We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Sildenafil and bosentan plasma concentrations in a human immunodeficiency virus-infected patient with pulmonary arterial hypertension treated with ritonavir-boosted protease inhibitor.
- Authors
Chinello, Pierangelo; Cicalini, Stefania; Pichini, Simona; Pacifici, Roberta; Tempestilli, Massimo; Cicini, Maria P.; Pucillo, Leopoldo P.; Petrosillo, Nicola
- Abstract
Sildenafil and bosentan are increasingly used for the treatment of pulmonary arterial hypertension (PAH) in HIV-infected patients. However, concerns exist about pharmacokinetic interactions among sildenafil, bosentan and antiretroviral drugs, including protease inhibitors (PI). We describe here the case of an HIV-infected patient with PAH, who was co-administered bosentan 125 mg twice daily and sildenafil 40 mg three times per day, together with a ritonavir-boosted PI-based antiretroviral therapy; plasma levels of bosentan, sildenafil, N-desmethylsildenafil, and PI were measured. The patient had a sildenafil Cthrough and Cmax of 276.94 ng/mL and 1733.19 ng/mL, respectively. The Cthrough and the Cmax of bosentan were 1546.53 ng/mL and 3365.99 ng/mL, respectively. The patient was able to tolerate as high sildenafil blood concentrations as 10 times those usually requested and did not report any significant adverse reaction to sildenafil during the follow-up period. Therapeutic drug monitoring should be considered during sildenafil therapy in patients concomitantly treated with ritonavir-boosted PI.
- Subjects
SILDENAFIL; PULMONARY artery physiology; HYPERTENSION; HIV-positive persons; ANTIRETROVIRAL agents
- Publication
Infectious Disease Reports, 2015, Vol 7, Issue 1, p19
- ISSN
2036-7449
- Publication type
Article
- DOI
10.4081/idr.2015.5822