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Inhaled corticosteroid use in HIV ‐positive individuals taking protease inhibitors: a review of pharmacokinetics, case reports and clinical management
Author(s) -
Saberi P,
Phengrasamy T,
Nguyen DP
Publication year - 2013
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12039
Subject(s) - medicine , protease , pharmacokinetics , drug , pharmacology , corticosteroid , nasal administration , drug interaction , budesonide , enzyme , biochemistry , chemistry
As a consequence of inhibition of the hepatic cytochrome P450 3A4 isozyme, treatment with HIV protease inhibitors can result in significant drug−drug interactions. One noteworthy interaction is between protease inhibitors and inhaled or intranasal corticosteroids. This interaction can result in adrenal insufficiency and iatrogenic C ushing's syndrome (with symptoms such as rapid weight gain, obesity, facial hirsutism and swelling), as well as hypertension, osteoporosis and decreased CD4 cell count. In this paper, we review and unite pharmacokinetic data, case reports and current research regarding this drug−drug interaction in order to suggest options for the clinical management of HIV ‐positive patients requiring treatment with protease inhibitors and inhaled or intranasal corticosteroids.