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Clinical Pharmacokinetics
Published in: Clinical Pharmacokinetics 15/2004

01-12-2004 | Review Article

Pharmacokinetics of Antiretrovirals in Pregnant Women

Authors: Dr Mark Mirochnick, Edmund Capparelli

Published in: Clinical Pharmacokinetics | Issue 15/2004

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Abstract

Antiretroviral treatment of HIV-infected pregnant women is widely used to prevent mother-to-child HIV transmission and as primary therapy of maternal HIV infection. The physiological changes associated with pregnancy have a large impact on drug disposition, and changes in antiretroviral pharmacokinetics during pregnancy must be understood for these drugs to be used safely and effectively in pregnant women.
Zidovudine and didanosine, two of the nucleoside reverse transcriptase inhibitors, demonstrate an increase in clearance and decrease in area under the concentration-time curve during pregnancy. The clinical significance of these changes is unknown due to the lack of a clear relationship between plasma concentrations of nucleoside reverse transcriptase inhibitors and clinical effects. Pharmacokinetic parameters of lamivudine, stavudine and abacavir are not significantly changed during pregnancy. There are no data describing the effect of pregnancy on the pharmacokinetics of the other nucleoside/nucleotide analogues (zalcitabine, emtricitabine and tenofovir). Pregnancy does not appear to have a significant effect on the pharmacokinetics of the non-nucleoside reverse transcriptase inhibitor nevirapine and there are no data describing the pharmacokinetics of the other non-nucleoside reverse transcriptase inhibitors (efavirenz and delavirdine) during pregnancy.
Reduced plasma concentrations during pregnancy have been described for several of the protease inhibitors, including nelfinavir (with administration of 750mg three times daily), indinavir, saquinavir and Kaletra® (a co-formulation of lopinavir and ritonavir). Plasma concentrations equivalent to those in nonpregnant adults have been reported in pregnant women receiving nelfinavir at doses of 1250mg twice daily, and the addition of ritonavir to saquinavir greatly increases saquinavir exposure to therapeutic concentrations in pregnant women. No pregnancy pharmacokinetic data are available for the newer protease inhibitors atazanavir and fosamprenavir, or with other dual protease inhibitor combinations that include low dose ritonavir to boost concentrations of the coadministered protease inhibitor. Further investigations of antiretroviral pharmacology during pregnancy, including protein binding studies, are urgently needed.
Footnotes
1
The use of trade names is for product identification purposes only and does not imply endorsement.
 
Literature
1.
2.
Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 1994; 331: 1173–80PubMed
3.
Cooper ER, Charurat M, Mofenson L, et al. Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr 2002; 29: 484–94PubMed
4.
Dorenbaum A, Cunningham C, Gelber RD, et al. Addition of two-dose intrapartum/newborn nevirapine to standard antiretroviral therapy to reduce perinatal human immunodeficiency virus type-1 transmission: Pediatric AIDS Clinical Trials Group 316. JAMA 2002; 288: 189–98PubMed
5.
6.
The European Mode of Delivery Collaboration. Elective caesarian-section versus vaginal delivery in prevention of vertical HIV transmission: a randomised clinical trial. Lancet 1999; 353: 1035–9
7.
Watts HD. Management of human immunodeficiency virus infection in pregnancy. N Engl J Med 2002; 346: 1879–91PubMed
8.
DeCock KM, Fowler MG, Mercier E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 2000; 283: 1175–82
9.
10.
Loebstein R, Lalkin A, Koren G. Pharmacokinetic changes during pregnancy and their clinical relevance. Clin Pharmacokinet 1997; 33: 328–43PubMed
11.
Burger DM, Hoetelmans RMW, Hugen PWH, et al. Low plasma concentrations of indinavir are related to virological treatment failure in HIV-1 infected patients on indinavir-containing triple therapy. Antiviral Ther 1998; 3: 315–20
12.
