Slide 10 of 22

Speaker notes: Now in the presence of a second PI, namely ritonavir, P-glycoprotein (in enterocytes) and CYP3A4 (in enterocytes and liver) are inhibited, leading to: increased half life possibly increased Cmax, depending on which PI is co-administered with ritonavir increased total exposure. Thus PI levels are above the required plasma concentration at the end of the dosing interval, and the inhibitory quotient (IQ) of the drug that is combined with RTV becomes more favourable.

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