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Prescribing intranasal steroids in HIV-positive patients: systematic review of the literature.
Seymour, N; Robinson, M; Richardson, D; Mohammed, H; Williams, D; McGilligan, J A.
  • Seymour N; Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
  • Robinson M; Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
  • Richardson D; Department of HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
  • Mohammed H; Department of HIV Medicine, Chelsea and Westminster NHS Foundation Trust, London, UK.
  • Williams D; Department of HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
  • McGilligan JA; Department of ENT, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
J Laryngol Otol ; 135(9): 755-758, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1747302
ABSTRACT

BACKGROUND:

There are significant drug-drug interactions between human immunodeficiency virus antiretroviral therapy and intranasal steroids, leading to high serum concentrations of iatrogenic steroids and subsequently Cushing's syndrome.

METHOD:

All articles in the literature on cases of intranasal steroid and antiretroviral therapy interactions were reviewed. Full-length manuscripts were analysed and the relevant data were extracted.

RESULTS:

A literature search and further cross-referencing yielded a total of seven reports on drug-drug interactions of intranasal corticosteroids and human immunodeficiency virus protease inhibitors, published between 1999 and 2019.

CONCLUSION:

The use of potent steroids metabolised via CYP3A4, such as fluticasone and budesonide, are not recommended for patients taking ritonavir or cobicistat. Mometasone should be used cautiously with ritonavir because of pharmacokinetic similarities to fluticasone. There was a delayed onset of symptoms in many cases, most likely due to the relatively lower systemic bioavailability of intranasal fluticasone.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / HIV / HIV Protease Inhibitors / Adrenal Cortex Hormones / Cushing Syndrome Type of study: Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adult / Humans / Male Language: English Journal: J Laryngol Otol Journal subject: Otolaryngology Year: 2021 Document Type: Article Affiliation country: S0022215121001791

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / HIV / HIV Protease Inhibitors / Adrenal Cortex Hormones / Cushing Syndrome Type of study: Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adult / Humans / Male Language: English Journal: J Laryngol Otol Journal subject: Otolaryngology Year: 2021 Document Type: Article Affiliation country: S0022215121001791