Differential effects of tipranavir plus ritonavir on atorvastatin or rosuvastatin pharmacokinetics in healthy volunteers

Antimicrob Agents Chemother. 2009 Oct;53(10):4385-92. doi: 10.1128/AAC.00449-09. Epub 2009 Aug 10.

Abstract

To identify pharmacokinetic (PK) drug-drug interactions between tipranavir-ritonavir (TPV/r) and rosuvastatin and atorvastatin, we conducted two prospective, open-label, single-arm, two-period studies. The geometric mean (GM) ratio was 1.37 (90% confidence interval [CI], 1.15 to 1.62) for the area under the concentration-time curve (AUC) for rosuvastatin and 2.23 (90% CI, 1.83 to 2.72) for the maximum concentration of drug in serum (Cmax) for rosuvastatin with TPV/r at steady state versus alone. The GM ratio was 9.36 (90% CI, 8.02 to 10.94) for the AUC of atorvastatin and 8.61 (90% CI, 7.25 to 10.21) for the Cmax of atorvastatin with TPV/r at steady state versus alone. Tipranavir PK parameters were not affected by single-dose rosuvastatin or atorvastatin. Mild gastrointestinal intolerance, headache, and mild reversible liver enzyme elevations (grade 1 and 2) were the most commonly reported adverse drug reactions. Based on these interactions, we recommend low initial doses of rosuvastatin (5 mg) and atorvastatin (10 mg), with careful clinical monitoring of rosuvastatin- or atorvastatin-related adverse events when combined with TPV/r.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / pharmacokinetics*
  • Atorvastatin
  • Drug Interactions
  • Female
  • Fluorobenzenes / adverse effects
  • Fluorobenzenes / pharmacokinetics*
  • Heptanoic Acids / adverse effects
  • Heptanoic Acids / pharmacokinetics*
  • Humans
  • Male
  • Middle Aged
  • Pyridines / adverse effects
  • Pyridines / pharmacokinetics*
  • Pyrimidines / adverse effects
  • Pyrimidines / pharmacokinetics*
  • Pyrones / adverse effects
  • Pyrones / pharmacokinetics*
  • Pyrroles / adverse effects
  • Pyrroles / pharmacokinetics*
  • Ritonavir / adverse effects
  • Ritonavir / pharmacokinetics*
  • Rosuvastatin Calcium
  • Sulfonamides / adverse effects
  • Sulfonamides / pharmacokinetics*
  • Young Adult

Substances

  • Anti-HIV Agents
  • Fluorobenzenes
  • Heptanoic Acids
  • Pyridines
  • Pyrimidines
  • Pyrones
  • Pyrroles
  • Sulfonamides
  • Rosuvastatin Calcium
  • Atorvastatin
  • Ritonavir
  • tipranavir