Dose escalation or immediate full dose when switching from efavirenz to nevirapine-based highly active antiretroviral therapy in HIV-1-infected individuals?

Alan Winston; Anton Pozniak; Nicola Smith; Carl Fletcher; Sundhiya Mandalia; Darmishta Parmar; Sarah Gibbons; David Back; Brian Gazzard; Mark Nelson

doi:10.1097/00002030-200402200-00029

Dose escalation or immediate full dose when switching from efavirenz to nevirapine-based highly active antiretroviral therapy in HIV-1-infected individuals?

AIDS. 2004 Feb 20;18(3):572-4. doi: 10.1097/00002030-200402200-00029.

Authors

Alan Winston¹, Anton Pozniak, Nicola Smith, Carl Fletcher, Sundhiya Mandalia, Darmishta Parmar, Sarah Gibbons, David Back, Brian Gazzard, Mark Nelson

Affiliation

¹ Department of Genitourinary and HIV Medicine, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.

PMID: 15090815
DOI: 10.1097/00002030-200402200-00029

Abstract

Efavirenz induces the metabolism of co-administered drugs through the induction of CYP A4. It is often necessary to switch fron efavirenz to nevirapine because of intolerance or toxicity. In a pharmacokinetic study we determined whether to dose-escalate nevirapine or start the full dose when switching from efavirenz. It was found that when changing from efavirenz to nevirapine individuals should commence on 200 mg twice a day, as this dose is associated with therapeutic plasma drug levels.

Publication types

Clinical Trial
Randomized Controlled Trial

MeSH terms

Adult
Alkynes
Anti-HIV Agents / administration & dosage*
Antiretroviral Therapy, Highly Active / methods
Benzoxazines
Cyclopropanes
Drug Administration Schedule
HIV Infections / drug therapy*
HIV Infections / virology
HIV-1*
Humans
Male
Middle Aged
Nevirapine / administration & dosage*
Oxazines / administration & dosage
Viral Load

Substances

Alkynes
Anti-HIV Agents
Benzoxazines
Cyclopropanes
Oxazines
Nevirapine
efavirenz