ArticleBritish journal of clinical pharmacology2004
Therapeutic drug monitoring of lopinavir/ritonavir given alone or with a non-nucleoside reverse transcriptase inhibitor.
Article in British journal of clinical pharmacology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 45 citations in OpenAlex.
- Pharmacokinetic evidence for the induction of lopinavir metabolism by efavirenz.British journal of clinical pharmacology · 2005Trial
- A population approach to study the influence of nevirapine administration on lopinavir pharmacokinetics in HIV-1 infected patients.European journal of clinical pharmacology · 2005Trial
- Outcomes of modern antiretroviral therapy in obese individuals living with HIV.The Journal of antimicrobial chemotherapy · 2022Article
- Review
- Potential drug-drug interactions associated with drugs currently proposed for COVID-19 treatment in patients receiving other treatments.Fundamental & clinical pharmacology · 2020Review
- Lopinavir/ritonavir in COVID-19 patients: maybe yes, but at what dose?The Journal of antimicrobial chemotherapy · 2020Article
- Impact of obesity on antiretroviral pharmacokinetics and immuno-virological response in HIV-infected patients: a case-control study.The Journal of antimicrobial chemotherapy · 2017Article
- Clinical use of cobicistat as a pharmacoenhancer of human immunodeficiency virus therapy.HIV/AIDS (Auckland, N.Z.) · 2016Review
- Modeling chemical interaction profiles: II. Molecular docking, spectral data-activity relationship, and structure-activity relationship models for potent and weak inhibitors of cytochrome P450 CYP3A4 isozyme.Molecules (Basel, Switzerland) · 2012Article
- Factors influencing lopinavir and atazanavir plasma concentration.The Journal of antimicrobial chemotherapy · 2010Article
- Lack of effect of efavirenz on the pharmacokinetics of tipranavir-ritonavir in healthy volunteers.Antimicrobial agents and chemotherapy · 2009Article
- Population pharmacokinetics of lopinavir in combination with ritonavir in HIV-1-infected patients.British journal of clinical pharmacology · 2005Article
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo evaluate the interindividual variability in the plasma concentrations of lopinavir in the context of routine monitoring with or without treatment with a non-nucleoside reverse transcriptase inhibitor and to assess the interaction between the coformulation of lopinavir/ritonavir and efavirenz or nevirapine.
methodsPlasma trough and peak concentrations (C(trough), C(max)) of lopinavir from 182 HIV-1-infected patients were analysed by high-performace liquid chromatography. Three lopinavir/ritonavir regimens were assessed, namely (A) 400 mg lopinavir/100 mg ritonavir twice daily given alone (n = 125), (B) 400/100 mg twice daily together with a non-nucleoside reverse transcriptase inhibitor (n = 25), and (C) 533/133 mg twice daily together with a non-nucleoside reverse transcriptase inhibitor (n = 32).
resultsMedian (ng ml(-1)) C(trough) and C(max) lopinavir (interquartile range, CV) were: (A) 4852 (3198-6891, 56%) and 8501 (6333-11 584, 41%), (B) 2979 (1704-5186, 74%) and 5612 (3362-11 704, 76%) and (C) 5082 (2696-7226, 74%) and 9757 (4883-12 963, 60%). Median C(trough) of lopinavir was lower in patients taking both efavirenz [P = 0.01, 95% confidence interval (CI) for difference between medians 343, 2713] and nevirapine (P = 0.019, 95% CI for difference between medians 354, 3681) compared with those taking lopinavir/ritonavir alone. A higher interindividual variability was observed when lopinavir/ritonavir was given with a non-nucleoside reverse transcriptase inhibitor. The risk of achieving a 'suboptimal'C(trough) of lopinavir (below a threshold of 3000 ng ml(-1)) was statistically higher in patients treated with a non-nucleoside reverse transcriptase inhibitor (P < 0.001, 95% CI for difference between percentages 8.8, 43.1%) compared with those receiving lopinavir/ritonavir alone.
conclusionsOur results confirmed the interaction between lopinavir and efavirenz, and also demonstrated a significant interaction between the former drug and nevirapine, resulting in lower C(trough) of lopinavir. The wide interpatient variability in this interaction suggests that therapeutic drug monitoring may be useful in optimizing the dose of lopinavir.
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