Optimizing concentrations of concomitant antiretrovirals by reducing etravirine doses: two case reports of complex drug-drug interactions

Antivir Ther. 2019;24(1):73-76. doi: 10.3851/IMP3274.

Abstract

We report the cases of two treatment-experienced HIV-infected patients with complex antiretroviral regimens that showed significant drug-drug interactions with etravirine. Unexpectedly high etravirine concentrations likely caused subtherapeutic levels of darunavir, elvitegravir and dolutegravir through concentration-dependent metabolic induction. Therapeutic drug monitoring allowed safe etravirine dose decreases to manage these interactions.

Publication types

  • Case Reports

MeSH terms

  • Anti-Retroviral Agents / administration & dosage*
  • Anti-Retroviral Agents / pharmacology
  • Anti-Retroviral Agents / therapeutic use
  • Darunavir / administration & dosage
  • Darunavir / pharmacology
  • Darunavir / therapeutic use
  • Drug Interactions*
  • Drug Monitoring*
  • Female
  • HIV Infections / drug therapy
  • HIV-1 / drug effects
  • Heterocyclic Compounds, 3-Ring / administration & dosage
  • Heterocyclic Compounds, 3-Ring / pharmacology
  • Heterocyclic Compounds, 3-Ring / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Nitriles
  • Oxazines
  • Piperazines
  • Pyridazines / administration & dosage*
  • Pyridazines / pharmacology
  • Pyridazines / therapeutic use
  • Pyridones
  • Pyrimidines
  • Quinolones / administration & dosage
  • Quinolones / pharmacology
  • Quinolones / therapeutic use

Substances

  • Anti-Retroviral Agents
  • Heterocyclic Compounds, 3-Ring
  • Nitriles
  • Oxazines
  • Piperazines
  • Pyridazines
  • Pyridones
  • Pyrimidines
  • Quinolones
  • etravirine
  • elvitegravir
  • dolutegravir
  • Darunavir