Document Detail


Interactions between antifungal and antiretroviral agents.
MedLine Citation:
PMID:  20345324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
IMPORTANCE OF THE FIELD: Since the advent of combination antiretroviral therapy, the incidence of opportunistic infections has declined and the life expectancy of HIV-infected people has significantly increased. However, opportunistic infections, including fungal diseases, remain a leading cause of hospitalizations and mortality in HIV-infected people. With the availability of several new antiretroviral and antifungal agents, drug-drug interactions emerge as a potential safety concern.
AREAS COVERED IN THIS REVIEW: Relevant literature was identified using a Medline search of articles published up to March 2010 and a review of conference abstracts. Search terms included HIV, antifungal agents and drug interactions. Original papers and relevant citations were considered for this review.
WHAT THE READER WILL GAIN: Readers will gain an understanding of the pharmacokinetic properties of antiretroviral and antifungal agents, and insight into significant drug-drug interactions which may require dosage adjustments or a change in therapy.
TAKE HOME MESSAGE: Azole antifungal drugs, with the exception of fluconazole, pose the greatest risk of two-way interactions with antiretroviral drugs through CYP450 enzymes effects. Limited studies suggest the risk of interactions between antiretroviral drugs and echinocandins is much lower. The combination of tenofovir and amphotericin B should be used with caution and close monitoring of renal function is required.
Authors:
Christine A Hughes; Michelle Foisy; Alice Tseng
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Expert opinion on drug safety     Volume:  9     ISSN:  1744-764X     ISO Abbreviation:  Expert Opin Drug Saf     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2011-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101163027     Medline TA:  Expert Opin Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  723-42     Citation Subset:  IM    
Affiliation:
University of Alberta, Faculty of Pharmacy & Pharmaceutical Sciences, 3126 Dent/Pharm Centre, Edmonton, AB, T6G 2N8 Canada. chughes@pharmacy.ualberta.ca
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MeSH Terms
Descriptor/Qualifier:
Amphotericin B / adverse effects,  pharmacokinetics
Anti-Retroviral Agents / adverse effects,  pharmacokinetics*
Antifungal Agents / adverse effects,  pharmacokinetics*
Azoles / adverse effects,  pharmacokinetics
Biotransformation
Cytochrome P-450 Enzyme System / metabolism
Drug Interactions
Echinocandins / adverse effects,  pharmacokinetics
HIV Infections / drug therapy
Humans
Kidney / metabolism
Microsomes, Liver / metabolism
Mycoses / drug therapy
Chemical
Reg. No./Substance:
0/Anti-Retroviral Agents; 0/Antifungal Agents; 0/Azoles; 0/Echinocandins; 1397-89-3/Amphotericin B; 9035-51-2/Cytochrome P-450 Enzyme System

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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