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V Launay-Vacher

Publications and source records attributed to V Launay-Vacher.

30 records · Page 2Linked to original sources
PubMed2001

Pharmacokinetics of abacavir in HIV-1-infected patients with impaired renal function.

BACKGROUND: Abacavir is a potent, novel 2'-deoxyguanosine analogue reverse transcriptase inhibitor (NRTI) which effectively suppresses HIV-1 replication. To date, there is no pharmacokinetic study in patients with renal impairment. METHODS: Five HIV-1-infected patients with various degrees of renal dysfunction (creatinine clearance 60, 40, 25, 20 and 1 haemodialyzed patient) were evaluated after being treated for at least 2 months with multi-antiretroviral therapy including abacavir. After an overnight fast, the subjects received their abacavir dosage (600 or 300 mg). Blood samples were withdrawn and plasma concentrations determined. A nonparametric pharmacokinetic analysis was then performed. The dialysability of abacavir was also evaluated. RESULTS: Time of maximum plasma concentration (T(max)) was constant among the subjects with a mean value of 0.7 +/- 0.27 h (range 0.33-1). Maximum plasma concentration (C(max)) ranged from 2.76 to 4.15 mg/l (mean 3.44 +/- 0.59). The elimination half-life ranged from 1.31 to 2.67 h (mean 2.08 +/- 0.51). Normalized C(max)/dose ranged from 0.007 to 0.014 mg/l and normalized AUC(0-inf)/dose ranged from 0.014 to 0.035 mg.h/l. In haemodialysis the dialysance was 60-80 ml/min with a fractional drug removal of 24% during a 4-hour haemodialysis session with a high permeability membrane. DISCUSSION: In our patients, absorption, elimination and distribution phases were not altered by renal insufficiency. Furthermore, our pharmacokinetic data are similar to those obtained in patients with normal renal function. Therefore, dosage adjustment is not necessary in patients with renal insufficiency. In haemodialyzed patients, treatment can be administered independently to the dialysis session because of the negligible elimination of abacavir in the dialysate.

Administration, Oral↗
PubMedDate not supplied

Neurotoxicity of valacyclovir in peritoneal dialysis: a pharmacokinetic study.

Valacyclovir is an effective oral agent for the treatment of herpes virus infection, however, the pharmacokinetics of the drug are altered in renal failure. It is increasingly recognized that dose adjustment of oral valacyclovir in renal failure is necessary to avoid neurotoxicity. We studied this drug in a continuous ambulatory peritoneal dialysis (CAPD) and immunocompromised patient. She developed neurotoxicity with an adjustment dosage of valacyclovir for a cutaneous zoster infection. The elimination half-time (15 h) was similar to that reported for end-stage renal disease patients, while the steady-state volume of distribution (85 l) and the area under the curve concentration (127 mg/l.h) were greater. The mean CAPD dialysance was only 5.27 ml/min with less than 1% of an administered dose being recovered in the 24-hour dialysate. 48 h after interrupting treatment, she recovered normal neurological status and 500 mg of valacyclovir every 2 days was effective and well tolerated.

Acyclovir↗