Joshi AS, Barrett JS, Fiske WD, et al. Population pharmacokinetics of efavirenz in phase II studies and relationship with efficacy. 30th Interscience Conference on Antimicrobial Agents and Chemotherapy; 1999 Sep 26–29; San Francisco
13.
Veldkamp AI, Hoetelmans RMW, Beijnen JH, et al. High exposure to nevirapine is associated with a higher initial HIV-1 RNA clearance rate, a higher likelihood to reach undetectability, and prolonged suppression of HIV-1 replication [abstract 239]. 7th European Conference on Clinical Aspects and Treatment of HIV-Infection; 1999 Oct 23–27; Lisbon
14.
Anderson PL, Brundage RC, Kakuda TN, et al. CD4 response is correlated with peak plasma concentrations of indinavir in adults with undetectable human immunodeficiency virus ribonucleic acid. Clin Pharmacol Ther 2002; 71: 280–5PubMed
15.
Morgan DJ. Drug disposition in mother and foetus. Clin Exp Pharmacol Physiol 1997; 24: 869–73PubMed
16.
Wright LL, Catz CS. Drug distribution during fetal life. In: Polin RA, Fox WW, editors. Fetal and neonatal physiology. Philadelphia (PA): WB Saunders Company, 1998: 169
17.
Krauer B, Krauer F, Hytten FE. Drug disposition and pharmacokinetics in the maternal-placental-fetal unit. Pharmacol Ther 1980; 10: 301–28PubMed
18.
Perucca E, Crema A. Plasma protein binding of drugs in pregnancy. Clin Pharmacokinet 1982; 7: 336–52PubMed
19.
Krauer B, Dayer P, Anner R. Changes in serum albumin and α1-acid glycoprotein concentrations during pregnancy: an analysis of fetal-maternal pairs. Br J Obstet Gynaecol 1984; 91: 875–81PubMed
20.
Connelly TJ, Ruo TI, Frederiksen MC, et al. Characterization of theophylline binding to serum proteins in pregnant and non-pregnant women. Clin Pharm Ther 1990; 47: 68–72
21.
Dean M, Stock B, Patterson RJ, et al. Serum protein binding of drugs during and after pregnancy in humans. Clin Pharm Ther 1980; 28: 253–61
22.
Heikkila A, Erkkola R. Review of β-lactam antibiotics in pregnancy: the need for adjustment of dosing schedules. Clin Pharmacokinet 1994; 27: 49–62PubMed
23.
Davis M, Simmons CJ, Dordini B, et al. Induction of hepatic enzymes during normal pregnancy. J Obstet Gynaecol Br Commonw 1973; 80: 690–4PubMed
24.
Wadelius M, Darj E, Frenne G, et al. Induction of CYP2D6 in pregnancy. Clin Pharmacol Ther 1997; 62(4): 400–7PubMed
25.
Juchau MR, Mirkin DL, Zachariah PK. Interactions of various 19-nor steroids with human placental microsomal cytochrome P-450. Chem Biol Interact 1976; 15: 337–47PubMed
26.
Phillipson A. Pharmacokinetics of ampicillin in pregnancy. J Infect Dis 1982; 136: 370–6
27.
Zaske DE, Cipolle RJ, Strate RG, et al. Rapid gentamicin elimination in obstetric patients. Obstet Gynecol 1980; 56: 559–64PubMed
28.
Yerby MS. The use of anticonvulsants during pregnancy. Semin Perinatol 2001; 25: 153–8PubMed
29.
Newport JD, Wilcox MM, Stowe ZN. Antidepressants during pregnancy and lactation: defining exposure and treatment issues. Semin Perinatol 2001; 25: 177–90PubMed
30.
Little B. Pharmacokinetics during pregnancy: evidence-based maternal dose formulation. Obstet Gynecol 1999; 93: 856–68
31.
Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. Baltimore (MD): Williams & Wilkins, 1994: 695, 814-5
32.
