Secondary Adrenal Insuffciency Due to the Co-Administration of Ritonavir and Inhaled Fluticasone Propionate Case report
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 3
Abstract
Ritonavir is a powerful inhibitor of the cytochrome P450 3A4 (CYP3A4) isoenzyme. It is used as a pharmaceutical enhancer in the management of HIV-positive patients. However, when co-administered with other drugs that are metabolised via the CYP3A4 pathway, ritonavir can potentially cause serious drug-drug interactions. Inhaled fluticasone propionate, which is used to treat asthma and chronic obstructive airway disease, is particularly prone to such interactions due to its physiological attributes. We report a HIV-positive 48-year-old male patient who presented to Al Nahdha Hospital, Muscat, Oman, in 2012 with weight loss, generalised weakness and fatigue and diagnosed with secondary adrenal insufciency as a result of concomitant ritonavir and inhaled fluticasone.
Authors and Affiliations
Ali Al-Maqbali| Department of Communicable Disease Surveillance & Control, Directorate General of Health Services, Ministry of Health, Al Batinah North Governorate, Oman, Bina Kamble| Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman, Salim Al-Qassabi| Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman, Ali Elgalib| Department of Internal Medicine, Al-Nahdha Hospital, Muscat, Oman
Keywords
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- EP ID EP14800
- DOI 10.18295/squmj.2017.17.03.014
- Views 329
- Downloads 17
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