Drug/Small Molecule:
ritonavir

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB annotates drug labels containing pharmacogenetic information approved by the US Food and Drug Administration (FDA), European Medicines Agency (EMA) and the Pharmaceuticals and Medical Devices Agency, Japan (PMDA). PharmGKB annotations provide a brief summary of the PGx in the label, an excerpt from the label and a downloadable highlighted label PDF file. A list of genes and phenotypes found within the label is mapped to label section headers and listed at the end of each annotation. PharmGKB also attempts to interpret the level of action implied in each label with the "PGx Level" tag.

Sources:

  • FDA Information is gathered from the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels" and from FDA-approved labels brought to our attention. Please note that drugs may be removed from or added to the FDA's Table without our knowledge. We periodically check the Table for changes and update PharmGKB accordingly. Drugs listed on the Table to our knowledge are tagged with the Biomarker icon. A drug label that has been removed from the Table will not have the Biomarker icon but will continue to have an annotation on PharmGKB stating the label has been removed from the FDA's Table. We acquire label PDF files from DailyMed.
  • EMA European Public Assessment Reports (EPARs) that contain PGx information were identified from [Article:24433361] and also by searching for drugs for which we have PGx-containing FDA drug labels.

We welcome any information regarding drug labels containing PGx information approved by the FDA, EMA, PMDA or other Medicine Agencies around the world - please contact feedback.


last updated 09/15/2014

European Medicines Agency (EMA) Label for ritonavir and CYP2D6, CYP3A4

Informative PGx

Summary

The EMA European Public Assessment Report (EPAR) for ritonavir (Norvir) does not contain pharmacogenetic information. It contains information regarding use of ritonavir as a pharmacokinetic enhancer for certain drugs to prolong their therapeutic effects. It is a potent inhibitor of CYP3A and CYP2D6-mediated biotransformation, and the EPAR provides a list of drugs contraindicated for concomitant use with ritonavir.

Annotation

The EMA-approved drug ritonavir (Norvir) is tagged with CYP3A4 and CYP2D6 in [Article:24433361].

Excerpts from the ritonavir (Norvir) EPAR:

Ritonavir dosed as a pharmacokinetic enhancer
Pharmacokinetic enhancement by ritonavir is based on ritonavir’s activity as a potent inhibitor of CYP3A- mediated metabolism. The degree of enhancement is related to the metabolic pathway of the co-administered protease inhibitor and the impact of the co-administered protease inhibitor on the metabolism of ritonavir.


Ritonavir has a high affinity for several cytochrome P450 (CYP) isoforms and may inhibit oxidation with the following ranked order: CYP3A4 > CYP2D6. Co-administration of Norvir and medicinal products primarily metabolised by CYP3A may result in increased plasma concentrations of the other medicinal product, which could increase or prolong its therapeutic and adverse effects. For select medicinal products (e.g. alprazolam) the inhibitory effects of ritonavir on CYP3A4 may decrease over time.

For the complete drug label text with sections containing pharmacogenetic information highlighted, see the ritonavir EMA drug label.

*Disclaimer: The contents of this page have not been endorsed by the EMA and are the sole responsibility of PharmGKB.

Genes and/or phenotypes found in this label

  • HIV
    • Drug interactions section, Information for patients section, Adverse reactions section, Pregnancy section, Pharmacodynamics section, Pharmacokinetics section, efficacy
    • source: European Medicines Agency (EMA) Label
  • CYP2D6
    • Contraindications section, Drug interactions section, Pharmacokinetics section, efficacy, metabolism/PK
    • source: European Medicines Agency (EMA) Label
  • CYP3A4
    • Contraindications section, Drug interactions section, Pharmacodynamics section, Pharmacokinetics section, Warnings and precautions section, efficacy, metabolism/PK
    • source: European Medicines Agency (EMA) Label

Links to Unannotated Labels

These links are to labels associated with ritonavir that have not been annotated by PharmGKB.

  1. DailyMed - DrugLabel PA166105239

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all ritonavir variant annotations

