Marked increase in etravirine and saquinavir plasma concentrations during atovaquone/proguanil prophylaxis

• Published in: Malaria Journal
• Main Authors: Ivanovic Jelena, Gallo Anna L, D'Avolio Antonio, Tempestilli Massimo, Bellagamba Rita, Tommasi Chiara, Nicastri Emanuele, Pucillo Leopoldo P, Narciso Pasquale
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2011
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/1475-2875-10-141; https://doaj.org/article/47b7319a229a46cb9715fb3ee102ddcb

Abstract The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations. The evidence that atovaquone/proguanil significantly interacts with etravirine and saquinavir, but not with raltegravir and maraviroc, suggests that the mechanism of interaction is related to cytochrome P450.