Pharmacokinetic interactions between depot medroxyprogesterone acetate and combination antiretroviral therapy

• Published in: Fertility and sterility Vol. 90; no. 4; pp. 965 - 971
• Main Authors: Nanda, Kavita, M.D., M.H.S, Amaral, Eliana, M.D., Ph.D, Hays, Melissa, M.P.H, Viscola, Marco A.M., M.D, Mehta, Neha, M.P.H, Bahamondes, Luis, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2008; Elsevier Science
• Subjects: Adult; Anti-Retroviral Agents - administration & dosage; Anti-Retroviral Agents - pharmacokinetics; Antibiotics. Antiinfectious agents. Antiparasitic agents; antiretroviral therapy; Antiviral agents; Biological and medical sciences; contraception; Contraceptives, Oral, Synthetic - administration & dosage; Contraceptives, Oral, Synthetic - pharmacokinetics; Delayed-Action Preparations - administration & dosage; Depot medroxyprogesterone acetate; Drug Interactions; Drug Therapy, Combination; Female; Gynecology. Andrology. Obstetrics; HIV; HIV Infections - blood; HIV Infections - drug therapy; Human viral diseases; Humans; Infectious diseases; Internal Medicine; Medical sciences; Medroxyprogesterone Acetate - administration & dosage; Medroxyprogesterone Acetate - pharmacokinetics; Obstetrics and Gynecology; pharmacokinetics; Pharmacology. Drug treatments; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; pharmacokinetics; Depot medroxyprogesterone acetate; HIV; contraception; antiretroviral therapy; Immunopathology; Antiretroviral agent; Drug combination; Gynecology; Retroviridae; AIDS; Contraception; Immune deficiency; Lentivirus; Obstetrics; Progestagen; Infection; Virus; Chemotherapy; Treatment; Viral disease; Medroxyprogesterone; Antiviral; Combined treatment; Human immunodeficiency virus; Pharmacokinetics
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2007.07.1348

Objective To evaluate the effect of an antiretroviral (ARV) therapy regimen containing zidovudine (AZT), lamivudine (3TC), and efavirenz (EFV) on the pharmacokinetics of depot medroxyprogesterone acetate (DMPA). Design Open-label, nonrandomized, clinical trial. Setting University hospital clinic. Patient(s) Thirty HIV-infected women; 15 using ARV therapy (AZT, 3TC, and EFV) and 15 non-users of ARV therapy, followed biweekly for 12 weeks. Intervention(s) Single injection of DMPA (150 mg IM) for both groups. Main Outcome Measure(s) Pharmacokinetic parameters of DMPA by liquid chromatography with mass spectrometry, and ovulation by serum P. Result(s) Maximum serum concentrations of DMPA were reached at 14 days after injection. The area under the curve was similar in both groups, as were the minimum concentration, half-life, and clearance. Only 1 woman, not using ARV therapy, ovulated at 11 weeks after DMPA. Conclusion(s) Pharmacokinetics of DMPA were similar in HIV-infected women, regardless of ARV therapy use, suggesting that triple therapy with AZT, 3TC, and EFV is not likely to interfere with the contraceptive effectiveness of DMPA.