Differential effects of tipranavir plus ritonavir on atorvastatin or rosuvastatin pharmacokinetics in healthy volunteers.
Author(s): Pham PA, la Porte CJ, Lee LS, van Heeswijk R, Sabo JP, Elgadi MM, Piliero PJ, Barditch-Crovo P, Fuchs E, Flexner C, Cameron DW
Affiliation(s): Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. email@example.com
Publication date & source: 2009-10, Antimicrob Agents Chemother., 53(10):4385-92. Epub 2009 Aug 10.
Publication type: Clinical Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
To identify pharmacokinetic (PK) drug-drug interactions between tipranavir-ritonavir (TPV/r) and rosuvastatin and atorvastatin, we conducted two prospective, open-label, single-arm, two-period studies. The geometric mean (GM) ratio was 1.37 (90% confidence interval [CI], 1.15 to 1.62) for the area under the concentration-time curve (AUC) for rosuvastatin and 2.23 (90% CI, 1.83 to 2.72) for the maximum concentration of drug in serum (Cmax) for rosuvastatin with TPV/r at steady state versus alone. The GM ratio was 9.36 (90% CI, 8.02 to 10.94) for the AUC of atorvastatin and 8.61 (90% CI, 7.25 to 10.21) for the Cmax of atorvastatin with TPV/r at steady state versus alone. Tipranavir PK parameters were not affected by single-dose rosuvastatin or atorvastatin. Mild gastrointestinal intolerance, headache, and mild reversible liver enzyme elevations (grade 1 and 2) were the most commonly reported adverse drug reactions. Based on these interactions, we recommend low initial doses of rosuvastatin (5 mg) and atorvastatin (10 mg), with careful clinical monitoring of rosuvastatin- or atorvastatin-related adverse events when combined with TPV/r.