Iatrogenic Cushing’s syndrome due to drug interaction between glucocorticoids and the ritonavir or cobicistat containing HIV therapies
- 1 October 2016
- journal article
- Published by Elsevier BV in Clinical Medicine
- Vol. 16 (5), 412-418
- https://doi.org/10.7861/clinmedicine.16-5-412
Abstract
Ritonavir and cobicistat, used as pharmacokinetic enhancers in combination with some antiretrovirals (ARVs) for the treatment of HIV, are potent inhibitors of the CYP3A4 isoenzyme. Most glucocorticoids are metabolised via the CYP3A4 pathway and iatrogenic Cushing’s syndrome (ICS), with possible secondary adrenal insufficiency (SAI), is a recognised complication following co-administration with ritonavir or cobicistat. A structured approach for identifying and managing potentially affected individuals has not been established.Keywords
This publication has 33 references indexed in Scilit:
- A case of iatrogenic adrenal suppression after co-administration of cobicistat and fluticasone nasal dropsAIDS, 2014
- Iatrogenic Cushing Syndrome Secondary to Ritonavir-Epidural Triamcinolone Interaction: An Illustrative Case and ReviewInterdisciplinary Perspectives on Infectious Diseases, 2014
- Triamcinolone and ritonavir leading to drug-induced Cushing syndrome and adrenal suppression: description of a new case and review of the literatureInfection, 2013
- Iatrogenic Cushing syndrome after intra-articular triamcinolone in a patient receiving ritonavir-boosted darunavirInternational Journal of STD & AIDS, 2013
- Inhaled corticosteroid use in HIV‐positive individuals taking protease inhibitors: a review of pharmacokinetics, case reports and clinical managementHIV Medicine, 2013
- Iatrogenic Cushing's Syndrome due to Coadministration of Ritonavir and Inhaled Budesonide in an Asthmatic Human Immunodeficiency Virus Infected PatientJournal of Asthma, 2010
- Drug interactions between inhaled corticosteroids and enzymatic inhibitorsEuropean Journal of Clinical Pharmacology, 2009
- Iatrogenic Cushing’s syndrome and secondary adrenal insufficiency after a single intra-articular administration of triamcinolone acetonide in HIV-infected patients treated with ritonavirClinical Rheumatology, 2008
- Iatrogenic Cushing’s Syndrome with Osteoporosis and Secondary Adrenal Failure in Human Immunodeficiency Virus-Infected Patients Receiving Inhaled Corticosteroids and Ritonavir-Boosted Protease Inhibitors: Six CasesJournal of Clinical Endocrinology & Metabolism, 2005
- Exogenous Cushing's Syndrome and Glucocorticoid WithdrawalEndocrinology and Metabolism Clinics of North America, 2005