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HIV Clin Trials. 2006 Jan-Feb;7(1):34-8.

Atazanavir plasma concentrations vary significantly between patients and correlate with increased serum bilirubin concentrations.

Author information

1
Albion Street Centre, Sydney, NSW, Australia. don.smith@sesiahs.health.nsw.gov.au

Abstract

BACKGROUND:

Atazanavir (ATV) is recommended to be dosed at 400 mg once daily or 300 mg daily coadministered with 100 mg ritonavir (RTV).

METHOD:

31 male patients receiving ATV either alone or boosted with RTV for more than 2 weeks had ATV concentration measured by high performance liquid chromatography (HPLC). ATV concentrations were adjusted to obtain a 24-hour trough level using a standard pharmacokinetic formula.

RESULTS:

25 samples were taken from patients who received 300 mg ATV, 6 with 200 mg, 3 with 400 mg, and 2 with 150 mg, all boosted with 100 mg RTV. In the unboosted group, patients received 400 mg (7) or 600 mg (2). The median adjusted 24-hour trough ATV concentration was 630 ng/mL (interquartile range [IQR] 355-1034) in the boosted and 113 ng/mL (IQR 50-225) in the unboosted group (p = .001). Median serum bilirubin concentration was 34 IU/L (IQR 27.5-49) and 41 IU/L (IQR 31-45) in the boosted and unboosted groups, respectively. In the boosted group, high ATV concentrations were significantly correlated with increased serum bilirubin concentrations (p = .003).

CONCLUSION:

ATV concentrations showed considerable interpatient variability. Bilirubin concentrations are an indicator of high ATV concentrations and may prove to be useful in selecting patients for therapeutic drug monitoring (TDM).

PMID:
16632461
DOI:
10.1310/0KX0-H9VH-99EE-5D0L
[Indexed for MEDLINE]

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