Open AccessHigh Indinavir Cmin Is Associated With Higher Toxicity in Patients on Indinavir-Ritonavir 800/100 mg Twice-Daily Regimen
Author(s) -
Caroline Solas,
Stéphanie Basso,
Isabelle PoizotMartin,
Isabelle Ravaux,
H Gallais,
JeanAlbert Gastaut,
Alain Durand,
Bruno Lacarelle
Publication year - 2002
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/00126334-200204010-00008
Subject(s) - indinavir , ritonavir , cmin , toxicity , trough concentration , regimen , medicine , pharmacology , sida , pharmacokinetics , human immunodeficiency virus (hiv) , antiretroviral therapy , viral load , immunology , viral disease , cmax
We retrospectively evaluated the incidence of side effects and treatment intervention according to indinavir trough concentration in 63 patients taking indinavir-ritonavir 800/100 mg twice daily. Median indinavir trough concentration was 1446 ng/mL at 800/100 mg twice daily associated with 60% of measured toxicity. Among patients with indinavir trough concentration >500 ng/mL, 46 of 49 had a dosage adjustment and 17 have had more than two dosage adjustments. The primary reason for dosage adjustment was toxicity in 69% (43 cases). Renal and cutaneous toxicity were predominant.After dosage adjustment, median indinavir trough concentration was 459 ng/mL, which was associated with 8% of toxicity. Trough concentrations >500 ng/mL were correlated with increased toxicity (p <.05) and more treatment intervention (p =.02). In conclusion, achievement of indinavir trough concentrations <500 ng/mL appears to be safe, and an optimal concentration range for indinavir trough concentration could be 150 to 500 ng/mL for an indinavir-ritonavir twice daily regimen.