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ea0028p56 | Clinical practice/governance and case reports | SFEBES2012

Secondary adrenal suppression and Cushing’s syndrome caused by ritonavir boosted effects of inhaled fluticasone, injected triamcinolone and topical clobetasol: A case series of 11 patients.

Gurazada Kalyan , Marshall Neal , Johnson Margaret , Hillman Tobias , Bouloux Pierre , Khoo Bernard

The HIV protease inhibitor (PI) ritonavir is used in conjunction with other antiretroviral treatments as a pharmacokinetic booster due to its potent inhibition of hepatic cytochrome P450 3A4 (CYP3A4). Co-administration of glucocorticoids metabolized by CYP3A4, with ritonavir leads to accumulation of these glucocorticoids, markedly increasing the risk of iatrogenic Cushings syndrome and suppression of the Hypothalamic-Pituitary-Adrenal axis. We present 11 patients receivi...

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Secondary adrenal suppression and Cushing’s syndrome caused by ritonavir boosted effects of inhaled fluticasone, injected triamcinolone and topical clobetasol: A case series of 11 patients.

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