Gene ? Variant?
(142)
Alternate Names ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available CA VA ABCB1 *1 N/A N/A N/A
No VIP available No VIP available VA CYP3A5 *3A N/A N/A N/A
No VIP available No VIP available VA CYP3A5 *6 N/A N/A N/A
No VIP available No VIP available VA CYP3A5 *7 N/A N/A N/A
No VIP available No VIP available VA UGT1A1 *1 N/A N/A N/A
No VIP available No VIP available VA UGT1A1 *28 N/A N/A N/A
No VIP available CA VA
rs1042640 *339G>C, 188155G>C, 234681544G>C, 627803G>C
G > C
3' UTR
No VIP available CA VA
rs1045642 208920T>A, 208920T>C, 25171488A>G, 25171488A>T, 3435T>A, 3435T>C, 87138645A>G, 87138645A>T, ABCB1*6, ABCB1: 3435C>T, ABCB1: C3435T, ABCB1: c.3435C>T, ABCB1:3435C>T, Ile1145=, Ile1145Ile, MDR1 3435C>T, MDR1 C3435T, PGP C3435T, c.3435C>T, mRNA 3853C>T
A > T
A > G
Synonymous
Ile1145Ile
No VIP available CA VA
rs10929303 *211T>C, 188027T>C, 234681416T>C, 627675T>C
T > C
3' UTR
No VIP available No Clinical Annotations available VA
rs1128503 1236T>C, 167964T>C, 25043506A>G, 87550285A>G, ABCB1 1236C>T, ABCB1*8, ABCB1: c.1236T>C, ABCB1:1236C>T, ABCB1:1236T>C, Gly412=, Gly412Gly, mRNA 1654T>C, p.Gly412Gly
A > G
Not Available
Gly412Gly
No VIP available No Clinical Annotations available VA
rs1523127 -131C>A, -566C>A, 119501039C>A, 25996185C>A, 6709C>A
C > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs1523130 -1663T>C, 119499507T>C, 25994653T>C, 5177T>C
T > C
5' UTR
No VIP available No Clinical Annotations available VA
rs15524 *14T>C, 1885T>C, 2125T>C, 3229T>C, 36708T>C, 37278757A>G, 99245914A>G
A > G
Not Available
No VIP available No Clinical Annotations available VA
rs17863778 234590974C>A, 391C>A, 537233C>A, 855+44951C>A, 855+63766C>A, 855+9539C>A, 97585C>A, Arg131=
C > A
Intronic
Arg131Arg
No VIP available No Clinical Annotations available VA
rs17868323 234590970T>G, 387T>G, 537229T>G, 855+44947T>G, 855+63762T>G, 855+9535T>G, 97581T>G, Asn129Lys, UGT1A7:N129K, rs17868323
T > G
Intronic
Asn129Lys
No VIP available No Clinical Annotations available VA
rs2032582 186947T>A, 186947T>G, 25193461A>C, 25193461A>T, 2677A, 2677G, 2677T, 2677T>A, 2677T>G, 3095G>T/A, 87160618A>C, 87160618A>T, 893 Ala, 893 Ser, 893 Thr, ABCB1*7, ABCB1: 2677G>T/A, ABCB1: 2677T/A>G, ABCB1: A893S, ABCB1: G2677T/A, ABCB1: c.2677G>T/A, ABCB1:2677G>A/T, ABCB1:2677G>T/A, ABCB1:A893T, Ala893Ser/Thr, MDR1, MDR1 G2677T/A, Ser893Ala, Ser893Thr, mRNA 3095G>T/A, p.Ala893Ser/Thr
A > T
A > C
Missense
Ser893Ala
Ser893Thr
No VIP available No Clinical Annotations available VA
rs212091 *1512T>C, 16176650T>C, 16236650T>C, 198217T>C
T > C
3' UTR
No VIP available No Clinical Annotations available VA
rs2306283 14089862A>G, 21329738A>G, 388A>G, 50611A>G, Asn130Asp, SLCO1B1*1B
A > G
Missense
Asn130Asp
No VIP available No Clinical Annotations available VA
rs2472677 -22-7659C>T, 119518417C>T, 24087C>T, 26013563C>T, 96-7659C>T, NR1I2:63396C>T, PXR 63396C>T
C > T
Intronic
No VIP available No Clinical Annotations available VA
rs2853826
A > G
Not Available
No VIP available CA VA
rs2854116 -501C>T, 116700169C>T, 20262585C>T, 4546C>T, APOC3: -455 T>C
C > T
5' Flanking
No VIP available CA VA
rs2854117 -528T>C, 116700142T>C, 20262558T>C, 4519T>C, APOC3: -482 C>T
T > C
5' Flanking
No VIP available No Clinical Annotations available VA
rs3213619 -129T>C, 117372T>C, 25263036A>G, 87230193A>G, ABCB1:T-129C
A > G
5' UTR
No VIP available No Clinical Annotations available VA
rs3732359 *370G>A, 119536429G>A, 26031575G>A, 42099G>A
G > A
3' UTR
No VIP available No Clinical Annotations available VA
rs3732360 *522C>T, 119536581C>T, 26031727C>T, 42251C>T
C > T
3' UTR
No VIP available No Clinical Annotations available VA
rs3743527 *543C>T, 16175681C>T, 16235681C>T, 197248C>T
C > T
3' UTR
No VIP available No Clinical Annotations available VA
rs3806596 -66T>C, 144318T>C, 234637707T>C, 583966T>C, 60+35196T>C, 856-37973T>C, 861+35196T>C, 867+15203T>C, 867+9374T>C, UGT1A3(-66)C>T
T > C
Intronic
No VIP available No Clinical Annotations available VA
rs3814057 *1195A>C, 119537254A>C, 26032400A>C, 42924A>C
A > C
3' UTR
No VIP available No Clinical Annotations available VA
rs3814058 *1232T>C, 119537291T>C, 26032437T>C, 42961T>C
T > C
3' UTR
No VIP available No Clinical Annotations available VA
rs3842 *193A>G, 214199A>G, 24997271T>C, 87504050T>C
T > C
Not Available
No VIP available No Clinical Annotations available VA
rs4148323 175755G>A, 211G>A, 234669144G>A, 61-6536G>A, 615403G>A, 856-6536G>A, 862-6536G>A, 868-6536G>A, Gly71Arg, UGT1A1*6, UGT1A1: G71R, UGT1A1:211G>A, UGT1A1:G211A, UGT1A1:Gly71Arg
G > A
Intronic
Gly71Arg
No VIP available No Clinical Annotations available VA
rs4149056 14091673T>C, 21331549T>C, 521T>C, 52422T>C, SLCO1B1*5, Val174Ala
T > C
Missense
Val174Ala
No VIP available CA VA
rs429358 17680159T>C, 388T>C, 45411941T>C, 7903T>C, APOE:Cys112Arg, ApoE epsilon 4, ApoE4, Cys130Arg
T > C
Missense
Cys130Arg
No VIP available CA VA
rs5128 *40G>C, 116703640G>C, 20266056G>C, 8017G>C, APOC3: 3238 C>G
G > C
3' UTR
No VIP available No Clinical Annotations available VA
rs628031 1222A>G, 160560845A>G, 64730302A>G, Met408Val
A > G
Missense
Met408Val
No VIP available No Clinical Annotations available VA
rs6785049 119533733G>A, 26028879G>A, 39403G>A, 684-93G>A, 795-93G>A, 912-93G>A
G > A
Intronic
No VIP available CA VA
rs7412 17680297C>T, 45412079C>T, 526C>T, 8041C>T, APOE epsilon 2, ApoE2, Arg176Cys
C > T
Missense
Arg176Cys
No VIP available No Clinical Annotations available VA
rs7586110 -57, -57T>G, 234590527T>G, 536786T>G, 855+44504T>G, 855+63319T>G, 855+9092T>G, 97138T>G, T>G, UGT1A7:, UGT1A7:-57T>G, rs7586110
T > G
Intronic
VIP No Clinical Annotations available No Variant Annotations available
rs776746 12083G>A, 219-237G>A, 321-1G>A, 37303382C>T, 581-237G>A, 689-1G>A, 99270539C>T, CYP3A5*1, CYP3A5*3, CYP3A5*3C, CYP3A5:6986A>G, g.6986A>G, intron 3 splicing defect, rs776746 A>G
C > T
Acceptor
No VIP available CA VA
rs8175347 233760235_233760236TA[5][6][7][8], 5-TA insertion in promoter, 7-TA insertion in promoter, 8-TA insertion in promoter, UGT1A1*28, UGT1A1*36, UGT1A1*37, microsatellite, short tandem repeat
(TA)6 > (TA)8
(TA)6 > (TA)5
(TA)6 > (TA)7
Not Available
No VIP available CA VA
rs8330 *440G>C, 188256G>C, 234681645G>C, 627904G>C
G > C
3' UTR
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 142

