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Atazanavir Powder for Oral Suspension and Fortovase

Determining the interaction of Atazanavir Powder for Oral Suspension and Fortovase and the possibility of their joint administration.

Check result:

Atazanavir Powder for Oral Suspension <> Fortovase

Relevance: 16.11.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using atazanavir together with saquinavir is not recommended. Combining these medications can increase the risk of an irregular heart rhythm that may be serious. In addition, atazanavir can increase the blood levels and effects of saquinavir. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with either of these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

CONTRAINDICATED: Saquinavir in combination with ritonavir has been shown to prolong the PR interval of the electrocardiogram in some patients. Theoretically, coadministration with other agents that prolong the PR interval, such as atazanavir, may result in elevated risk of conduction disturbances and atrioventricular block. However, clinical data are lacking. There is also potential for a pharmacokinetic interaction due to CYP450 3A4 inhibition by atazanavir. In a study of 18 HIV patients, coadministration of atazanavir (300 mg once a day) and saquinavir mesylate hard gelatin capsule (HGC)/ritonavir (1600 mg/100 mg once a day) resulted in an increase in saquinavir systemic exposure (AUC), peak plasma concentration (Cmax), and trough plasma concentration (Cmin) of 60%, 42%, and 112%, respectively. Ritonavir AUC and Cmax were increased by 41% and 34% respectively, while atazanavir pharmacokinetics was unchanged. Data are not available for saquinavir HGC/ritonavir given in a dosage of 1000 mg/100 mg twice a day with atazanavir 300 mg once a day.

MANAGEMENT: Due to the increased risk for life-threatening cardiac arrhythmia, the use of ritonavir-boosted saquinavir with atazanavir is considered contraindicated.

References

Boffito M, Kurowski M, Kruse G, et al. "Atazanavir enhances saquinavir hard-gel concentrations in a ritonavir-boosted once-daily regimen." AIDS 18 (2004): 1291-7
FDA. U.S. Food and Drug Administration "FDA drug safety communication: Ongoing safety review of Invirase (saquinavir) and possible association with abnormal heart rhythms. Available from: URL: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm201221.h" ([2010 Feb 23]):
EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid."
Haas DW, Zala C, Schrader S, et al. "Therapy with atazanavir plus saquinavir in patients failing highly active antiretroviral therapy: a randomized comparative pilot trial." AIDS 17 (2003): 1339-1349
"Product Information. Invirase (saquinavir)." Roche Laboratories, Nutley, NJ.
"Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb, Princeton, NJ.
Biondi L "Health Canada endorsed important safety information on Invirase (saquinavir mesylate). Available from: URL: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medeff/advisories-avis/prof/2010/invirase_hpc-cps-eng.pdf." ([2010 Apr 14]):
Cerner Multum, Inc. "Australian Product Information." O 0
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Atazanavir Powder for Oral Suspension

Generic Name: atazanavir

Brand name: Reyataz

Synonyms: Atazanavir

What is Atazanavir Powder for Oral Suspension?

Fortovase

Generic Name: saquinavir

Brand name: Invirase, Fortovase

Synonyms: n.a.

What is Fortovase?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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