Endocrine Disorders: Evaluation and Management
Summary
- Adrenal suppression can occur in antiretroviral-treated patients receiving inhaled steroids, including fluticasone[Chen 1999; Clevenbergh 2002; ref: HillebrandHaverkort 1999; Johnson 2006; Nocent 2004; Rouanet 2003] and budesonide,[Le Roux 2001; Blondin 2013] or using topical steroids or local injections of triamcinolone[Sobngwi 2003; Dort 2009; Yombi 2008; Ramanathan 2008; Song 2013]
- The cause of adrenal suppression appears to be a pharmacologic interaction between glucocorticoids and antiretrovirals, including ritonavir[Ramanathan 2008; Saberi 2013] and cobicistat
- Flunisolide and beclomethasone appear to have the lowest interaction potential with ritonavir and other PIs,[Saberi 2013; Boyd 2013] and fluticasone appears to have the greatest potential[Saberi 2013; Foisy 2008]
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Keywords: Drug-Drug Interactions, Endocrine Disorders