Barry M, Mulcahy F, Merry C, et al. Pharmacokinetics and potential interactions amongst antiretroviral agents used to treat patients with HIV infection. Clin Pharmacokinet 1999; 36: 289–304PubMed
33.
Collins JM, Unadkat JD. Clinical pharmacokinetics of zidovudine: an overview of current data. Clin Pharmacokinet 1989; 17: 1–9PubMed
34.
Singlas E, Pioger JC, Taburet AM, et al. Comparative pharmacokinetics of zidovudine (AZT) and its metabolite (GAZT) in healthy subjects and HIV seropositive patients. Eur J Clin Pharmacol 1989; 36: 639–40PubMed
35.
Klecker RW, Collins JM, Yarchoan R, et al. Plasma and cerebrospinal fluid pharmacokinetics of 3-azido-3-de-oxythymidine: a novel pyrimidine analog with potential application for the treatment of patients with AIDS and related diseases. Clin Pharmacol Ther 1987; 41: 407–12PubMed
36.
Watts HD, Brown ZA, Tartaglione T, et al. Pharmacokinetic disposition of zidovudine during pregnancy. J Infect Dis 1991; 163: 226–32PubMed
37.
Sperling RS, Roboz J, Dische R, et al. Zidovudine pharmacokinetics during pregnancy. Am J Perinatol 1992; 9: 247–9PubMed
38.
O’sullivan MJ, Boyer PJ, Scott GB, et al. The pharmacokinetics and safety of zidovudine in the third trimester of pregnancy for women infected with human immunodeficiency virus and their infants. Phase I Acquired Immunodeficiency Syndrome Clinical Trials Group Study (protocol 082). Am J Obstet Gynecol 1993; 168: 1510–6PubMed
39.
Moodley J, Moodley K, Pillay K, et al. Pharmacokinetics and antiretroviral activity of lamivudine alone or when coadministered with zidovudine in human immunodeficiency virus type 1-infected pregnant women and their offspring. J Infect Dis 1998; 178: 1327–33PubMed
40.
Furman PA, Fyfe JA, St Clair MH, et al. Phosphorylation of 3’-azido-3’-deoxythymidine and selective interaction of the 5’-triphosphate with human immunodeficiency virus reverse transcriptase. Proc Natl Acad Sci U S A 1986; 83: 8333–7PubMed
41.
Wattanagoon Y, Na Bangchang K, Hoggard PG, et al. Pharmacokinetics of zidovudine phosphorylation in human immunodeficiency virus-positive Thai patients and healthy volunteers. Antimicrob Agents Chemother 2000; 44: 1986–9PubMed
42.
Stretcher BN, Pesce AJ, Frame PT, et al. Pharmacokinetics of zidovudine phosphorylation in peripheral blood mononuclear cells from patients infected with human immunodeficiency virus. Antimicrob Agents Chemother 1994; 38: 1541–7PubMed
43.
Ho HT, Hitchcock MJ. Cellular pharmacology of 2’,3’-dideoxy-2’,3’-didehydrothymidine, a nucleoside analog active against human immunodeficiency virus. Antimicrob Agents Chemother 1989; 33: 844–9PubMed
44.
Barry M, Khoo S, Back DJ, et al. The effect of zidovudine dose on the formation of intracellular phosphorylated metabolites. AIDS 1996; 10: 1361–7PubMed
45.
Sale M, Sheiner LB, Volberding P, et al. Zidovudine response relationships in early human immunodeficiency virus infection. Clin Pharmacol Ther 1993; 54: 556–66PubMed
46.
Pons JC, Taburet AM, Singlas E, et al. Placental passage of azidothymidine (AZT) during the second trimester of pregnancy: a study by direct fetal blood sampling under ultrasound. Eur J Obstet Gynecol Reprod Biol 1991; 40: 229–31PubMed
47.
Schenker S, Johnson RF, King TS, et al. Azidothymidine (zidovudine) transport by the human placenta. Am J Med Sci 1990; 299: 16–20PubMed
48.
