Pharmacokinetic interactions between depot medroxyprogesterone acetate and combination antiretroviral therapy

Fertil Steril. 2008 Oct;90(4):965-71. doi: 10.1016/j.fertnstert.2007.07.1348. Epub 2007 Sep 19.

Abstract

Objective: To evaluate the effect of an antiretroviral (ARV) therapy regimen containing zidovudine (AZT), lamivudine (3TC), and efavirenz (EFV) on the pharmacokinetics of depot medroxyprogesterone acetate (DMPA).

Design: Open-label, nonrandomized, clinical trial.

Setting: University hospital clinic.

Patient(s): Thirty HIV-infected women; 15 using ARV therapy (AZT, 3TC, and EFV) and 15 non-users of ARV therapy, followed biweekly for 12 weeks.

Intervention(s): Single injection of DMPA (150 mg IM) for both groups.

Main outcome measure(s): Pharmacokinetic parameters of DMPA by liquid chromatography with mass spectrometry, and ovulation by serum P.

Result(s): Maximum serum concentrations of DMPA were reached at 14 days after injection. The area under the curve was similar in both groups, as were the minimum concentration, half-life, and clearance. Only 1 woman, not using ARV therapy, ovulated at 11 weeks after DMPA.

Conclusion(s): Pharmacokinetics of DMPA were similar in HIV-infected women, regardless of ARV therapy use, suggesting that triple therapy with AZT, 3TC, and EFV is not likely to interfere with the contraceptive effectiveness of DMPA.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / pharmacokinetics
  • Contraceptives, Oral, Synthetic / administration & dosage*
  • Contraceptives, Oral, Synthetic / pharmacokinetics*
  • Delayed-Action Preparations / administration & dosage
  • Drug Interactions
  • Drug Therapy, Combination
  • Female
  • HIV Infections / blood*
  • HIV Infections / drug therapy*
  • Humans
  • Medroxyprogesterone Acetate / administration & dosage*
  • Medroxyprogesterone Acetate / pharmacokinetics*

Substances

  • Anti-Retroviral Agents
  • Contraceptives, Oral, Synthetic
  • Delayed-Action Preparations
  • Medroxyprogesterone Acetate