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. 2010 May 15;24(8):1223-6.
doi: 10.1097/QAD.0b013e3283389129.

Lower atovaquone/proguanil concentrations in patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir

Matthijs van Luin  1 , Marchina E Van der Ende, Clemens Richter, Mirjam Visser, Diari Faraj, Andre Van der Ven, Luc Gelinck, Frank Kroon, Ferdinand W Wit, Ron H N Van Schaik, Paul F M Kuks, David M Burger
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Lower atovaquone/proguanil concentrations in patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir

Matthijs van Luin et al. AIDS. .

Abstract

HIV-infected travellers frequently use atovaquone/proguanil as malaria prophylaxis. We compared atovaquone/proguanil pharmacokinetics between healthy volunteers and HIV-infected patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir. The geometric mean ratio (95% confidence interval) area under the curve (AUC)0-->t for atovaquone relative to the healthy volunteers was 0.25 (0.16-0.38), 0.26 (0.17-0.41) and 0.54 (0.35-0.83) for patients on efavirenz, lopinavir/ritonavir and atazanavir/ritonavir, respectively. Proguanil plasma concentrations were also significantly lower (38-43%). Physicians should be alert for atovaquone/proguanil prophylaxis failures in patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir.

Trial registration: ClinicalTrials.gov NCT00421473.

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