Darunavir: pharmacokinetics and drug interactions

Antivir Ther. 2008;13(1):1-13.

Abstract

Darunavir (TMC114) is a new HIV protease inhibitor that has demonstrated substantial antiretroviral activity against wild-type HIV-1 virus and multidrug-resistant strains. Darunavir inhibits and is primarily metabolized by cytochrome P450 3A (CYP3A) isoenzymes and is coadministered with low-dose ritonavir (darunavir/r); ritonavir is an inhibitor of CYP3A isoenzymes and pharmacologically enhances darunavir, resulting in increased plasma concentrations and allowing for a lower daily dose. The t1/2 (terminal elimination half-life) of darunavir is 15 h in the presence of ritonavir. An extensive darunavir/r drug-drug interaction programme has been undertaken, covering a wide range of therapeutic areas. Studies conducted in HIV-negative healthy volunteers and in HIV-infected patients show that the potential for interactions is well characterized and the interactions are manageable. For most drugs investigated, no dose adjustments of darunavir/r or the co-administered drug are required. This article reviews all the pharmacokinetic and drug-drug interaction studies conducted to date for darunavir/r, providing guidance on how to co-administer darunavir/r with many other antiretroviral or non-antiretroviral medications commonly used in HIV-infected individuals.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Darunavir
  • Drug Interactions*
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / pharmacokinetics*
  • HIV Protease Inhibitors / pharmacology*
  • Humans
  • Sulfonamides / pharmacokinetics*
  • Sulfonamides / pharmacology*

Substances

  • HIV Protease Inhibitors
  • Sulfonamides
  • Darunavir