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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: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it




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.