Effects of esomeprazole on the pharmacokinetics of atazanavir and fosamprenavir in a patient with human immunodeficiency virus infection

Pharmacotherapy. 2006 Apr;26(4):511-4. doi: 10.1592/phco.26.4.511.


The effects of proton pump inhibitors on the pharmacokinetics of atazanavir and amprenavir (administered as fosamprenavir) were rigorously evaluated in healthy volunteers in two studies, but formal studies in persons infected with human immunodeficiency virus (HIV) are lacking. We describe a 65-year-old man with HIV who underwent a 12-hour intensive pharmacokinetic study while receiving esomeprazole with atazanavir-ritonavir and subsequently, an 8-hour study while receiving esomeprazole with fosamprenavir-ritonavir. Consistent with the data in healthy volunteers, a major interaction between esomeprazole and atazanavir-ritonavir was observed in this patient-marked reductions in atazanavir trough plasma concentration and in the area under the concentration-time curve from 0-24 hours-whereas an interaction between esomeprazole and fosamprenavir-ritonavir was not apparent in this patient.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / pharmacokinetics*
  • Anti-Ulcer Agents / pharmacokinetics*
  • Atazanavir Sulfate
  • Carbamates / pharmacokinetics*
  • Drug Interactions
  • Esomeprazole / adverse effects
  • Esomeprazole / pharmacokinetics*
  • Furans
  • HIV Infections / drug therapy*
  • HIV Infections / physiopathology
  • HIV Protease Inhibitors / adverse effects
  • HIV Protease Inhibitors / pharmacokinetics*
  • Humans
  • Male
  • Oligopeptides / drug effects
  • Oligopeptides / pharmacokinetics*
  • Organophosphates / pharmacokinetics*
  • Prospective Studies
  • Proton Pump Inhibitors*
  • Pyridines / pharmacokinetics*
  • Sulfonamides / pharmacokinetics*


  • Anti-HIV Agents
  • Anti-Ulcer Agents
  • Carbamates
  • Furans
  • HIV Protease Inhibitors
  • Oligopeptides
  • Organophosphates
  • Proton Pump Inhibitors
  • Pyridines
  • Sulfonamides
  • Atazanavir Sulfate
  • Esomeprazole
  • fosamprenavir