Efavirenz + Pioglitazone = Precautionary

Effect on Concentration

Efavirenz
Unknown
Applies within class?
No
Pioglitazone
Decrease
Applies within class?
No

Pharmacologic Effects

Efavirenz
Effect
N/A
Applies within class?
No
Pioglitazone
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 22-Nov-2022

Summary

Sources

Pioglitazone vs efavirenz ^

Study Design

This study simulated the pharmacokinetic (PK) interaction between pioglitazone (PIO) and efavirenz (EFV) using physiologically based pharmacokinetic (PBPK) modeling. Plasma profiles were simulated in 50 virtual individuals receiving PIO with or without EFV for 14 days. PIO was dosed as either 15mg QD or 22.5mg QD and EFV was dosed as 600mg QD.

Study Results

Using geometric mean ratios and 90% confidence intervals, the AUC and Cmax for PIO 15mg + EFV was 0.59 (0.52-0.67) and 0.75 (0.70-0.80), respectively, compared to PIO 15mg alone. When dosed as 22.5mg QD, the AUC and Cmax was 0.89 (0.78-1.01) and 1.12 (1.05-1.20), respectively, compared to PIO 15mg alone.The authors state that an increase in PIO dose to 22.5mg QD is sufficient to overcome induction by EFV.The effect on EFV was not formerly studied.If EFV is removed the PIO dose would need to be decreased.***this recommendation is based on a computer simulation and not a human study

Study Conclusions

References

C Marzolini, R Rajoli, L Elzi, et al. Pharmacokinetic interactions between antidiabetics and efavirenz using pbpk modeling. Conference On Retroviruses And Opportunistic Infections. Seattle, WA. ; 2015.