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Brand Name: Invirase (hard gel); Fortovase (soft gel)
Disease: HIV
Drug Class: protease inhibitor
Version: 21
Date Updated: March 2024
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Absorption Model |
First order (different absorption parameters for each formulation) |
| Volume of Distribution Details |
Minimal PBPK with Vsac and Q (Method 2) |
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Route of Elimination |
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Perpetrator DDI |
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Validation |
The exposure of 1000mg BID saquinavir with 100 mg BID ritonavir regimen for hard gel were reasonably well recovered (3/3 within 2-fold). With the exception of the 1000 mg BID saquinavir with 100 mg BID ritonavir regimen for soft gel, the exposures of ritonavir-boosted regimens were well recovered (4/5 within 1.5-fold). Ten clinical DDI studies where saquinavir (soft gel) was administered with either ritonavir, cimetidine, ketoconazole, rifampin, erythromycin, or rifabutin were used to verify the PBPK model of saquinavir as a victim. In comparison of predicted vs. observed AUC, 80% of the studies were within 2-fold. Two clinical DDI studies where saquinavir (hard gel) was administered with either ritonavir or nelfinavir were used to verify the PBPK model of saquinavir (hard gel) as a victim. In comparison of predicted vs. observed AUC, 50% of the studies were within 2-fold. Three clinical DDI studies where saquinavir was administered with either midazolam or rifabutin were used to verify the PBPK model of rifabutin (soft gel) as a perpetrator. In comparison of predicted vs. observed AUC, 100% of the studies were within 2-fold. |
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Limitations |
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Table 1 of main text, further discussion in supplemental file. Clarification: the value of intrinsic CL for hepatic elimination (0.41) is for undefined human liver microsomes according to retrograde calculation, with a unit of uL/min/mg. The operating hepatic CLint is driven by S9, which has a value of 0.13, obtained from sensitivity analysis to match HLM value above. This clarification will be informed to the journal.
Compound files from publication: Physiologically Based Pharmacokinetic Modeling for Predicting the Effect of Intrinsic and Extrinsic Factors on Darunavir or Lopinavir Exposure Coadministered With Ritonavir Wagner, C., Zhao, P., Arya, V., Mullick, C., Struble, K. and Au, S (2017). https://doi.org/10.1002/jcph.936 /PMID#: 28569994 The compound file is the final model used for simulations in combination with ritonavir (submitted to repository referencing the same article). Correction: Ritonavir's pKa 2 should be 2.6, reported in Supp. Table 1 was 2.8 https://accp1.onlinelibrary.wiley.com/doi/full/10.1002/jcph.936
An optimized Rosuvastatin (V19) model was used and DDIs predominantly driven by gut BCRP inhibition are reasonably recovered. Altogether, the following inhibitors were used: Capmatinib Fenebrutinib Fostamatinib Itraconazole Zepatier The workspace represents the DDI between Rosuvastatin and Zepatier. Zepatier is an antiviral medicine that contains the active substances elbasvir and grazoprevir. The two compounds were simulated as Inhibitor 1 and Inhibitor 2, respectively. Link to the publication with further details: http://doi.org/10.1002/psp4.12672
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