Overview

Generic Names
  • Abbott 84538
  • ritonavir
Trade Names
  • Norvir
  • Norvir Sec
Brand Mixture Names
  • Kaletra (Lopinavir + Ritonavir)

PharmGKB Accession Id:
PA451260

Description

An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV.

Source: Drug Bank

Indication

Indicated in combination with other antiretroviral agents for the treatment of HIV-infection.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Ritonavir inhibits the HIV viral proteinase enzyme which prevents cleavage of the gag-pol polyprotein, resulting in noninfectious, immature viral particles.

Source: Drug Bank

Pharmacology

Ritonavir is a protease inhibitor with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Protease inhibitors block the part of HIV called protease. HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV-1. Ritonavir binds to the protease active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the viral polyproteins resulting in the formation of immature non-infectious viral particles. Protease inhibitors are almost always used in combination with at least two other anti-HIV drugs.

Source: Drug Bank

Food Interaction

Avoid St.John's Wort.|Take with food.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. Five metabolites have been identified. The isopropylthiazole oxidation metabolite (M-2) is the major metabolite and has antiviral activity similar to that of ritonavir, however, plasma concentrations are low. The cytochrome P450 enzymes CYP3A and CYP2D6 are primarily involved in the metabolism of ritonavir.

Source: Drug Bank

Protein Binding

98-99%

Source: Drug Bank

Absorption

The absolute bioavailability of ritonavir has not been determined.

Source: Drug Bank

Half-Life

3-5 hours

Source: Drug Bank

Toxicity

Human experience of acute overdose with ritonavir is limited. One patient in clinical trials took ritonavir 1500 mg/day for two days. The patient reported paresthesias which resolved after the dose was decreased. A post-marketing case of renal failure with eosinophilia has been reported with ritonavir overdose. The approximate lethal dose was found to be greater than 20 times the related human dose in rats and 10 times the related human dose in mice.

Source: Drug Bank

Chemical Properties

Chemical Formula

C37H48N6O5S2

Source: Drug Bank

Isomeric SMILES

CC(C)c1nc(cs1)CN(C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](Cc2ccccc2)C[C@@H]([C@H](Cc3ccccc3)NC(=O)OCc4cncs4)O

Source: OpenEye

Canonical SMILES

CC(C)[C@H](NC(=O)N(C)CC1=CSC(=N1)C(C)C)C(=O)N[C@H]

