Key result
Concomitant use of clopidogrel, isoniazid, and ritonavir in a patient with HIV and latent tuberculosis resulted in significant drug interactions leading to clopidogrel non-responsiveness.
Case Report (n=1)
Highlights a novel and clinically significant drug-drug interaction between clopidogrel, isoniazid, and ritonavir that diminishes clopidogrel efficacy.
Answers are grounded in this paper and cite their sources.
May warrant monitoring for clopidogrel non-responsiveness with these agents; hypothesis-generating for interactions in HIV/TB co-infection.
Patients with HIV are at an increased risk for cardiovascular disease, both as a result of treatment with protease inhibitors and from the disease itself. The medication regimens of patients with HIV and cardiovascular comorbidities are complex and require careful assessment for potentially serious drug-drug interactions. We report a case of clopidogrel non-responsiveness in a patient with HIV, latent tuberculosis and cardiovascular disease with a history of myocardial infarction. To our knowledge, this is the first report of significant drug interactions between clopidogrel, isoniazid and ritonavir. This case underscores the importance of a detailed drug interaction screening in infectious disease patients taking complex medication regimens, including clopidogrel.
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Metzger et al. (2013) conducted a case report in HIV, latent tuberculosis, and cardiovascular disease (n=1). Concomitant use of clopidogrel, isoniazid, and ritonavir was evaluated on Clopidogrel non-responsiveness. Concomitant use of clopidogrel, isoniazid, and ritonavir in a patient with HIV and latent tuberculosis resulted in significant drug interactions leading to clopidogrel non-responsiveness.
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