AEGiS-Glasgow [PL6.2] Drug-drug interactions

Seventh International Congress on Drug Therapy in HIV Infection

Glasgow, UK - 14-17 November 2004

[PL6.2] Drug-drug interactions

Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL6.2

David Back
Department of Pharmacology & Therapeutics, University of Liverpool, Liverpool, UK

As access to HAART widens and the number of licensed antiretrovirals (and therefore potential combinations of drugs) increases, there is the need to elucidate how best to optimise therapy. Although there may be only a single licensed dosage of a drug, in reality decision making regarding dosing can be complex when faced with the range of possible drug combinations to be used in patients of varying weight, hepatic and renal status, baseline genotype, race and sex. In this context we must keep in mind the concept of individualised patient care. The complexity of drug-drug interactions has proven to be a major challenge for those treating HIV positive patients. Alterations in the pharmacokinetics (PK) of the antiretroviral and/or co- administered drug are common and often difficult to predict due to the complex nature of drug disposition. The main focus of the talk will be to review the latest drug-drug interaction data involving, for example, double boosted PIs including tipranavir, tenofovir, drugs in co-infected patients, herbals. In addition some of the latest insights into mechanisms of drug interactions will be given as well as a listing of useful resources to capture the latest drug interaction data.

HIV medicine is rife with proven and potential drug-drug interactions. Although many interactions can be predicted on the basis of preclinical pharmacology, and regulatory agencies require PK studies when a significant interaction is anticipated, there are still many drug combinations that have been inadequately studied. Given also that unexpected interactions appear and unexpected failures of certain drug combinations occur, there is the need to have some understanding of the concentrations of antiretroviral drugs achieved in an individual patient. Here is a role for therapeutic drug monitoring.

SESSION 6: RESISTANCE AND PHARMACOKINETICS

2004-11-14
PL6.2

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