oxford University Press
• Subject: Adolescent / Adult / Aged / AIDS / Anti-HIV Agents - pharmacokinetics / Anti-HIV Agents - therapeutic use / Antibiotics. Antiinfectious agents. Antiparasitic agents / Antiretrovirals / Antiviral agents / Antivirals / Area Under Curve / Biological and medical sciences / Blood plasma / CD4 Lymphocyte Count / Drug Interactions / Drug Therapy, Combination / Female / HIV 1 / HIV Infections - drug therapy / HIV Infections - virology / HIV Protease Inhibitors - pharmacokinetics / HIV Protease Inhibitors - therapeutic use / HIV-1 - drug effects / HIV-1 - physiology / Human immunodeficiency virus 1 / Human viral diseases / Humans / Indinavir - pharmacokinetics / Indinavir - therapeutic use / Infectious diseases / Major Articles / Male / Medical sciences / Middle Aged / Nevirapine - pharmacokinetics / Nevirapine - therapeutic use / Nucleosides / Pharmacokinetics / Pharmacology. Drug treatments / Protease inhibitors / Reverse transcriptase inhibitors / Reverse Transcriptase Inhibitors - pharmacokinetics / Reverse Transcriptase Inhibitors - therapeutic use / RNA / RNA, Viral - blood / Viral diseases / Viral diseases of the lymphoid tissue and the blood. Aids