Other drugs

Apart from the nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs/NtRTIs), other agents have also been linked to mitochondrial toxicity. The poison cyanide, for example, rapidly halts mitochondrial energy production. Metformin (Glucophage), used to manage antiretroviral-related blood sugar elevations, increases the risk of elevated lactate levels. Also, hydroxycarbamide (Hydrea), which used to be called hydroxyurea, contributes to mitochondrial damage by boosting ddI levels.

Ribavirin (Copegus / Rebeto / Virazole), a nucleoside analogue used in combination with interferon to treat hepatitis C, can increase the likelihood of mitochondrial damage and associated conditions when used with NRTIs.1 2 The United States Food and Drug Administration (FDA) mandated a warning against co-administration of ddI (didanosine, Videx/VidexEC) and ribavirin after identifying more than 30 cases of liver failure, fatty liver, pancreatitis, and severe lactate elevation.3

Other mitotoxic drugs include valproic acid (Depakote), ibuprofen, aspirin, tetracycline, aminoglycoside antibiotics such as vancomycin, chloramphenicol, amitryptiline (Elavil), imipramine, chlorpromazine (Thorazine), amiodarone (Cordarone), and tamoxifen.

References

  1. Lafeuillade A et al. Increased mitochondrial toxicity with ribavirin in HIV/HCV coinfection. Lancet 357: 280-281, 2001
  2. Bani-Sadr F et al. Risk factors for symptomatic mitochondrial toxicity in HIV/hepatitis C virus-coinfected patients during interferon plus ribavirin-based therapy. J Acquir Immune Defic Syndr 40: 47-52, 2005
  3. Fleischer R et al. Nucleoside analogues and mitochondrial toxicity. Clin Infect Dis 38: e79-e80, 2004
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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