Source: Drug Bank

Average Molecular Weight

720.944

Source: Drug Bank

Monoisotopic Molecular Weight

720.312760056

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Interactions

Drug Description
ritonavir The serum concentration of Abacavir may be decreased by protease inhibitors such as Ritonavir. The antiviral response should be closely monitored. (source: Drug Bank)
ritonavir The serum concentration of Abacavir may be decreased by protease inhibitors such as Ritonavir. The antiviral response should be closely monitored. (source: Drug Bank)
ritonavir Ritonavir increases the effect/toxicity of alfuzosin (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir Ritonavir decreases the effect of theophylline (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of amiodarone (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of amiodarone (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, amitriptyline, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of amitriptyline if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, amoxapine, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of amoxapine if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir This CYP3A4 inhibitor increases the effect and toxicity of aprepitant (source: Drug Bank)
ritonavir Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
ritonavir Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
ritonavir Association with dose adjustment (source: Drug Bank)
ritonavir Association with dose adjustment (source: Drug Bank)
ritonavir The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
ritonavir The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of the statin (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of the statin (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of bepridil (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of bepridil (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may increase the serum concentration of bromazepam by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of bromazepam if ritonavir is initiated, discontinued or dose changed. Dosage adjustments may be required. (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of bupropion (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of bupropion (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of buspirone (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of buspirone (source: Drug Bank)
ritonavir Ritonavir increases the effect of carbamazepine (source: Drug Bank)
ritonavir Ritonavir increases the effect of carbamazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir Increased effects/toxicity of ciclesonide (source: Drug Bank)
ritonavir Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
ritonavir Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, clomipramine, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of clomipramine if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of clozapine (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of clozapine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of cyclosporine (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may increase the effect of cyclosporine. (source: Drug Bank)
ritonavir Ritonavir may increase the serum concentration of dantrolene by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dantrolene if ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir This potent CYP3A4 inhibitor slows darifenacin/solifenacin metabolism (source: Drug Bank)
ritonavir This potent CYP3A4 inhibitor slows darifenacin/solifenacin metabolism (source: Drug Bank)
ritonavir Increases the effect of ritonavir (source: Drug Bank)
ritonavir Increases the effect of ritonavir (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, desipramine, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of desipramine if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir Ritonavir increases levels/effect of digoxin (source: Drug Bank)
ritonavir Ritonavir increases levels/effect of digoxin (source: Drug Bank)
ritonavir The protease inhibitor increases the effect and toxicity of ergot derivative (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may increase the effect and toxicity of the ergot derivative, dihydroergotamine. (source: Drug Bank)
ritonavir Ritonavir increases diltiazem levels (source: Drug Bank)
ritonavir Ritonavir increases diltiazem levels (source: Drug Bank)
ritonavir Possible decrease of valproate levels (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, doxepin, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of doxepin if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir The protease inhibitor increases the effect and toxicity of eletriptan (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may increase the effect and toxicity of eletriptan. (source: Drug Bank)
ritonavir This protease inhibitor, ritonavir, may increase the effect and toxicity of eplerenone. (source: Drug Bank)
ritonavir The protease inhibitor increases the effect and toxicity of ergot derivative (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may increase the effect and toxicity of the ergot derivative, ergotamine. (source: Drug Bank)
ritonavir This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank)
ritonavir This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank)
ritonavir Increased toxicity of both agents (source: Drug Bank)
ritonavir Increased toxicity of both agents (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir Ritonavir could decrease the contraceptive efficacy (source: Drug Bank)
ritonavir Ritonavir could decrease the contraceptive efficacy (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of fentanyl/alfentanyl (source: Drug Bank)
ritonavir Ritonavir increases the toxicity of the anti-arrhythmic (source: Drug Bank)
ritonavir Ritonavir increases the toxicity of the anti-arrhythmic (source: Drug Bank)
ritonavir Increased risk of serotonin syndrome (source: Drug Bank)
ritonavir Increased risk of serotonin syndrome (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may increase the effect and toxicity of fusidic acid. (source: Drug Bank)
ritonavir This CYP3A4 inhibitor increases levels/toxicity of gefitinib (source: Drug Bank)
ritonavir This CYP3A4 inhibitor increases levels/toxicity of gefitinib (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, imipramine, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of imipramine if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir The imidazole increases the effect and toxicity of ritonavir (source: Drug Bank)
ritonavir The imidazole increases the effect and toxicity of ritonavir (source: Drug Bank)
ritonavir The imidazole increases the effect and toxicity of ritonavir (source: Drug Bank)
ritonavir The imidazole increases the effect and toxicity of ritonavir (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of the statin (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of the statin (source: Drug Bank)
ritonavir Mefloquine decreases the effect of ritonavir (source: Drug Bank)
ritonavir Mefloquine decreases the effect of ritonavir (source: Drug Bank)
ritonavir Ritonavir increases the levels of analgesic (source: Drug Bank)
ritonavir Ritonavir increases the levels of analgesic (source: Drug Bank)
ritonavir The protease inhibitor decreases the effect of methadone (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may decrease the effect of methadone. (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of benzodiazepine (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of the tricyclics (source: Drug Bank)
ritonavir Ritonavir may increase the effect and toxicity of the tricyclic antidepressant, nortriptyline, by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nortriptyline if ritonavir if initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir decreases the effect of olanzapine (source: Drug Bank)
