Elvitegravir
=============

**PD Dialyzability**: Unlikely

Pharmacokinetic Parameters [1]_ [2]_ 
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/////// |pk|
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|pk1|   |v1|
|pk2|   |v2|
|pk3|   |v3|
|pk4|   |v4|
|pk5|   |v5|
|pk6|   |v6|
|pk7|   |v7|
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CAPD/CCPD Dosing: [1]_ [2]_ 
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No dosing recommendation for PD population was found in literature. However, due to major hepatic metabolism, extensive protein binding and minimal renal excretion of unchanged drug, it is unlikely that dosing adjustment is required. 

Literature Summary:
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None identified


References
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.. [1] Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. Drugbank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(Database issue):D668-672.

.. [2] Tseng A. Selected properties of Elvitegravir. Immunodeficiency Clinic [Internet]. 2014 Dec [cited 2018 Jan 19]. 1-6. Available from www.hivclinic.ca

.. |pk| replace:: Elvitegravir
.. |pk1| replace:: Molecular Weight (Da)  
.. |pk2| replace:: Plasma Protein Binding (%)
.. |pk3| replace:: Volume of Distribution (L/Kg) 
.. |pk4| replace:: Hepatic Metabolism 
.. |pk5| replace:: Excreted Unchanged (%) 
.. |pk6| replace:: Half-Life; Normal Renal Function (hours)
.. |pk7| replace:: Half-Life; ESRD (hours) 
.. |v1| replace:: 447
.. |v2| replace:: 98 - 99
.. |v3| replace:: Unknown
.. |v4| replace:: CYP3A (major), UGT 1A1/3
.. |v5| replace:: Unknown (6.7% as metabolites)
.. |v6| replace:: 8.7
.. |v7| replace:: Unknown
.. |L1| replace:: Pharmacokinetics of nelfinavir and nevirapine in a patient with end-stage renal failure on continuous ambulatory peritoneal dialysis
.. |L2| replace:: 34 year old HIV postive female. CrCl < 10 mL/min. ESRD secondary to chronic pyelonephritis on CAPD.
.. |L3| replace:: Nevirapine 200mg BID + nelfinavir 1250mg BID +  zidovudine 250mg BID
.. |L4| replace:: Concentrations in dialysate were ~50% of those in plasma
.. |L5| replace:: No adverse effects reported over 16 weeks
.. |L6| replace:: Approximately 16 mg of nevirapine lost through dialysate in 24-hour period. 
.. |L7| replace:: Following 12 weeks of treatment: CD4+ (x103 cells/L): 110🡪 240 Viral load (RNA copies/mL): 88000 at baseline 🡪 <50 
.. |L8| replace:: Plasma trough concentrations were similar to those found in study where patients received nevirapine 200mg once daily.
.. |L9| replace:: Pharmacokinetics of ritonavir and nevirapine in peritoneal dialysis 
.. |L10| replace:: 40 year old HIV positive male. On CAPD, ESRD secondary to HIV-associated nephropathy
.. |L11| replace:: Nevirapine 200mg q12h + ritonavir 600mg q12h + zidovudine 100mg q8h + didanosine 100mg q24h
.. |L12| replace:: No change in PK parameters in comparison to normal renal function, except AUC was increased. 
.. |L13| replace:: No adverse effects seen during study 
.. |L14| replace:: Extraction ratio (%): 51.9%
.. |L15| replace:: PD Clearance (ml/min): 3.3mL/min