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Volume 38, Number 1, February 2005

Dose reduction for the management of indinavir-related toxicity in human immunodeficiency virus type 1-infected patients in Taiwan: clinical and pharmacokinetic assessment


Sung-Ching Pan, Szu-Min Hsieh, Chien-Ching Hung, Pei-Fong Huang, Mao-Yuan Chen, Shan-Chwen Chang
Department of Internal Medicine, National Taiwan University Hospital, Taipei; and Department of Parasitology, National Taiwan University, Taipei, Taiwan

Received: May 17, 2004    Revised: June 21, 2004    Accepted: July 30, 2004   

 

Corresponding author:

Dr. Szu-Min Hsieh, Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. E-mail: hsmaids@hotmail.com This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Methods:

This study evaluated the feasibility of reducing the indinavir (IDV) dosage in Taiwanese patients receiving the standard IDV/ritonavir (RTV) dosage of 800/100 mg twice a day who had undetectable plasma human immunodeficiency virus type 1 (HIV-1) RNA but had developed IDV-related toxicities. After dosage reduction to IDV/RTV 600/100 mg twice a day, the dose-related toxicity decreased and plasma HIV RNA remained undetectable at 24 weeks post-switch in all patients. The maximal plasma concentration (Cmax) and area under the plasma concentration-time curve of IDV decreased significantly (median, 6.3 vs 4.3 µg/mL and 1892 vs 1292 µg•min/mL, p=0.01 and 0.001, respectively) but the minimal plasma concentration remained at a similar level (median, 1.0 vs 0.8 µg/mL, p=0.12). This study found that the reduction in the dosage of IDV in HIV-1 infected patients receiving the standard IDV/RTV regimen guided by therapeutic drug monitoring decreased the Cmax, dose-related toxicity and medical cost without compromising viral control.

 



 

Key words:

Drug toxicity, human immunodeficiency virus (HIV), indinavir, pharmacokinetics, ritonavir


 



 

J Microbiol Immunol Infect 2005;38:31-34.