ritonavir Ritonavir decreases the effect of olanzapine (source: Drug Bank)
ritonavir Ritonavir decreases the effect of theophylline (source: Drug Bank)
ritonavir The protease inhibitor increases the effect and toxicity of pimozide (source: Drug Bank)
ritonavir The protease inhibitor, ritonavir, may increase the effect and toxicity of pimozide. (source: Drug Bank)
ritonavir Ritonavir increases the toxicity of piroxicam (source: Drug Bank)
ritonavir Ritonavir increases the toxicity of piroxicam (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of propafenone (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of propafenone (source: Drug Bank)
ritonavir Ritonavir increases the levels of analgesic (source: Drug Bank)
ritonavir Ritonavir increases the levels of analgesic (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of quinidine (source: Drug Bank)
ritonavir Ritonavir increases the effect and toxicity of quinidine (source: Drug Bank)
ritonavir This combination presents an increased risk of toxicity (source: Drug Bank)
ritonavir Increased levels of ranolazine - risk of toxicity (source: Drug Bank)
ritonavir Rifabutin decreases the effect of ritonavir (source: Drug Bank)
ritonavir Rifabutin decreases the effect of ritonavir (source: Drug Bank)
ritonavir Rifampin decreases the effect of ritonavir (source: Drug Bank)
ritonavir Rifampin decreases the effect of ritonavir (source: Drug Bank)
ritonavir The protease inhibitor, Ritonavir, may increase the blood concentration of Tacrolimus. Monitor for changes in the therapeutic/toxic effects of Tacrolimus if Ritonavir therapy is initiated, discontinued or altered. (source: Drug Bank)
ritonavir Ritonavir may reduce the metabolism of Tadalafil. Concomitant therapy should be avoided if possible due to high risk of Tadalafil toxicity. (source: Drug Bank)
ritonavir Ritonavir may decrease the therapeutic effect of Tamoxifen by decreasing the production of active metabolites. Concomitant therapy should be avoided. (source: Drug Bank)
ritonavir Ritonavir may decrease the therapeutic effect of Tamoxifen by decreasing the production of active metabolites. Concomitant therapy should be avoided. (source: Drug Bank)
ritonavir Ritonavir, a CYP3A4/2D6 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4/2D6 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Ritonavir is initiated, discontinued, or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a CYP3A4/2D6 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4/2D6 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Ritonavir is initiated, discontinued, or dose changed. (source: Drug Bank)
ritonavir Ritonavir may increase the plasma concentration of Telithromycin. Consider alternate therapy or monitor therapeutic/adverse effects. (source: Drug Bank)
ritonavir Ritonavir may inhibit the metabolism and clearance of Temsirolimus. Concomitant therapy should be avoided. (source: Drug Bank)
ritonavir The strong CYP3A4 inhibitor, Ritonavir, may decrease the metabolism and clearance of Teniposide, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Teniposide if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
ritonavir Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
ritonavir Ritonavir decreases the effect of theophylline (source: Drug Bank)
ritonavir Ritonavir decreases the effect of theophylline (source: Drug Bank)
ritonavir The strong CYP3A4 inhibitor, Ritonavir, may decrease the metabolism and clearance of Tiagabine, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Tiagabine if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity. (source: Drug Bank)
ritonavir Ritonavir may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity. (source: Drug Bank)
ritonavir The p-glycoprotein inhibitor, Ritonavir, may increase the bioavailability of oral Topotecan. A clinically significant effect is also expected with IV Topotecan. Concomitant therapy should be avoided. (source: Drug Bank)
ritonavir Ritonavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Ritonavir may decrease the effect of Tramadol by decreasing active metabolite production. (source: Drug Bank)
ritonavir Ritonavir increases levels/effect of trazodone (source: Drug Bank)
ritonavir The protease inhibitor, Ritonavir, may increase the efficacy/toxicity of Trazodone by inhibiting Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir The protease inhibitor, Ritonavir, may increase the efficacy/toxicity of Trazodone by inhibiting Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir The strong CYP2C8 inhibitor, Ritonavir, may decrease the metabolism and clearance of oral Tretinoin. Consider alternate therapy or monitor for changes in Tretinoin effectiveness and adverse/toxic effects if Ritonavir is initiated, discontinued to dose changed. (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
ritonavir The strong CYP3A4/CYP2D6 inhibitor, Ritonavir, may decrease the metabolism and clearance of Trimipramine, a CYP3A4/CYP2D6 substrate. Consider alternate therapy or monitor for changes in therapeutic and adverse effects of Trimipramine if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a potent CYP3A4 inhibitor, may decrease the metabolism and clearance of Vardenafil. Concomitant therapy is contraindicated. (source: Drug Bank)
ritonavir Ritonavir, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Ritonavir is initiated, discontinued, or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may increase the serum concentration of Veramapil, a CYP3A4 substrate, by decreasing its metabolism and clearance. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Verapamil if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may decrease the metabolism of Vinblastine. Consider alternate therapy to avoid Vinblastine toxicity. Monitor for changes in the therapeutic/adverse effects of Vinblastine if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 and p-glycoprotein inhibitor, may increase the serum concentration of Vincristine by decreasing its metabolism and/or increasing efflux. Consider alternate therapy to avoid Vincristine toxicity. Monitor for changes in the therapeutic and adverse effects of Vincristine if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may increase the serum concentration of Vinorelbine by decreasing its metabolism. Consider alternate therapy to avoid Vinorelbine toxicity. Monitor for changes in the therapeutic and adverse effects of Vinorelbine if Ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir may decrease the serum concentration of voriconazole by increasing its metabolism. Concomitant therapy with high dose ritonavir is contraindicated. Caution should be used with lower doses as decreased voriconazole efficacy may occur. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may increase the serum concentration of zolpidem by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zolpidem if ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may increase the serum concentration of zonisamide by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zonisamide if ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP3A4 inhibitor, may increase the serum concentration of zopiclone by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zopiclone if ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)
ritonavir Ritonavir, a strong CYP2D6 inhibitor, may increase the serum concentration of zuclopenthixol by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zuclopenthixol if ritonavir is initiated, discontinued or dose changed. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to ritonavir: 88