Patterson TA, Binienda ZK, Lipe GW, et al. Transplacental pharmacokinetics and fetal distribution of azidothymidine, its glucuronide, and phosphorylated metabolites in late-term rhesus macaques after maternal infusion. Drug Metab Dispos 1997; 25: 453–9PubMed
49.
Dancis J, Lee J, Mendoza S, et al. Nucleoside transport by perfused human placenta. Placenta 1993; 14: 547–54PubMed
50.
Sandberg JA, Slikker W. Developmental pharmacology and toxicology of anti-HIV therapeutic agents: dideoxynucleosides. FASEB J 1995; 9: 1157–63PubMed
51.
Rodman JH, Flynn PM, Robbins B, et al. Systemic pharmacokinetics and cellular pharmacology of zidovudine in human immunodeficiency virus type 1-infected women and newborn infants. J Infect Dis 1999; 180: 1844–50PubMed
52.
Shafer N, Chuachoowong R, Mock PA, et al. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomized controlled trial. Lancet 1999; 353: 773–80
53.
Lallemant M, Gnazague J, Le Coeur S, et al. A trial of shortened zidovudine regimens to prevent mother-to-child transmission of human immunodeficiency virus type 1. N Engl J Med 2000; 343: 982–91PubMed
54.
Dorenbaum A, Rodman JH, Mirochnick M, et al. Systemic pharmacokinetics (PK) of oral zidovudine (ZDV) given during labor to HIV-1 infected pregnant women during labor and delivery [abstract 660]. 7th Conference on Retroviruses and Opportunistic Infections; 2000 Jan 30–Feb 2; San Francisco
55.
Bhadrakom C, Simonds RJ, Mei JV, et al. Oral zidovudine during labor to prevent perinatal HIV transmission, Bangkok: tolerance and zidovudine concentration in cord blood. AIDS 2000; 14: 509–16PubMed
56.
Moodley D. The SAINT trial: nevirapine (NVP) versus zidovudine (ZVD) + lamivudine (3TC) in prevention of peripartum HIV transmission [abstract]. Programme supplement of the XIII International AIDS Conference; 2000 Jul 9–14; Durban: 16
57.
Perry CM, Faulds D. Lamivudine: a review of its antiviral activity, pharmacokinetic properties and therapeutic efficacy in the management of HIV infection. Drugs 1997; 53: 657–80PubMed
58.
Moore KH, Yuen GJ, Raasch RH, et al. Pharmacokinetics of lamivudine administered alone and with trimethoprim-sulfamethoxazole. Clin Pharmacol Ther 1996; 59: 550–8PubMed
59.
Moore KH, Barrett JE, Shaw S, et al. The pharmacokinetics of lamivudine phosphorylation in peripheral blood mononuclear cells from patients infected with HIV-1. AIDS 1999; 3: 2239–50
60.
Bloom SL, Dias KM, Bawdon RE, et al. The maternal-fetal transfer of lamivudine in the ex vivo human placenta. Am J Obstet Gynecol 1997; 176: 291–3PubMed
61.
Mandelbrot L, Peytavin G, Firtion G, et al. Maternal-fetal transfer and amniotic fluid accumulation of lamivudine in human immunodeficiency virus-infected pregnant women. Am J Obstet Gynecol 2001; 184(2): 153–8PubMed
62.
Knupp CA, Shyu WC, Dolin R, et al. Pharmacokinetics of didanosine in patients with acquired immunodeficiency syndrome or acquired immunodeficiency syndrome-related complex. Clin Pharmacol Ther 1991; 49: 523–35PubMed
63.
Knupp CA, Hak LJ, Coakley DF, et al. Disposition of didanosine in HIV-seropositive patients with normal renal function or chronic renal failure: influence of hemodialysis and continuous ambulatory peritoneal dialysis. Clin Pharmacol Ther 1996; 60: 535–42PubMed
64.
