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Ritonavir and Fluticasone Combination May Cause Cushing's Di

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From http://www.medscape.com/43529.rhtml?srcmp=AIDS-101201

<P ALIGN="center"><B>Ritonavir and Fluticasone Combination May Cause Cushing's Disease</B></P>

MELBOURNE, Australia (Reuters Health) Oct 05 - Two cases of iatrogenic Cushing's disease in HIV patients who took both ritonavir and fluticasone have raised concerns about co-morbidity, according to Dr. Cassie Workman of the AIDS Research Initiative in Darlinghurst, Sydney.

Speaking Friday at the 13th Annual Conference of the Australasian Society of HIV Medicine in Melbourne, Dr. Workman cited two patients in her practice who developed Cushing's disease after taking the two medications together. She described asking the drug companies if there was any literature to support this and said to those assembled that she was told no such literature existed.

According to Dr. Workman, one case appeared 5 months after commencement of co-medication, and the other after 20 months. When one of the drugs was withdrawn in each case, the symptoms resolved.

Dr. Workman said to Reuters Health that "drug interactions are not necessarily predictable, especially when we're using HIV drugs that have never been done in long-term studies before."

"Certainly a number of them are now metabolized through the liver through one enzyme system which is critical at building up levels of other drugs," she said. "Regardless of what the literature says, there may be a drug interaction."

Dr. Workman stressed to Reuters Health that heightened awareness by treating clinicians is essential.


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