Optimizing Concentrations of Concomitant Antiretrovirals by Reducing Etravirine Doses: Two Case Reports of Complex Drug-drug Interactions

Abstract

We report the cases of two treatment-experienced HIV-infected patients with complex antiretroviral regimens that showed significant drug–drug interactions with etravirine. Unexpectedly high etravirine concentrations likely caused subtherapeutic levels of darunavir, elvitegravir and dolutegravir through concentration-dependent metabolic induction. Therapeutic drug monitoring allowed safe etravirine dose decreases to manage these interactions.