Ahluwalia G, Johnson MA, Fridland A, et al. Cellular pharmacology of the anti-HIV agent 2′,3′-dideoxyinosine [abstract]. Proc Am Acad Cancer Res 1988; 29: 349P
65.
Wang Y, Livingston E, Patil S, et al. Pharmacokinetics of didanosine in antepartum and postpartum human immunodeficiency virus: infected pregnant women and their neonates: an AIDS Clinical Trials Group study. J Infect Dis 1999; 180: 1536–41PubMed
66.
Pereira CM, Nosbisch C, Winter HR, et al. Transplacental pharmacokinetics of dideoxyinosine in pigtailed macaques. Antimicrob Agents Chemother 1994; 38: 781–6PubMed
67.
Bartlett JG, Gallant JE. Medical management of HIV infection. Baltimore (MD): Johns Hopkins University, Division of Infectious Diseases, 2001: 278
68.
Wade N, Unadkat J, Huang S, et al. Pharmacokinetics and safety of d4T and 3TC in HIV-infected pregnant women and their infants (PACTG 332) [abstract 886]. Conference on Retroviruses and Opportunistic Infections; 2003 Feb 10–14; Boston
69.
70.
Sarner L, Fakoya A. Acute onset lactic acidosis and pancreatitis in the third trimester of pregnancy in HIV-1 positive women taking antiretroviral medication. Sexual Transm Infect 2002; 78: 58–9
71.
Daluge SM, Good SS, Faletto MB, et al. 1592U89, a novel carbocyclic nucleoside analog with potent, selective antihuman immunodeficiency virus activity. Antimicrob Agents Chemother 1997; 41: 1082–93PubMed
72.
McDowell JA, Lou Y, Symonds WS, et al. Multiple-dose pharmacokinetics and pharmacodynamics of abacavir alone and in combination with zidovudine in human immunodeficiency virus-infected adults. Antimicrob Agents Chemother 2000; 44: 2061–7PubMed
73.
Harris M, Back D, Kewn S, et al. Intracellular carbovir triphosphate levels in patients taking abacavir once a day. AIDS 2002; 16: 1196–7PubMed
74.
Best B, Capparelli E, Stek A, et al. Abacavir pharmacokinetics during pregnancy. 33rd Annual Meeting of the American College of Clinical Pharmacology; 2004 Oct 3–5, Phoenix
75.
Tuntland T, Odinecs A, Pereira CM, et al. In vitro models to predict the in vivo mechanism, rate, and extent of placental transfer of dideoxynucleoside drugs against human immunodeficiency virus. Am J Obstet Gynecol 1999; 180: 198–206PubMed
76.
Bawdon RE. The ex vivo human placental transfer of the anti-HIV nucleoside inhibitor abacavir and the protease inhibitor amprenavir. Infect Dis Obstet Gynecol 1998; 6: 244–6PubMed
77.
Cheeseman SH, Hattox SE, McLaughlin MM, et al. Pharmacokinetics of nevirapine: initial single-rising-dose study in humans. Antimicrob Agents Chemother 1993; 37(2): 178–82PubMed
78.
Lamson MJ, Sabo JP, MacGregor TR, et al. Single dose pharmacokinetics and bioavailability of nevirapine in healthy volunteers. Biopharm Drug Dispos 1999; 20: 285–91PubMed
79.
Lamson MJ, Cort S, Sabo JP, et al. Effects of food or antacid on the bioavailability of nevirapine 200mg in 24 healthy volunteers [abstract]. 11th World Conference on AIDS; 1996 Jul 7–12; Vancouver
80.
Murphy RL, Montaner J. Nevirapine: a review of its development, pharmacological profile and potential for clinical use. Expert Opin Investig Drugs 1996; 5(9): 1183–99
81.
Cheeseman SH, Havlir D, McLaughlin MM, et al. Phase I/II evaluation of nevirapine alone and in combination with zidovudine for infection with human immunodeficiency virus. J Acquir Immune Defic Syndr Hum Retrovirol 1995; 8(2): 141–51PubMed
82.