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Single-nucleotide polymorphisms in the UDP-glucuronosyltransferase 1A-3' untranslated region are associated with atazanavir-induced nephrolithiasis in patients with HIV-1 infection: a pharmacogenetic study. The Journal of antimicrobial chemotherapy. 2014. Nishijima Takeshi, et al. PubMed
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Voriconazole and atazanavir: a CYP2C19-dependent manageable drug-drug interaction. Pharmacogenomics. 2014. Calcagno Andrea, et al. PubMed
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Intracellular accumulation of atazanavir/ritonavir according to plasma concentrations and OATP1B1, ABCB1 and PXR genetic polymorphisms. The Journal of antimicrobial chemotherapy. 2014. D'Avolio Antonio, et al. PubMed
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High prevalence of the UGT1A1*28 variant in HIV-infected individuals in Greece. International journal of STD & AIDS. 2014. Panagopoulos P, et al. PubMed
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Understanding variability with voriconazole using a population pharmacokinetic approach: implications for optimal dosing. The Journal of antimicrobial chemotherapy. 2014. Dolton Michael J, et al. PubMed
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Impact of CYP polymorphisms, ethnicity and sex differences in metabolism on dosing strategies: the case of efavirenz. European journal of clinical pharmacology. 2014. Naidoo Panjasaram, et al. PubMed
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Clinical and pharmacogenetic factors affecting neonatal bilirubinemia following atazanavir treatment of mothers during pregnancy. AIDS research and human retroviruses. 2013. Eley Timothy, et al. PubMed
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Mitochondrial DNA Variation and Changes in Adiponectin and Endothelial Function in HIV-Infected Adults After Antiretroviral Therapy Initiation. AIDS research and human retroviruses. 2013. Hulgan Todd, et al. PubMed
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ABCB1 and ABCC1 variants associated with virological failure of first-line protease inhibitors antiretroviral regimens in Northeast Brazil patients. Journal of clinical pharmacology. 2013. Coelho Antonio V C, et al. PubMed
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Evaluating the in vitro inhibition of UGT1A1, OATP1B1, OATP1B3, MRP2, and BSEP in predicting drug-induced hyperbilirubinemia. Molecular pharmaceutics. 2013. Chang Jae H, et al. PubMed
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Effect of the UGT1A1*28 allele on unconjugated hyperbilirubinemia in HIV-positive patients receiving Atazanavir: a systematic review. The Annals of pharmacotherapy. 2013. Culley Celia L, et al. PubMed
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Impact of UGT1A1 Gilbert variant on discontinuation of ritonavir-boosted atazanavir in AIDS Clinical Trials Group Study A5202. The Journal of infectious diseases. 2013. Ribaudo Heather J, et al. PubMed
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Short communication: UGT1A1*28 variant allele is a predictor of severe hyperbilirubinemia in HIV-infected patients on HAART in southern Brazil. AIDS research and human retroviruses. 2012. Turatti Lisiane, et al. PubMed
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Switching to unboosted atazanavir reduces bilirubin and triglycerides without compromising treatment efficacy in UGT1A1*28 polymorphism carriers. The Journal of antimicrobial chemotherapy. 2012. Ferraris Laurenzia, et al. PubMed
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PharmGKB summary: very important pharmacogene information for CYP3A5. Pharmacogenetics and genomics. 2012. Lamba Jatinder, et al. PubMed
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The Dual Role of Pharmacogenetics in HIV Treatment: Mutations and Polymorphisms Regulating Antiretroviral Drug Resistance and Disposition. Pharmacological reviews. 2012. Michaud Veronique, et al. PubMed
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HIV-1 antiretroviral drug therapy. Cold Spring Harbor perspectives in medicine. 2012. Arts Eric J, et al. PubMed
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Complex drug interactions of the HIV protease inhibitors 3: effect of simultaneous or staggered dosing of digoxin and ritonavir, nelfinavir, rifampin, or bupropion. Drug metabolism and disposition: the biological fate of chemicals. 2012. Kirby Brian J, et al. PubMed
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Severe atazanavir-associated hyperbilirubinemia revealing Canton G6PD deficiency in an Asian HIV-infected patient. AIDS (London, England). 2012. Javelle Emilie, et al. PubMed
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Short communication: use of serum bilirubin levels as surrogate marker of early virological response to atazanavir-based antiretroviral therapy. AIDS research and human retroviruses. 2011. Morello Judit, et al. PubMed
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Complex Drug Interactions of HIV Protease Inhibitors 2: In Vivo Induction and In Vitro to In Vivo Correlation of Induction of Cytochrome P450 1A2, 2B6 and 2C9 by Ritonavir or Nelfinavir. Drug metabolism and disposition: the biological fate of chemicals. 2011. Kirby Brian J, et al. PubMed
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Complex Drug Interactions of HIV Protease Inhibitors 1: Inactivation, Induction and Inhibition of Cytochrome P450 3A by Ritonavir or Nelfinavir. Drug metabolism and disposition: the biological fate of chemicals. 2011. Kirby Brian J, et al. PubMed
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Detrimental effect of atazanavir plasma concentrations on total serum bilirubin levels in the presence of UGT1A1 polymorphisms. Journal of acquired immune deficiency syndromes (1999). 2011. Cicconi Paola, et al. PubMed
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Very important pharmacogene summary: ABCB1 (MDR1, P-glycoprotein). Pharmacogenetics and genomics. 2011. Hodges Laura M, et al. PubMed
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Association of pharmacogenetic markers with premature discontinuation of first-line anti-HIV therapy: an observational cohort study. The Journal of infectious diseases. 2011. Lubomirov Rubin, et al. PubMed
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Successful tacrolimus treatment following renal transplant in a HIV-infected patient with raltegravir previously treated with a protease inhibitor based regimen. Drug metabolism and drug interactions. 2011. Cousins Darren, et al. PubMed
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Nuclear receptor-mediated induction of CYP450 by antiretrovirals: functional consequences of NR1I2 (PXR) polymorphisms and differential prevalence in whites and sub-Saharan Africans. Journal of acquired immune deficiency syndromes (1999). 2010. Svärd Jenny, et al. PubMed
