Abstract
Rifampicin (RIF) decreases serum concentrations of several antiretroviral drugs. We carried out a prospective, comparative study to define efavirenz (EFV) pharmacokinetics in 16 cases and 13 controls. Cases were HIV and tuberculosis (TB) co-infected adults assuming RIF 600 mg once daily and EFV 800 mg once daily. Patients on EFV at standard 600 mg dose without RIF were taken as controls. EFV levels in plasma were assayed by high-performance liquid chromatography (HLPC) predose (Ctrough) and at 1, 2, 3, 4, 5, 6, 8, 10, 11, 12, 13, 14, 16, 18, 22 and 24 hours post-dose, and pharmacokinetic parameters were determined by non-compartmental methods. Among cases, 81% were males, mean age was 37 years, 50% were Caucasians, mean weight was 64 kg, mean CD4 cell counts and log HIV RNA copies were 160/μl and 5.2 /μl, respectively. Cases had a significantly higher Cl/F/kg if compared with controls (0.269 ± 0.12 versus 0.167 + 0.05 L/h/kg, p < 0.01). Otherwise, dose-dependent pharmacokinetic parameters of EFV were similar between cases and controls. Interindividual variability was consistently higher among TB cases compared to controls for all considered parameters. All cases completed combined treatment and no increased EFV toxicity was observed. These results suggest that a dose of 800 mg of EFV in association with rifampicin may be appropriate for patients of weight > 60 kg in Europe. Therapeutic drug monitoring may be beneficial for patients on combination therapy with RIF.
Keywords: Efavirenz, rifampicin, pharmacokinetic interaction, HIV infection
Current HIV Research
Title: Multiple-Dose Pharmacokinetics of Efavirenz with and without the Use of Rifampicin in HIV-Positive Patients
Volume: 5 Issue: 3
Author(s): Alberto Matteelli, Mario Regazzi, Paola Villani, Giuseppina De Iaco, Maria Cusato, Anna Cristina C. Carvalho, Silvio Caligaris, Lina Tomasoni, Maria Manfrin, Susanna Capone and Giampiero Carosi
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Keywords: Efavirenz, rifampicin, pharmacokinetic interaction, HIV infection
Abstract: Rifampicin (RIF) decreases serum concentrations of several antiretroviral drugs. We carried out a prospective, comparative study to define efavirenz (EFV) pharmacokinetics in 16 cases and 13 controls. Cases were HIV and tuberculosis (TB) co-infected adults assuming RIF 600 mg once daily and EFV 800 mg once daily. Patients on EFV at standard 600 mg dose without RIF were taken as controls. EFV levels in plasma were assayed by high-performance liquid chromatography (HLPC) predose (Ctrough) and at 1, 2, 3, 4, 5, 6, 8, 10, 11, 12, 13, 14, 16, 18, 22 and 24 hours post-dose, and pharmacokinetic parameters were determined by non-compartmental methods. Among cases, 81% were males, mean age was 37 years, 50% were Caucasians, mean weight was 64 kg, mean CD4 cell counts and log HIV RNA copies were 160/μl and 5.2 /μl, respectively. Cases had a significantly higher Cl/F/kg if compared with controls (0.269 ± 0.12 versus 0.167 + 0.05 L/h/kg, p < 0.01). Otherwise, dose-dependent pharmacokinetic parameters of EFV were similar between cases and controls. Interindividual variability was consistently higher among TB cases compared to controls for all considered parameters. All cases completed combined treatment and no increased EFV toxicity was observed. These results suggest that a dose of 800 mg of EFV in association with rifampicin may be appropriate for patients of weight > 60 kg in Europe. Therapeutic drug monitoring may be beneficial for patients on combination therapy with RIF.
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Matteelli Alberto, Regazzi Mario, Villani Paola, De Iaco Giuseppina, Cusato Maria, Carvalho C. Anna Cristina, Caligaris Silvio, Tomasoni Lina, Manfrin Maria, Capone Susanna and Carosi Giampiero, Multiple-Dose Pharmacokinetics of Efavirenz with and without the Use of Rifampicin in HIV-Positive Patients, Current HIV Research 2007; 5 (3) . https://dx.doi.org/10.2174/157016207780636588
DOI https://dx.doi.org/10.2174/157016207780636588 |
Print ISSN 1570-162X |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4251 |
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