For Consumers
Labeling update for Lexiva ((fosamprenavir)
The Lexiva (fosamprenavir) label was recently updated to include new drug-drug interaction information regarding phenytoin (an anticonvulsant) and paroxetine (an antidepressent).
Details of the newly added information are shown below.
Table 6. Established And Other Potentially Significant Drug Interaction
| Concomitant Drug Class: Drug Name | Effect on Concentration of Amprenavir or Concomitant Drug | Clinical Comment |
|---|---|---|
| Anticonvulsants: Phenytoin | LEXIVA/ritonavir ↑amprenavir ↓phenytoin |
Plasma phenytoin concentrations should be monitored and phenytoin dose should be increased as appropriate. No change in LEXIVA/ritonavir dose is recommended. |
| Antidepressant: Paroxetine, trazodone |
↓Paroxetine | Coadministration of paroxetine with LEXIVA/ritonavir significantly decreased plasma levels of paroxetine. Any paroxetine dose adjustment should be guided by clinical effect (tolerability and efficacy). |
In addition, section 12.3 Pharmacokinetics, Table 10 and 12, were updated to show the results of the interaction study with phenytoin as follows:
Table 10. Drug Interactions: Pharmacokinetic Parameters for Amprenavir After Administration of LEXIVA in the Presence of the Coadministered Drug(s)
| Coadministered Drug(s) and Dose(s) | Dose of LEVIVA | n | % Change in Pharmacokinetic Parameters of Coadministered Drug (90% CI) | ||
|---|---|---|---|---|---|
| Cmax | AUC | Cmin | |||
| Phenytoin 300 mg q.d. for 10 days |
700 mg b.i.d. plus ritonavir 100 mg b.i.d. for 10 days | 13 | ↔ | ↑ 20 (↑ 8 to ↑ 34) |
↑ 19 (↑ 6 to ↑ 13) |
Table 12. Drug Interactions: Pharmacokinetic Parameters for Coadministered Drug in the Presence of Amprenavir After Administration of LEXIVA
| Coadministered Drug(s) and Dose(s) | Dose of LEVIVA | n | % Change in Pharmacokinetic Parameters of Coadministered Drug (90% CI) | ||
|---|---|---|---|---|---|
| Cmax | AUC | Cmin | |||
| Phenytoin 300 mg q.d. for 10 days |
700 mg b.i.d. plus ritonavir 100 mg b.i.d. for 10 days | 14 | ↓ 20 (↓ 12 to ↓ 27) |
↓ 22 (↓ 17 to ↓ 27) |
↓ 29 (↓ 23 to ↓ 34) |
The complete revised label is available at http://www.fda.gov/cder/foi/label/2007/021548s014lbl.pdf
Richard Klein
Office of Special Health Issues
Food and Drug Administration
Kimberly Struble
Division of Antiviral Drug Products
Food and Drug Administration