Havlir D, Cheeseman SH, McLaughlin M, et al. High dose nevirapine: safety, pharmacokinetics and antiviral effect in patients with human immunodeficiency virus infection. J Infect Dis 1995 Mar; 171: 534–45
83.
Taylor GP, Lyall E, Back D, et al. Pharmacological implications of prolonged in utero exposure to nevirapine. Lancet 2000; 355: 2134–5PubMed
84.
Aweeka F, Lizak P, Frenkel L, et al. Steady state nevirapine pharmacokinetics during second and third trimester pregnancy and postpartum: PACTG 1022. 11th Conference on Retroviruses and Opportunistic Infections; 2004 Feb 8–11; San Francisco
85.
Hitti J, Frenkel L, Stek A, et al. Maternal toxicity with continuous nevirapine in pregnancy: results from PACTG 1022. J AIDS 2004; 36: 772–6
86.
Mirochnick M, Siminski S, Fenton T, et al. Nevirapine pharmacokinetics in pregnant women and in their infants following in utero exposure. Pediatr Infect Dis J 2001; 20: 803–5PubMed
87.
Mirochnick M, Fenton T, Gagnier P, et al. Pharmacokinetics of nevirapine in human immunodeficiency virus type-1 infected pregnant women and their neonates. J Infect Dis 1998 Aug; 178: 368–74PubMed
88.
Musoke P, Guay L, Bagenda D, et al. A phase I study of the safety and pharmacokinetics of nevirapine in HIV-1 infected pregnant Ugandan women and their neonates. AIDS 1999; 13(4): 479–86PubMed
89.
Guay L, Musoke P, Fleming T, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-infant transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 1999; 354: 795–802PubMed
90.
Mirochnick M, Dorenbaum A, Blanchard S, et al. Pre-dose infant nevirapine (NVP) concentration with the 2-dose intrapartum-infant NVP regimen [abstract 796]. 9th Conference on Retroviruses and Opportunistic Infections; 2002 Feb 24–28; Seattle
91.
Eshleman SH, Mracna M, Guay L, et al. Selection and fading of resistance mutations in Ugandan women and infants receiving nevirapine prophylaxis to prevent HIV-1 vertical transmission (HIVNET-012). AIDS 2001; 15: 1951–7PubMed
92.
93.
Sustiva package insert. Wilmington (DE): Dupont Pharmaceuticals Company, 2000
94.
Fundaro C, Genovese O, Rendeli C, et al. Myelomeningocele in a child with intrauterine exposure to efavirenz. AIDS 2002; 16(2): 299–300PubMed
95.
Rescriptor package insert. La Jolla (CA): Agouron Pharmaceuticals, 2001
96.
Temesgen Z, Wright AJ. Antiretrovirals. Mayo Clin Proc 1999; 74: 1284–301PubMed
97.
Barry M, Gibbons S, Back D, et al. Protease inhibitors in patients with HIV disease: clinically important pharmacokinetic considerations. Clin Pharmacokinet 1997; 32: 194–209PubMed
98.
Mirochnick M, Dorenbaum A, Holland D, et al. Concentrations of protease inhibitors in cord blood following in utero exposure. Pediatr Infect Dis J 2002; 9: 835–9
99.
Marzolini C, Rudin C, Decosterd LA, et al. Transplacental passage of protease inhibitors at delivery. AIDS 2002; 16: 889–93PubMed
100.
Viracept package insert. La Jolla (CA): Agouron Pharmaceuticals, 2001
101.
Pai VB. Nahata MC. Nelfinavir mesylate: a protease inhibitor. Ann Pharmacother 1999; 33: 325–39PubMed
102.
Bryson YJ, Stek A, Mirochnick M, et al. PACTG 353: a phase I study of safety, pharmacokinetics and antiviral activity of combination nelfinavir (NFV), ZDV and 3TC in HIV infected pregnant women and their infants. 7th Conference on Retroviruses and Opportunistic Infections; 2000 Jan 30–Feb 2; San Francisco
103.
