ArticleBritish journal of clinical pharmacology2006
Pharmacokinetics of nelfinavir in HIV-1-infected pregnant and nonpregnant women.
Article in British journal of clinical pharmacology, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review.PLoS medicine · 2016Pooled it
- Protecting the fetus against HIV infection: a systematic review of placental transfer of antiretrovirals.Clinical pharmacokinetics · 2014Pooled it
- Impact of Pregnancy and Vitamin A Supplementation on CYP2D6 Activity.Journal of clinical pharmacology · 2023Trial
- Steady-state pharmacokinetics, cord blood concentrations, and safety of ritonavir-boosted fosamprenavir in pregnancy.Journal of acquired immune deficiency syndromes (1999) · 2013Trial
- Atazanavir pharmacokinetics with and without tenofovir during pregnancy.Journal of acquired immune deficiency syndromes (1999) · 2011Trial
- Biological sex differences in pharmacokinetics and adverse drug reactions.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Pharmacokinetics of drugs in pregnancy.Seminars in perinatology · 2015Review
- Alteration in cytochrome P450 3A4 activity as measured by a urine cortisol assay in HIV-1-infected pregnant women and relationship to antiretroviral pharmacokinetics.HIV medicine · 2015Article
- Interpreting tacrolimus concentrations during pregnancy and postpartum.Transplantation · 2013Review
- Review
- Pharmacokinetics of tacrolimus during pregnancy.Therapeutic drug monitoring · 2012Article
- Pharmacokinetic optimization of antiretroviral therapy in pregnancy.Clinical pharmacokinetics · 2012Review
- Selection of HIV resistance associated with antiretroviral therapy initiated due to pregnancy and suspended postpartum.Journal of acquired immune deficiency syndromes (1999) · 2011Article
- Clinical therapeutics in pregnancy.Journal of biomedicine & biotechnology · 2011Article
- Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in Johannesburg, South Africa.Journal of acquired immune deficiency syndromes (1999) · 2010Article
- Factors associated with HIV RNA levels in pregnant women on non-suppressive highly active antiretroviral therapy at conception.Antiviral therapy · 2010Article
- Genital tract, cord blood, and amniotic fluid exposures of seven antiretroviral drugs during and after pregnancy in human immunodeficiency virus type 1-infected women.Antimicrobial agents and chemotherapy · 2009Article
- Pharmacologic and nonpharmacologic options for the management of HIV infection during pregnancy.HIV/AIDS (Auckland, N.Z.) · 2009Article
- Pharmacokinetics of new 625 mg nelfinavir formulation during pregnancy and postpartum.HIV medicine · 2008Article
- Practical therapeutic drug management in HIV-infected patients: use of population pharmacokinetic models supplemented by individualized Bayesian dose optimization.Journal of clinical pharmacology · 2008Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo compare steady-state nelfinavir (NFV) pharmacokinetics in pregnant and nonpregnant HIV-infected women.
methodsTwenty-five pregnant HIV-infected women were selected from an ongoing observational study evaluating the pharmacokinetics of antiretroviral agents during pregnancy. Twenty of them were in the third and five in the second trimester. Data for the control group of 21 HIV-infected nonpregnant women were taken from a previous multicentre pharmacokinetic trial. All the participating women achieved steady-state plasma concentrations while on a highly active antiretroviral therapy (HAART) regimen including NFV (1250 mg bid) and two nucleoside reverse transcriptase inhibitors (NRTIs). Blood samples for NFV measurement were collected predose (C(trough)) and at 0.5, 1, 2, 3, 4, 5, 6, 8 and 12 h post dose.
resultsDuring the third trimester of pregnancy NFV AUC(0-12 h) median (range) values were 25.76 (12.61-42.74) microg h(-1) ml(-1), and were 32.49 (19.16-63.81) microg h(-1) ml(-1) in the control group [mean difference - 9.30 microg h(-1) ml(-1); 95% confidence interval (CI) -15.76, -2.83; P < 0.05). Median oral clearance (CL/F) was significantly higher in pregnant women than in the control group (48.5 l h(-1), range 29.3-99.1 l h(-1) vs. 38.5 l h(-1), range 19.6-65.2 l h(-1); mean difference 12.6 l h(-1); 95% CI 3.3, 21.9) but the difference disappeared when CL/F was adjusted for body weight. C(trough) was significantly (P < 0.01) lower in pregnant compared with nonpregnant women (median 0.8 microg ml(-1), range 0-2.6 microg ml(-1) vs. 1.5 microg ml(-1), range 0.5-4.9 microg ml(-1); mean difference -1.0 microg ml(-1); 95% CI -1.7, -0.31). The median elimination half-life of NFV observed during pregnancy was 3.7 h (range 1.4-6.6 h), compared with 5.2 (range 3.1-10.1 h) in the control group (mean difference -1.7; 95% CI -2.8, -0.51).
conclusionsOur results indicate that women in the later stages of pregnancy may be exposed to subtherapeutic concentrations of NFV. Thus, adjustments in drug dosage or frequency of administration may be required.
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