Interactions between protease inhibitors and acid‐reducing agents: a systematic review

Objective The purpose of this article is to provide a systematic review of the available pharmacokinetic and clinical data on drug interactions between protease inhibitors (PIs) and acid‐reducing agents, and their clinical relevance. Methods A literature search was performed using Medline and EMBASE, s of the previous 2 years of major conferences were searched and the drug information service of the manufacturer of every currently available PI was contacted. All data were summarized, and verified by at least two authors. Results A total of 1231 references were identified, 22 of which were studies of pharmacokinetic interactions between PIs and acid‐suppressive agents and a further 12 of which provided pharmacokinetic and/or clinical data. Conclusions Many pharmacokinetic studies show a lack of a drug interaction between at least one acid‐reducing agent and most PIs. Little clinical information is available, except on interactions between atazanavir and acid‐reducing agents. This is probably a consequence of the complexity of the interaction.