Bryson YJ, Stek A, Mirochnick M, et al. Pharmacokinetics, antiviral activity and safety of nelfinavir (NFV) with ZDV/3TC in pregnant HIV-infected women and their infants: PACTG 353 cohort 2 [abstract 795]. 9th Conference on Retroviruses and Opportunistic Infections; 2002 Feb 24–28; Seattle
104.
Mirochnick M, Bryson Y, Stek A, et al. Pharmacokinetics (PK) of nelfinavir (NFV) and its M8 metabolite in pregnant HIV-infected women and their infants: PACTG 353. Pediatric Academic Societies Meeting; 2003 May 3–6; Seattle
105.
Hayashi S, Beckerman K, Homma M, et al. Pharmacokinetics of indinavir in HIV-positive pregnant women. AIDS 2000; 14: 1061–2PubMed
106.
Wara D, Tuomala R, Bryson Y, et al. PACTG 358: safety, pharmacokinetics and antiretroviral activity of indinavir, zidovudine (ZDV) and lamuvidine (3TC) in HIV-1 seropositive pregnant women and infants [abstract 447]. 2nd Conference on Global Strategies for the Prevention of HIV Transmission from Mothers to Infants; 1999 Sep 1–5; Montreal
107.
Inverase package insert. Nutley (NJ): Roche Pharmaceuticals, 2000
108.
Fortovase package insert. Nutley (NJ): Roche Pharmaceuticals, 2000
109.
Holladay JW, Dewey MJ, Michniak BB, et al. Elevated alpha1-acid glycoprotein reduces the volume of distribution and systemic clearance of saquinavir. Drug Metab Dispos 2001; 29: 299–303PubMed
110.
Acosta EP, Zorrilla C, Van Dyke R, et al. Pharmacokinetics of saquinavir-SGC in HIV-infected pregnant women. HIV Clin Trials 2001; 2: 460–5PubMed
111.
Vithayasai V, Moyle GJ, Supajatura V, et al. Safety and efficacy of saquinavir soft-gelatin capsules + zidovudine + optional lamivudine in pregnancy and prevention of vertical HIV transmission. J Acquir Immune Defic Syndr 2002; 30: 410–2PubMed
112.
Acosta EP, Bardeguez A, Zorrilla CD, et al. Pharmacokinetics of saquinavir plus low-dose ritonavir in human immunodeficiency virus-infected pregnant women. Antimicrob Agents Chemother 2004; 48: 430–6PubMed
113.
Scott G, Rodman J, Scott W, et al. Pharmacokinetic and virologic response to ritonavir (RTV) in combination with zidovudine (ZDV) and lamivudine (3TC) in HIV-1-infected pregnant women and their infants [abstract 794]. 9th Conference on Retroviruses and Opportunistic Infections; 2002 Feb 24–28; Seattle
114.
Norvir package insert. Abbott Park (IL): Abbott Laboratories, 2000
115.
Boffito M, Hoggard PG, Lindup WE, et al. Lopinavir protein binding in vivo through the 12-hour dosing interval. Ther Drug Monit 2004; 26: 35–9PubMed
116.
Stek A, Mirochnick M, Capparelli E, et al. Reduced lopinavir exposure during pregnancy: preliminary pharmacokinetic results from PACTG 1026. XV International AIDS Conference; 2004 Jul 11–16; Bangkok
117.
Mylocel package insert. Bloomington (MN): MGI Pharma Inc, 2001
118.
Metadata
Title
Pharmacokinetics of Antiretrovirals in Pregnant Women
Authors
Dr Mark Mirochnick
Edmund Capparelli
Publication date
01-12-2004
Publisher
Springer International Publishing
Published in
Clinical Pharmacokinetics / Issue 15/2004
Print ISSN: 0312-5963
Electronic ISSN: 1179-1926
DOI
https://doi.org/10.2165/00003088-200443150-00002

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