Important note: Information in this article was accurate in May 2006. The state of the art may have changed since the publication date.
Dosing rifabutin and lopinavir/r – sub-optimal rifabutin levels reported in five patients dosed according to current guidelines
HIV Treat Bull - Vol. 7, No. 5, May 2006
Hasanin Khachi and colleagues from Barts and the London Trust reported drug levels of rifabutin in five patients concurrently using lopinavir/r-based ARV regimens. Following current guidelines (BHIVA, CDC), rifabutin dose was reduced from 300mg daily to 150mg three times a week, in five patients, and levels were measured using standard therapeutic drug monitoring after two weeks.
Rifabutin levels for all five patients were sub-therapeutic, (see Table 1) with one patient deteriorating clinically.
The researchers concluded that this data suggests current BHIVA and CDC guidelines result in sub-therapeutic rifabutin levels and that further formal investigations are required to establish the clinical significance of this, and determine the optimum dosing regimes for Kaletra and rifabutin in co-infected patients.
Table 1: Rifabutin levels at week 2
Rifabutin post-dose: 0.501.0 mg/l
Kaletra trough level: for wild type virus: 1000 ng/l
*Experienced patients: 8000 ng/l
Ref: Khachi H, Ladenheim D, Orkin C et al. Pharmacokinetic interactions between rifabutin and lopinavir/ritonavir in HIV-infected patients with mycobacterial co-infection. Oral abstract O12.
2008-03-10
IB060705-07
©2008. I-BASE HIV Treatment Bulletin. Permission to reproduce courtesy of HIV i-Base, Third Floor East, Thrale House, 44-46 Southwark Street, London SE1 1UN - T: +44 (0) 20 7407 8488 F: +44 (0) 20 7407 8489
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted grants 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 Always watch for outdated information.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 2008. 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, 2008. 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.