{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:45:21Z","timestamp":1773413121641,"version":"3.50.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Carbamazepine (CBZ) is an antiseizure medication known to induce the expression of cytochrome P4503A metabolic enzymes. Here, we describe a man living with HIV who underwent several changes in the daily dose of CBZ, which resulted in different induction effects on darunavir trough concentrations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A 59-year-old man with HIV, successfully undergoing maintenance antiretroviral treatment with darunavir\/cobicistat once daily (combined with raltegravir), was prescribed CBZ for recurrent trigeminal neuralgia. Over subsequent months, the patient underwent various changes in the doses (from 200 to 800 mg\/d) and trough concentrations (from 3.6 to 18.0 mg\/L) of CBZ, guided by clinical response to trigeminal neuralgia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A highly significant inverse association was observed between darunavir trough concentration and both CBZ dose or trough concentration (coefficient of determination &gt;0.75, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). Ultimately, the darunavir dose was increased to 600 mg twice daily with ritonavir and dolutegravir to ensure optimal antiretroviral coverage, anticipating potential further uptitration of CBZ doses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The impact of CBZ on boosted darunavir exposure seemed to be dose- and concentration-dependent. The management of such drug\u2013drug interactions in daily practice was facilitated through therapeutic drug monitoring. This case underscores the importance of a multidisciplinary approach that incorporates both antiretroviral and nonantiretroviral comedications contributing to the optimal management of polypharmacy in individuals living with HIV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ftd.0000000000001179","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T18:02:22Z","timestamp":1715277742000},"page":"277-280","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Effect of Carbamazepine on Darunavir Trough Concentrations: When the Dose Can Make the Difference\u2014A Case Study"],"prefix":"10.1097","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1512-6530","authenticated-orcid":false,"given":"Dario","family":"Cattaneo","sequence":"first","affiliation":[{"name":"Gestione Ambulatoriale Politerapie (GAP) Outpatient clinic, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy;"},{"name":"Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Caloni","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Caronni","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nunziata","family":"Calvagna","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Bonini","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Giacomelli","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Gervasoni","sequence":"additional","affiliation":[{"name":"Gestione Ambulatoriale Politerapie (GAP) Outpatient clinic, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy;"},{"name":"Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"issue":"suppl 1","key":"R1-20250603","first-page":"36","article-title":"Carbamazepine in the treatment of epilepsy in people with intellectual disability","volume":"42","author":"Waisburg","year":"1998","journal-title":"J Intellect Disabil Res"},{"key":"R2-20250603","first-page":"CD005451","article-title":"Carbamazepine for chronic neuropathic pain and fibromyalgia in adults","volume":"2014","author":"Wiffen","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"R3-20250603","doi-asserted-by":"crossref","first-page":"765","DOI":"10.3109\/00498254.2015.1118774","article-title":"Evaluation of cytochrome P450 inductions by anti-epileptic drug oxcarbazepine, 10-hydroxyoxcarbazepine, and carbamazepine using human hepatocytes and HepaRG 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review","volume":"42","author":"Cattaneo","year":"2020","journal-title":"Ther Drug Monit"},{"key":"R10-20250603","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1055\/s-0037-1600991","article-title":"Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017","volume":"51","author":"Hiemke","year":"2018","journal-title":"Pharmacopsychiatry"},{"key":"R11-20250603","doi-asserted-by":"crossref","first-page":"6132","DOI":"10.1128\/AAC.00942-12","article-title":"Comparison of the in vivo pharmacokinetics and in vitro dissolution of raltegravir in HIV patients receiving the drug by swallowing or by chewing","volume":"56","author":"Cattaneo","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"R12-20250603","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/jac\/dkr498","article-title":"Inter- and intra-patient variability of raltegravir pharmacokinetics in HIV-1-infected subjects","volume":"67","author":"Cattaneo","year":"2012","journal-title":"J Antimicrob Chemother"},{"key":"R13-20250603","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1177\/0091270010395939","article-title":"Limited sampling strategies for the estimation of raltegravir daily exposure in HIV-infected patients","volume":"52","author":"Cattaneo","year":"2012","journal-title":"J Clin Pharmacol"},{"key":"R14-20250603","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s40266-023-01037-1","article-title":"Polypharmacy and aging in people living with HIV: 6 years of experience in a multidisciplinary outpatient clinic","volume":"40","author":"Cattaneo","year":"2023","journal-title":"Drugs Aging"}],"container-title":["Therapeutic Drug 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