Title:Sildenafil Plasma Concentrations in Two HIV Patients with Pulmonary Hypertension Treated with Ritonavir-Boosted Protease Inhibitors
Volume: 10
Issue: 2
Author(s): Pierangelo Chinello, Stefania Cicalini, Simona Pichini, Roberta Pacifici, Massimo Tempestilli and Nicola Petrosillo
Affiliation:
Keywords:
HIV, protease inhibitors, pulmonary arterial hypertension, sildenafil
Abstract: Sildenafil is increasingly used for the therapy of pulmonary arterial hypertension (PAH) in HIV infected
patients. However, concerns exist about pharmacokinetic interactions between sildenafil and protease inhibitors (PI); in
particular, ritonavir has been shown to increase sildenafil AUC and Cmax by several folds. The aim of our study was to
determine the plasma levels of sildenafil and PI in two HIV patients with PAH treated with antiretroviral therapy
including ritonavir-boosted PI. Our patients both experienced sildenafil Cmax above 500 ng/mL; however, they did not
report any significant adverse reactions to sildenafil during the follow-up period. Therapeutic drug monitoring of
sildenafil should be taken in consideration during treatment in order to avoid overdosage.