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Genetic factors influencing severe atazanavir-associated hyperbilirubinemia in a population with low UDP-glucuronosyltransferase 1A1*28 allele frequency. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2010. Park Wan Beom, et al. PubMed
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Prediction of adverse drug reactions using decision tree modeling. Clinical pharmacology and therapeutics. 2010. Hammann F, et al. PubMed
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Coprescription of tamoxifen and medications that inhibit CYP2D6. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2010. Sideras Kostandinos, et al. PubMed
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A Phenotype-Genotype Approach to Predicting CYP450 and P-Glycoprotein Drug Interactions With the Mixed Inhibitor/Inducer Tipranavir/Ritonavir. Clinical pharmacology and therapeutics. 2010. Dumond J B, et al. PubMed
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ADME pharmacogenetics: investigation of the pharmacokinetics of the antiretroviral agent lopinavir coformulated with ritonavir. Pharmacogenetics and genomics. 2010. Lubomirov Rubin, et al. PubMed
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Pharmacokinetics and pharmacodynamics of GS-9350: a novel pharmacokinetic enhancer without anti-HIV activity. Clinical pharmacology and therapeutics. 2010. Mathias A A, et al. PubMed
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Pharmacogenomic adaptation of antiretroviral therapy: overcoming the failure of lopinavir in an African infant with CYP2D6 ultrarapid metabolism. European journal of clinical pharmacology. 2010. Gorny Matthias, et al. PubMed
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Atazanavir pharmacokinetics in genetically determined CYP3A5 expressors versus non-expressors. The Journal of antimicrobial chemotherapy. 2009. Anderson Peter L, et al. PubMed
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Is there a place for drug combination strategies using clinical pharmacology attributes?--review of current trends in research. Current clinical pharmacology. 2009. Srinivas Nuggehally R. PubMed
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Histone deacetylase inhibitors induce a very broad, pleiotropic anticancer drug resistance phenotype in acute myeloid leukemia cells by modulation of multiple ABC transporter genes. Clinical cancer research : an official journal of the American Association for Cancer Research. 2009. Hauswald Stefanie, et al. PubMed
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Genetic determinants of response to clopidogrel and cardiovascular events. The New England journal of medicine. 2009. Simon Tabassome, et al. PubMed
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ABCB1 polymorphisms and the concentrations of lopinavir and ritonavir in blood, semen and saliva of HIV-infected men under antiretroviral therapy. Pharmacogenomics. 2009. Estrela Rita de Cassia, et al. PubMed
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Redox regulation of multidrug resistance in cancer chemotherapy: molecular mechanisms and therapeutic opportunities. Antioxidants & redox signaling. 2009. Kuo Macus Tien. PubMed
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Several major antiepileptic drugs are substrates for human P-glycoprotein. Neuropharmacology. 2008. Luna-Tortós Carlos, et al. PubMed
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Application and interpretation of hPXR screening data: Validation of reporter signal requirements for prediction of clinically relevant CYP3A4 inducers. Biochemical pharmacology. 2008. Cui Xiaoming, et al. PubMed
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CYP3A5 genotype has no impact on plasma trough concentrations of lopinavir and ritonavir in HIV-infected subjects. Clinical pharmacology and therapeutics. 2008. Estrela R C E, et al. PubMed
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Structure, function and regulation of P-glycoprotein and its clinical relevance in drug disposition. Xenobiotica; the fate of foreign compounds in biological systems. 2008. Zhou S-F. PubMed
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Pharmacokinetics and safety of saquinavir/ritonavir and omeprazole in HIV-infected subjects. Clinical pharmacology and therapeutics. 2008. Singh K, et al. PubMed
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Pharmacogenetics of antiretroviral agents. Current opinion in HIV and AIDS. 2008. Owen Andrew, et al. PubMed
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Lopinavir-ritonavir dramatically affects the pharmacokinetics of irinotecan in HIV patients with Kaposi's sarcoma. Clinical pharmacology and therapeutics. 2008. Corona G, et al. PubMed
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A human immunodeficiency virus protease inhibitor is a novel functional inhibitor of human pregnane X receptor. Drug metabolism and disposition: the biological fate of chemicals. 2008. Healan-Greenberg Christine, et al. PubMed
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The effect of lopinavir/ritonavir on the renal clearance of tenofovir in HIV-infected patients. Clinical pharmacology and therapeutics. 2008. Kiser J J, et al. PubMed
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Ritonavir 100 mg does not cause QTc prolongation in healthy subjects: a possible role as CYP3A inhibitor in thorough QTc studies. Clinical pharmacology and therapeutics. 2008. Sarapa N, et al. PubMed
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Polymorphisms in the drug transporter gene ABCB1 predict antidepressant treatment response in depression. Neuron. 2008. Uhr Manfred, et al. PubMed
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Citalopram enantiomers in plasma and cerebrospinal fluid of ABCB1 genotyped depressive patients and clinical response: a pilot study. Pharmacological research : the official journal of the Italian Pharmacological Society. 2008. Nikisch Georg, et al. PubMed
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The effect of ABCB1 polymorphism on the pharmacokinetics of saquinavir alone and in combination with ritonavir. Clinical pharmacology and therapeutics. 2007. la Porte C J L, et al. PubMed
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Contribution of 20 single nucleotide polymorphisms of 13 genes to dyslipidemia associated with antiretroviral therapy. Pharmacogenetics and genomics. 2007. Arnedo Mireia, et al. PubMed
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Genetic factors influencing atazanavir plasma concentrations and the risk of severe hyperbilirubinemia. AIDS (London, England). 2007. Rodríguez-Nóvoa Sonia, et al. PubMed
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Cobalamin potentiates vinblastine cytotoxicity through downregulation of mdr-1 gene expression in HepG2 cells. Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology. 2007. Marguerite Véronique, et al. PubMed
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Mechanism of inhibition of P-glycoprotein mediated efflux by vitamin E TPGS: influence on ATPase activity and membrane fluidity. Molecular pharmaceutics. 2007. Collnot Eva-Maria, et al. PubMed
