Atazanavir with Boceprevir Interaction Details
Brand Names Associated with Atazanavir
- Atazanavir
- ATZ
- Reyataz®
Brand Names Associated with Boceprevir
- Boceprevir
- Victrelis®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 29, 2024
Interaction Effect
Reduced effectiveness of both ritonavir-boosted atazanavir and boceprevir
Interaction Summary
Concomitant use of ritonavir-boosted atazanavir with boceprevir is not recommended due to decreased drug exposure and a potential for reduced effectiveness of both medications[1]. In a pharmacokinetic study in healthy volunteers (n=39), coadministration of ritonavir boosted HIV protease inhibitors atazanavir, lopinavir, and darunavir, in combination with boceprevir resulted in reduced exposure of both medications. If concomitant use is required, treatment response and the potential for virologic rebound should be closely monitored [2][1].
Severity
Major
Onset
Unspecified
Evidence
Established
How To Manage Interaction
Using ritonavir-boosted atazanavir together with boceprevir is not recommended and may result in decreased exposure and reduced effectiveness of both medications[1]. If concomitant use is required, close monitoring of hepatitis C virus (HCV) treatment response and the potential for HCV and HIV virologic rebound is recommended [1][2].
Mechanism Of Interaction
Decreased systemic exposure of both ritonavir-boosted atazanavir and boceprevir
Literature Reports
A) In a pharmacokinetic study in 39 healthy volunteers, coadministration of boceprevir and ritonavir-boosted HIV protease inhibitors including atazanavir, lopinavir, and darunavir, resulted in reduced exposures of both boceprevir and the HIV protease inhibitors. A 34% to 44% reduction in AUC and a 25% to 36% reduction in Cmax was observed for the ritonavir-boosted protease inhibitors and mean trough concentrations were decreased by 49%, 43%, and 59% for ritonavir boosted atazanavir, lopinavir and darunavir, respectively. Boceprevir exposure was reduced by 45% when administered with lopinavir/ritonavir and by 32% with ritonavir-boosted darunavir, but was not effected by administration with ritonavir-boosted atazanavir [1][2].
References
1 ) Merck & Co., Inc.: Dear Health Care Professional letter for VICTRELIS(TM) (boceprevir). Merck & Co., Inc.. West Point, PA. 2012. Available from URL: http://www.merck.... . As accessed 2012-02-09.
2 ) U.S. Food and Drug Administration (FDA): FDA Drug Safety Communication: Important drug interactions between Victrelis (boceprevir) and ritonavir-boosted human immunodeficiency virus (HIV) protease inhibitor drugs. U.S. Food and Drug Administration (FDA). Rockville, MD. 2012. Available from URL: http://www.fda.go... . As accessed 2012-02-09.
Atazanavir Overview
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Atazanavir is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children who are at least 3 months of age and weigh at least 22 lb (10 kg). Atazanavir is in a class of medications called protease inhibitors. It works by decreasing the amount of HIV in the blood. Although atazanavir does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Atazanavir must be given with other medications that treat HIV infection to completely treat the infection. Taking these medications along with practicing safer sex and making other lifestyle changes may decrease the risk of transmitting the HIV virus to other people.
Boceprevir Overview
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Boceprevir is used along with two other medications (ribavirin [Copegus, Rebetol] and peginterferon alfa [Pegasys]) to treat chronic hepatitis C (an ongoing viral infection that damages the liver) in people who have not yet been treated for this condition or whose condition did not improve when they were treated with ribavirin and peginterferon alfa alone. Boceprevir is in a class of medications called protease inhibitors. It works by decreasing the amount of hepatitis C virus (HCV) in the body. Boceprevir may not prevent the spread of hepatitis C to other people.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.