[
    {
        "id": "osp-10801",
        "type": "article-journal",
        "title": "Secondary Adrenal Insufficiency Due to the Co-Administration of Ritonavir and Inhaled Fluticasone Propionate: Case report",
        "author": [
            {
                "family": "Al-Maqbali",
                "given": "Ali"
            },
            {
                "family": "Kamble",
                "given": "Bina"
            },
            {
                "family": "Elgalib",
                "given": "Salim"
            },
            {
                "family": "Ali",
                "given": ""
            }
        ],
        "URL": "https://omanscience.com/en/articles/secondary-adrenal-insufficiency-due-to-the-co-administration-of-ritonavir-and-inhaled-fluticasone-propionate-case-report",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2025
                ]
            ]
        },
        "container-title": "Sultan Qaboos University Medical Journal",
        "volume": "17",
        "issue": "3",
        "page": "339-342",
        "DOI": "10.18295/squmj.2017.17.03.014",
        "publisher": "Sultan Qaboos University",
        "ISSN": "2075-051X",
        "abstract": "Ritonavir is a powerful inhibitor of the cytochrome P450 3A4 (CYP3A4) isoenzyme. It is used as a pharmaceutical enhancer in the management of HIV-positive patients. However, when co-administered with other drugs that are metabolised via the CYP3A4 pathway, ritonavir can potentially cause serious drug-drug interactions. Inhaled fluticasone propionate, which is used to treat asthma and chronic obstructive airway disease, is particularly prone to such interactions due to its physiological attributes. We report a HIV-positive 48-year-old male patient who presented to Al Nahdha Hospital, Muscat, Oman, in 2012 with weight loss, generalised weakness and fatigue and diagnosed with secondary adrenal insufficiency as a result of concomitant ritonavir and inhaled fluticasone."
    }
]