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Gilbert's disease and atazanavir: from phenotype to UDP-glucuronosyltransferase haplotype. Hepatology (Baltimore, Md.). 2006. Lankisch Tim O, et al. PubMed
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Ritonavir-fluticasone interaction causing Cushing syndrome in HIV-infected children and adolescents. The Pediatric infectious disease journal. 2006. Arrington-Sanders Renata, et al. PubMed
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Orosomucoid (alpha1-acid glycoprotein) plasma concentration and genetic variants: effects on human immunodeficiency virus protease inhibitor clearance and cellular accumulation. Clinical pharmacology and therapeutics. 2006. Colombo Sara, et al. PubMed
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Systematic screening for polymorphisms in the CYP3A4 gene in the Chinese population. Pharmacogenomics. 2006. Du Jing, et al. PubMed
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Drug-drug interaction between pitavastatin and various drugs via OATP1B1. Drug metabolism and disposition: the biological fate of chemicals. 2006. Hirano Masaru, et al. PubMed
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Gefitinib modulates the function of multiple ATP-binding cassette transporters in vivo. Cancer research. 2006. Leggas Markos, et al. PubMed
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Drug interactions with lipid-lowering drugs: mechanisms and clinical relevance. Clinical pharmacology and therapeutics. 2006. Neuvonen Pertti J, et al. PubMed
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Impact of P-glycoprotein on clopidogrel absorption. Clinical pharmacology and therapeutics. 2006. Taubert Dirk, et al. PubMed
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Evaluation of 170 xenobiotics as transactivators of human pregnane X receptor (hPXR) and correlation to known CYP3A4 drug interactions. Current drug metabolism. 2006. Sinz Michael, et al. PubMed
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Associations among race/ethnicity, ApoC-III genotypes, and lipids in HIV-1-infected individuals on antiretroviral therapy. PLoS medicine. 2006. Foulkes Andrea S, et al. PubMed
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Single nucleotide polymorphisms in human P-glycoprotein: its impact on drug delivery and disposition. Expert opinion on drug delivery. 2006. Dey Surajit. PubMed
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Overview of the pharmacogenetics of HIV therapy. The pharmacogenomics journal. 2006. Rodríguez-Nóvoa S, et al. PubMed
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In vitro inhibition of UDP glucuronosyltransferases by atazanavir and other HIV protease inhibitors and the relationship of this property to in vivo bilirubin glucuronidation. Drug metabolism and disposition: the biological fate of chemicals. 2005. Zhang Donglu, et al. PubMed
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Gilbert syndrome and the development of antiretroviral therapy-associated hyperbilirubinemia. The Journal of infectious diseases. 2005. Rotger Margalida, et al. PubMed
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Modeling the influence of APOC3, APOE, and TNF polymorphisms on the risk of antiretroviral therapy-associated lipid disorders. The Journal of infectious diseases. 2005. Tarr Philip E, et al. PubMed
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Influence of lipid lowering fibrates on P-glycoprotein activity in vitro. Biochemical pharmacology. 2004. Ehrhardt Manuela, et al. PubMed
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Interactions of human P-glycoprotein with simvastatin, simvastatin acid, and atorvastatin. Pharmaceutical research. 2004. Hochman Jerome H, et al. PubMed
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Polymorphisms in human MDR1 (P-glycoprotein): recent advances and clinical relevance. Clinical pharmacology and therapeutics. 2004. Marzolini Catia, et al. PubMed
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MDR1 gene polymorphisms and phase 1 viral decay during HIV-1 infection: an adult AIDS Clinical Trials Group study. Journal of acquired immune deficiency syndromes (1999). 2003. Haas David W, et al. PubMed
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Genetic polymorphisms of the human MDR1 drug transporter. Annual review of pharmacology and toxicology. 2003. Schwab Matthias, et al. PubMed
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CYP3A4 induction by drugs: correlation between a pregnane X receptor reporter gene assay and CYP3A4 expression in human hepatocytes. Drug metabolism and disposition: the biological fate of chemicals. 2002. Luo Gang, et al. PubMed
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Med-psych drug-drug interactions update. Psychosomatics. 2002. Armstrong Scott C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Peptide mimetic HIV protease inhibitors are ligands for the orphan receptor SXR. The Journal of biological chemistry. 2001. Dussault I, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Interaction of omeprazole, lansoprazole and pantoprazole with P-glycoprotein. Naunyn-Schmiedeberg's archives of pharmacology. 2001. Pauli-Magnus C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
The role of intestinal P-glycoprotein in the interaction of digoxin and rifampin. The Journal of clinical investigation. 1999. Greiner B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Biochemical, cellular, and pharmacological aspects of the multidrug transporter. Annual review of pharmacology and toxicology. 1999. Ambudkar S V, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Effect of ritonavir on the pharmacokinetics of ethinyl oestradiol in healthy female volunteers. British journal of clinical pharmacology. 1998. Ouellet D, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Simple high-performance liquid chromatographic determination of the protease inhibitor indinavir in human plasma. Journal of chromatography. B, Biomedical sciences and applications. 1998. Jayewardene A L, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Competitive, non-competitive and cooperative interactions between substrates of P-glycoprotein as measured by its ATPase activity. Biochimica et biophysica acta. 1997. Litman T, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
P-glycoprotein structure and evolutionary homologies. Cytotechnology. 1993. Croop J M. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Clinical pharmacokinetics of prednisone and prednisolone. Clinical pharmacokinetics. 1990. Frey B M, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00503
PDB:
RIT
KEGG Compound:
C07240
KEGG Drug:
D00427
PubChem Compound:
392622
PubChem Substance:
46505050
612199
Drugs Product Database (DPD):
2241480
BindingDB:
520
ChemSpider:
347980
HET:
RIT
Therapeutic Targets Database:
DAP000169

Clinical Trials

These are trials that mention ritonavir and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.