Pharmacokinetics and Drug-Drug Interactions of Long-Acting Intramuscular Cabotegravir and Rilpivirine

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Serval ID
serval:BIB_66D364242E0A
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Pharmacokinetics and Drug-Drug Interactions of Long-Acting Intramuscular Cabotegravir and Rilpivirine
Journal
Clin Pharmacokinet
Author(s)
Hodge D., Back D. J., Gibbons S., Khoo S. H., Marzolini C.
ISSN
1179-1926 (Electronic)
0312-5963 (Print)
ISSN-L
0312-5963
Publication state
Published
Issued date
07/2021
Peer-reviewed
Oui
Volume
60
Number
7
Pages
835-853
Language
english
Notes
Hodge, Daryl
Back, David J
Gibbons, Sara
Khoo, Saye H
Marzolini, Catia
eng
MR/V020498/1/MRC_/Medical Research Council/United Kingdom
Research Support, Non-U.S. Gov't
Review
Switzerland
Clin Pharmacokinet. 2021 Jul;60(7):835-853. doi: 10.1007/s40262-021-01005-1. Epub 2021 Apr 8.
Abstract
Combined antiretroviral treatments have significantly improved the morbidity and mortality related to HIV infection, thus transforming HIV infection into a chronic disease; however, the efficacy of antiretroviral treatments is highly dependent on the ability of infected individuals to adhere to life-long drug combination therapies. A major milestone in HIV treatment is the marketing of the long-acting intramuscular antiretroviral drugs cabotegravir and rilpivirine, allowing for infrequent drug administration, with the potential to improve adherence to therapy and treatment satisfaction. Intramuscular administration of cabotegravir and rilpivirine leads to differences in pharmacokinetics and drug-drug interaction (DDI) profiles compared with oral administration. A notable difference is the long elimination half-life with intramuscular administration, which reaches 5.6-11.5 weeks for cabotegravir and 13-28 weeks for rilpivirine, compared with 41 and 45 h, respectively, with their oral administration. Cabotegravir and rilpivirine have a low potential to cause DDIs, however these drugs can be victims of DDIs. Cabotegravir is mainly metabolized by UGT1A1, and rilpivirine is mainly metabolized by CYP3A4, therefore these agents are susceptible to DDIs with inhibitors, and particularly inducers of drug-metabolizing enzymes. Intramuscular administration of cabotegravir and rilpivirine has the advantage of eliminating DDIs occurring at the gastrointestinal level, however interactions can still occur at the hepatic level. This review provides insight on the intramuscular administration of drugs and summarizes the pharmacology of long-acting cabotegravir and rilpivirine. Particular emphasis is placed on DDI profiles after oral and intramuscular administration of these antiretroviral drugs.
Keywords
*Anti-HIV Agents/therapeutic use, Drug Interactions, *HIV Infections/drug therapy, *hiv-1, Humans, *Pharmaceutical Preparations, Pyridones, Rilpivirine
Pubmed
Create date
25/08/2023 6:17
Last modification date
25/01/2024 8:37
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