Interactions between etonogestrel-releasing contraceptive implant and 3 antiretroviral regimens.
Atazanavir
Efavirenz
Etonogestrel
Long-acting reversible contraceptives
Lopinavir
Pharmacokinetics
Journal
Contraception
ISSN: 1879-0518
Titre abrégé: Contraception
Pays: United States
ID NLM: 0234361
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
23
11
2020
revised:
05
08
2021
accepted:
09
08
2021
pubmed:
19
8
2021
medline:
28
1
2022
entrez:
18
8
2021
Statut:
ppublish
Résumé
Long-acting reversible contraceptives are effective contraceptives for women with HIV, but there are limited data on etonogestrel implant and antiretroviral therapy pharmacokinetic drug-drug interactions. We evaluated etonogestrel/antiretroviral therapy drug-drug interactions, and the effects of etonogestrel on ritonavir-boosted-atazanavir, ritonavir-boosted-lopinavir, and efavirenz pharmacokinetics. We enrolled postpartum women using etonogestrel implants and receiving ritonavir-boosted-atazanavir, ritonavir-boosted-lopinavir, or efavirenz-based regimens between 2012 and 2015. Etonogestrel implants were inserted 2 to 12 weeks postpartum. We performed pharmacokinetic sampling pre-etonogestrel insertion and 6 to 7 weeks postinsertion. We measured antiretroviral concentrations pre and postetonogestrel insertion, and compared etonogestrel concentrations between antiretroviral regimens. We considered a minimum serum etonogestrel concentration of 90 pg/mL adequate for ovulation suppression. We collected pharmacokinetic data for 74 postpartum women, 22 on ritonavir-boosted-atazanavir, 26 on ritonavir-boosted-lopinavir, and 26 on efavirenz. The median serum concentrations of etonogestrel when co-administered were highest with etonogestrel/ritonavir-boosted-atazanavir (604 pg/mL) and etonogestrel/ritonavir-boosted-lopinavir (428 pg/mL), and lowest with etonogestrel/efavirenz (125 pg/mL); p < 0.001. Minimum concentration (C Unlike efavirenz, ritonavir-boosted-atazanavir and ritonavir-boosted-lopinavir were not associated with significant decreases in etonogestrel concentrations. Efavirenz was associated with a significant decrease in etonogestrel concentrations. The findings demonstrate no interactions between etonogestrel and ritonavir-boosted-lopinavir or ritonavir-boosted-atazanavir, but confirm the decreased efficacy of etonogestrel with efavirenz-based antiretrovirals. This information should be used to counsel women with HIV who desire long-acting reversible contraceptives.
Identifiants
pubmed: 34407424
pii: S0010-7824(21)00350-4
doi: 10.1016/j.contraception.2021.08.006
pmc: PMC8678338
mid: NIHMS1752166
pii:
doi:
Substances chimiques
Anti-HIV Agents
0
Contraceptive Agents
0
Drug Combinations
0
HIV Protease Inhibitors
0
atazanavir, ritonavir drug combination
0
etonogestrel
304GTH6RNH
Atazanavir Sulfate
4MT4VIE29P
Desogestrel
81K9V7M3A3
Ritonavir
O3J8G9O825
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
67-74Subventions
Organisme : NICHD NIH HHS
ID : K23 HD104517
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI068616
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI068632
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI106716
Pays : United States
Informations de copyright
Copyright © 2021. Published by Elsevier Inc.
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