Pharmacokinetics of zidovudine and acetaminophen in a patient on chronic acetaminophen therapy. NLM AIDSLINE Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Click here to return to AIDSLINE main menu
DonateNow
Print this Article


Pharmacokinetics of zidovudine and acetaminophen in a patient on chronic acetaminophen therapy.

Ann Pharmacother. 1994 Mar;28(3):327-30. Unique Identifier : AIDSLINE MED/94250987
Burger DM; Meenhorst PL; Koks CH; Beijnen JH; Department of Pharmacy, Slotervaart Hospital, Amsterdam, The; Netherlands.

Abstract: OBJECTIVE: To report a case of a potential interaction between acetaminophen and zidovudine in a patient who had used high daily doses of acetaminophen over many years. CASE SUMMARY: A 43-year-old man presented with HIV-1 infection, recurrent oral candidiasis, and chronic use of acetaminophen, codeine, and diazepam before he started zidovudine therapy. Although literature was available regarding short-term combined use of acetaminophen and zidovudine, information was lacking on zidovudine therapy and kinetics after long-term use of acetaminophen. Acetaminophen and zidovudine pharmacokinetics were determined on several occasions. The results showed extremely rapid absorption of both drugs (tmax the time to reach maximum concentration, 10-15 minutes for acetaminophen and 15-20 minutes for zidovudine) and, consequently, relatively high maximum plasma concentration (Cmax). No influence on other pharmacokinetic parameters of either drug could be detected. Because the effect of high Cmax values of zidovudine is unknown, the patient was treated with a third of the dose of zidovudine used at that time (zidovudine 100 mg q6h). No toxicity or opportunistic infections developed within the next 8 months, after which the patient died of a cause unrelated to HIV infection. DISCUSSION: The observed pharmacokinetic profiles of both drugs are discussed and compared with two studies dealing with zidovudine therapy in combination with short-term use of acetaminophen and with a case report of acetaminophen-induced hepatotoxicity during concomitant use of zidovudine. CONCLUSIONS: Long-term use of acetaminophen may accelerate the absorption of zidovudine. Although other causes cannot be ruled out, there was no influence on other pharmacokinetic parameters of zidovudine. No influence of zidovudine on acetaminophen concentrations was found. Combined use of zidovudine 100 mg q6h and acetaminophen 500 mg q4h appeared to be safe and effective for at least eight months.
Keywords: Acetaminophen/ADMINISTRATION & DOSAGE/*PHARMACOKINETICS Acquired Immunodeficiency Syndrome/DRUG THERAPY/*METABOLISM Administration, Oral Adult Case Report Comparative Study Drug Administration Schedule Drug Interactions Homosexuality Human *HIV-1 Injections, Intravenous Male Time Factors Zidovudine/ADMINISTRATION & DOSAGE/*PHARMACOKINETICS JOURNAL ARTICLE

KWDacetaminophen/administration&dosage/KWDpharmacokineticsacquiredimmunodeficiencysyndrome/drugtherapy/KWDmetabolismadministration,oraladultcasereportcomparativestudydrugadministrationscheduledruginteractionshomosexualityhumanKWDhiv-1injections,intravenousmaletimefactorszidovudine/administration&dosage/KWDpharmacokineticsjournalarticle
940930
M9491024

Copyright © 1994 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1994. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1994. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .