Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1997 Nov;41(11):2428–2432. doi: 10.1128/aac.41.11.2428

Pharmacokinetics of saquinavir, zidovudine, and zalcitabine in combination therapy.

G F Vanhove 1, H Kastrissios 1, J M Gries 1, D Verotta 1, K Park 1, A C Collier 1, K Squires 1, L B Sheiner 1, T F Blaschke 1
PMCID: PMC164140  PMID: 9371345

Abstract

We investigated the pharmacokinetics of zidovudine, zalcitabine, and saquinavir in AIDS Clinical Trial Group protocol 229. Patients received either saquinavir, zalcitabine, or a combination of both, together with zidovudine three times a day. Approximately 100 patients were enrolled in each treatment arm, and intensive pharmacokinetic studies were performed on about 25 patients per arm at weeks 1 and 12. We estimated the pharmacokinetic parameters of all three drugs by using parametric and nonparametric methods. The mean values of the pharmacokinetic parameters of zidovudine (clearance [CL]/bioavailability [F], 168 liters/h; volume of distribution [V]/F, 185 liters; half-life, 0.76 h) and zalcitabine (CL/F, 25 liters/h; V/F, 92.2 liters; half-life, 2.7 h) were similar to those reported previously. For saquinavir, the mean pharmacokinetic parameter estimates using parametric methods were as follows: maximum concentration of drug in serum [Cmax], 70.8 ng/ml; time to Cmax, 3.11 h; area under the curve, 809 ng x h/ml; CL/F, 989 liters/h; V/F, 1,503 liters; half-life, 1.38 h. For all three drugs, clearance decreased with age. Weight did not influence the clearance of zidovudine, but the clearance of zalcitabine and saquinavir increased with weight. There were no differences in pharmacokinetic parameters between study weeks and arms, suggesting that there is no change in kinetics with chronic administration and that there are no significant pharmacokinetic interactions among these three drugs.

Full Text

The Full Text of this article is available as a PDF (183.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blum M. R., Liao S. H., Good S. S., de Miranda P. Pharmacokinetics and bioavailability of zidovudine in humans. Am J Med. 1988 Aug 29;85(2A):189–194. [PubMed] [Google Scholar]
  2. Collier A. C., Coombs R. W., Schoenfeld D. A., Bassett R. L., Timpone J., Baruch A., Jones M., Facey K., Whitacre C., McAuliffe V. J. Treatment of human immunodeficiency virus infection with saquinavir, zidovudine, and zalcitabine. AIDS Clinical Trials Group. N Engl J Med. 1996 Apr 18;334(16):1011–1017. doi: 10.1056/NEJM199604183341602. [DOI] [PubMed] [Google Scholar]
  3. Klecker R. W., Jr, Collins J. M., Yarchoan R. C., Thomas R., McAtee N., Broder S., Myers C. E. Pharmacokinetics of 2',3'-dideoxycytidine in patients with AIDS and related disorders. J Clin Pharmacol. 1988 Sep;28(9):837–842. doi: 10.1002/j.1552-4604.1988.tb03225.x. [DOI] [PubMed] [Google Scholar]
  4. Klecker R. W., Jr, Collins J. M., Yarchoan R., Thomas R., Jenkins J. F., Broder S., Myers C. E. Plasma and cerebrospinal fluid pharmacokinetics of 3'-azido-3'-deoxythymidine: a novel pyrimidine analog with potential application for the treatment of patients with AIDS and related diseases. Clin Pharmacol Ther. 1987 Apr;41(4):407–412. doi: 10.1038/clpt.1987.49. [DOI] [PubMed] [Google Scholar]
  5. Macnab K. A., Gill M. J., Sutherland L. R., De Boer Visser N., Church D. Erratic zidovudine bioavailability in HIV seropositive patients. J Antimicrob Chemother. 1993 Mar;31(3):421–428. doi: 10.1093/jac/31.3.421. [DOI] [PubMed] [Google Scholar]
  6. Matthews S. J., Cersosimo R. J., Spivack M. L. Zidovudine and other reverse transcriptase inhibitors in the management of human immunodeficiency virus-related disease. Pharmacotherapy. 1991;11(6):419–449. [PubMed] [Google Scholar]
  7. Meng T. C., Fischl M. A., Boota A. M., Spector S. A., Bennett D., Bassiakos Y., Lai S. H., Wright B., Richman D. D. Combination therapy with zidovudine and dideoxycytidine in patients with advanced human immunodeficiency virus infection. A phase I/II study. Ann Intern Med. 1992 Jan 1;116(1):13–20. doi: 10.7326/0003-4819-116-1-13. [DOI] [PubMed] [Google Scholar]
  8. Ruhnke M., Bauer F. E., Seifert M., Trautmann M., Hille H., Koeppe P. Effects of standard breakfast on pharmacokinetics of oral zidovudine in patients with AIDS. Antimicrob Agents Chemother. 1993 Oct;37(10):2153–2158. doi: 10.1128/aac.37.10.2153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Schapiro J. M., Winters M. A., Stewart F., Efron B., Norris J., Kozal M. J., Merigan T. C. The effect of high-dose saquinavir on viral load and CD4+ T-cell counts in HIV-infected patients. Ann Intern Med. 1996 Jun 15;124(12):1039–1050. doi: 10.7326/0003-4819-124-12-199606150-00003. [DOI] [PubMed] [Google Scholar]
  10. Unadkat J. D., Collier A. C., Crosby S. S., Cummings D., Opheim K. E., Corey L. Pharmacokinetics of oral zidovudine (azidothymidine) in patients with AIDS when administered with and without a high-fat meal. AIDS. 1990 Mar;4(3):229–232. doi: 10.1097/00002030-199003000-00008. [DOI] [PubMed] [Google Scholar]
  11. Vanhove G. F., Gries J. M., Verotta D., Sheiner L. B., Coombs R., Collier A. C., Blaschke T. F. Exposure-response relationships for saquinavir, zidovudine, and zalcitabine in combination therapy. Antimicrob Agents Chemother. 1997 Nov;41(11):2433–2438. doi: 10.1128/aac.41.11.2433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Wilde M. I., Langtry H. D. Zidovudine. An update of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs. 1993 Sep;46(3):515–578. doi: 10.2165/00003495-199346030-00010. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES