Clopidogrel Increases Dasabuvir Exposure With or Without Ritonavir, and Ritonavir Inhibits the Bioactivation of Clopidogrel.

ABSTRACT: Dasabuvir is mainly metabolized by cytochrome P450 (CYP) 2C8 and is predominantly used in a regimen containing ritonavir. Ritonavir and clopidogrel are inhibitors of CYP3A4 and CYP2C8, respectively. In a randomized, crossover study in 12 healthy subjects, we examined the impact of clinical doses of ritonavir (for 5 days), clopidogrel (for 3 days), and their combination on dasabuvir pharmacokinetics, and the effect of ritonavir on clopidogrel. Clopidogrel, but not ritonavir, increased the geometric mean AUC_0-∞ of dasabuvir 4.7-fold; range 2.0-10.1-fold (P = 8·10^-7 ), compared with placebo. Clopidogrel and ritonavir combination increased dasabuvir AUC_0-∞ 3.9-fold; range 2.1-7.9-fold (P = 2·10^-6 ), compared with ritonavir alone. Ritonavir decreased

SUBMITTER: Itkonen MK 

PROVIDER: S-EPMC6585621 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature