3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

THERAPEUTIC DRUG MONITORING OF INDINAVIR BOOSTED WITH RITONAVIR IN PEDIATRIC PATIENTS

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. MoPe9.2C02

Curras V.¹, Höcht C.¹, Bramuglia G.¹, Rubio M.¹, Cáceres Guido P.², Mato G.², Mecikovsky D.³, Bologna R.^3
1Cátedra de Farmacología, Facultad de Farmacia y Bioquímica (UBA), Buenos Aires, Argentina, ²Area de Farmacia, Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina, ³Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría Juan P Garrahan, Buenos Aires, Argentina

INTRODUCTION: The aim of this work is to evaluate the results of therapeutic drug monitoring (TDM) assessed in the course of clinical routine practice in pediatric patients whose antiretroviral treatment includes indinavir boosted with ritonavir.

METHODS: 13 ambulatory patients receiving indinavir plus ritonavir (median: 38 months of treatment) were included in this work. In these patients, two plasmatic levels of indinavir were determined by HPLC: a “trough” level and a “peak” level (one hour after the corresponding dose). The average dosage of indinavir was 250 mg/m²/12hs.

RESULTS: Eight of thirteen patients yielded subtherapeutic levels with 2 patients with non detectable levels (median troughs: 0.73 µg/mL). One patient showed a peak level over the range (14.6 µg/mL). Median peak observed was 3.8 µg/mL. The therapeutic range proposed for indinavir was 0.150 and 10 µg/mL for troughs and peaks respectively, even though these levels were determined for adult patients. From the clinical viewpoint, most of the patients belong to categories B and C of the CDC pediatric classification system (A3: 1, B3: 4, C1: 1, C2: 2, C3: 5).

CONCLUSIONS: Although pediatric dosage of indinavir boosted with ritonavir is not yet defined, previous works suggested a dosage regimen of 400 mg/m² indinavir plus 125 mg/m² ritonavir every 12 hours. Since previous assessments of plasmatic levels of patients from our hospital had shown that this dosage regimen could lead to high levels associated with toxic reactions, the initial scheme consisted of 250 mg/m² indinavir plus 100 mg/m² ritonavir every 12 hours. TDM of indinavir showed that this regimen led to sub – therapeutic levels in this patients. Even though indinavir is boosted with ritonavir, the high variability observed in the plasmatic levels suggests that TDM of indinavir is advisable.

Download PDF of this abstract.

050724
Clinical | MoPe9.2C02 | Verónica Curras
9.2 2 9.2 Paediatric treatment strategies

Copyright © 2005 - International AIDS Society (IAS). All information and content relating to the abstracts from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. 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, 2005. 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. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.