Marked increase in etravirine and saquinavir plasma concentrations during atovaquone/proguanil prophylaxis

Malar J. 2011 May 21:10:141. doi: 10.1186/1475-2875-10-141.

Abstract

The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations. The evidence that atovaquone/proguanil significantly interacts with etravirine and saquinavir, but not with raltegravir and maraviroc, suggests that the mechanism of interaction is related to cytochrome P450.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-HIV Agents / pharmacokinetics*
  • Antimalarials / administration & dosage*
  • Atovaquone / administration & dosage*
  • Chemoprevention / methods
  • Drug Combinations
  • Drug Interactions*
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • Humans
  • Malaria / prevention & control
  • Nitriles
  • Plasma / chemistry*
  • Proguanil / administration & dosage*
  • Pyridazines / pharmacokinetics*
  • Pyrimidines
  • Saquinavir / pharmacokinetics*

Substances

  • Anti-HIV Agents
  • Antimalarials
  • Drug Combinations
  • Nitriles
  • Pyridazines
  • Pyrimidines
  • atovaquone, proguanil drug combination
  • etravirine
  • Saquinavir
  • Proguanil
  • Atovaquone