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[Not Available].
Aurélie Barrail-Tran1, Anne-Marie Taburet1, Jean-Marie Poirier2
1Pharmacie clinique, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France.
Therapie
|July 10, 2016
Summary
Therapeutic drug monitoring of indinavir, an HIV protease inhibitor, is recommended to ensure effective treatment and minimize toxicity. This approach helps achieve optimal drug concentrations in patients with HIV, particularly when not co-administered with ritonavir.
Area of Science:
- Pharmacology and pharmacokinetics
- Infectious diseases
- Drug metabolism
Context:
- Indinavir, an HIV protease inhibitor, exhibits significant inter-individual variability in plasma concentrations due to extensive hepatic metabolism.
- Understanding the relationship between indinavir exposure and patient outcomes is crucial for optimizing HIV therapy.
Purpose:
- To evaluate the evidence supporting the use of therapeutic drug monitoring (TDM) for indinavir in HIV-infected patients.
- To determine if TDM can improve virological efficacy and reduce toxicity associated with indinavir therapy.
Summary:
- Virological efficacy in HIV patients with wild-type virus is linked to indinavir trough concentrations above 100-150 ng/mL.
- Nephrotoxicity risk increases with trough concentrations exceeding 500-1000 ng/mL.
- Concentration-controlled studies indicate TDM facilitates achievement of safe and effective indinavir levels.
Impact:
- Therapeutic drug monitoring of indinavir is highly recommended when used alone and recommended when co-administered with ritonavir.
- TDM can guide individualized dosing strategies to optimize treatment outcomes in HIV management.
- This evidence supports the clinical utility of TDM for indinavir, enhancing patient care and safety.
