Drug-Drug Interactions with Antiretroviral Drugs in Pregnant Women Living with HIV : Are They Different from Non-Pregnant Individuals?
Bukkems, Vera E. (Radboud University Medical Center and Radboud Institute for Health Sciences (RIHS). Department of Pharmacy)
Colbers, Angela (Radboud University Medical Center and Radboud Institute for Health Sciences (RIHS). Department of Pharmacy)
Marzolini, Catia (University of Liverpool. Department of Molecular and Clinical Pharmacology)
Molto, Jose (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Burger, David M. (Radboud University Medical Center and Radboud Institute for Health Sciences (RIHS). Department of Pharmacy)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Although the separate effects of drug-drug interactions and pregnancy on antiretroviral drug pharmacokinetics have been widely studied and described, their combined effect is largely unknown. Physiological changes during pregnancy may change the extent or clinical relevance of a drug-drug interaction in a pregnant woman. This review aims to provide a detailed overview of the mechanisms, magnitude, and clinical significance of antiretroviral drug-drug interactions in pregnant women. We performed a literature search and selected studies that compared the magnitude of drug-drug interactions with antiretroviral drugs in pregnant vs non-pregnant women. Forty-eight papers examining drug-drug interactions during pregnancy were selected, of which the majority focused on pharmacokinetic boosting. Other selected studies examined the drug-drug interactions between efavirenz and lumefantrine, efavirenz and tuberculosis drugs, etravirine and tenofovir disoproxil fumarate, atazanavir and tenofovir disoproxil, and mefloquine and nevirapine in pregnant compared to non-pregnant women. The clinical significance of antiretroviral drug-drug interactions changed during pregnancy from a minimal effect to a contra-indication. In almost all cases, the clinical significance of a drug-drug interaction was more relevant in pregnant women, owing to the combined effects of pregnancy-induced physiological changes and drug-drug interactions leading to a lower absolute drug exposure. Multiple studies show that the clinical relevance of a drug-drug interaction can change during pregnancy. Unfortunately, many potential interactions have not been studied in pregnancy, which may place pregnant women living with human immunodeficiency virus and their newborns at risk.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Clinical Pharmacokinetics, Vol. 59 (july 2020) , p. 1217-1236, ISSN 1179-1926

DOI: 10.1007/s40262-020-00914-x
PMID: 32696442

20 p, 932.4 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles