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Pharmacokinetics and pharmacodynamics of cytochrome P450 inhibitors for HIV treatment
Ist Teil von
Expert opinion on drug metabolism & toxicology, 2019-05, Vol.15 (5), p.417-427
Ort / Verlag
England: Taylor & Francis
Erscheinungsjahr
2019
Quelle
MEDLINE
Beschreibungen/Notizen
Introduction: Drugs used in HIV treatment; all protease inhibitors, some
non-nucleoside reverse transcriptase inhibitors, and pharmacoenhancers ritonavir and cobicistat
can inhibit cytochrome P450 (CYP) enzymes. CYP inhibition can cause clinically significant
drug-drug interactions (DDI), leading to increased drug exposure and potential
toxicity.
Areas covered: A complete understanding of pharmacodynamics and CYP-mediated DDI
is crucial to prevent adverse side effects and to achieve optimal efficacy. We summarized the
pharmacodynamics of all the CYP inhibitors used for HIV treatment, followed by a discussion of
drug interactions between these CYP inhibitors and other drugs, and a discussion on the effect
of CYP polymorphisms. We also discussed the potential advancements in improving the
pharmacodynamics of these CYP inhibitors by using nanotechnology strategy.
Expert opinion: The drug-interactions in HIV patients receiving ARV drugs are
complicated, especially when patients are on CYP inhibitors-based ART regimens. Therefore,
evaluation of CYP-mediated drug interactions is necessary prior to prescribing ARV drugs to HIV
subjects. To improve the treatment efficacy and minimize DDI, novel approaches such as
nanotechnology may be the potential alternative approach. However, further studies with large
cohort need to be conducted to provide strong evidence for the use of nano-formulated ARVs to
effectively treat HIV patients.
Trial registration:
ClinicalTrials.gov identifier: NCT00002162.