Drug/Small Molecule:
atazanavir

Overview

Generic Names: ATV; ATZ; Atazanavir sulfate; BMS-232632; atazanavir
Trade Names: Latazanavir; Reyataz; Zrivada
PharmGKB Accession Id: PA10251

Description

Atazanavir (formerly known as BMS-232632) is an antiretroviral drug of the protease inhibitor (PI) class. Like other antiretrovirals, it is used to treat infection of human immunodeficiency virus (HIV). Atazanavir is distinguished from other PIs in that it can be given once-daily (rather than requiring multiple doses per day) and has lesser effects on the patient's lipid profile (the amounts of cholesterol and other fatty substances in the blood). Like other protease inhibitors, it is used only in combination with other HIV medications. The U.S. Food and Drug Administration (FDA) approved atazanavir on June 20, 2003. Wikipedia (source: Drug Bank)

Indication

For use, in combination with other antiretroviral agents, in the treatment of HIV-1 infection. (source: Drug Bank)

ATC Therapeutic Category

  • J05AE:Protease inhibitors

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Atazanavir selectively inhibits the virus-specific processing of viral Gag and Gag-Pol polyproteins in HIV-1 infected cells, thus preventing formation of mature virions. (source: Drug Bank)

Pharmacology

Atazanavir (ATV) is an azapeptide HIV-1 protease inhibitor (PI). It 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. Atazanavir 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 Interactions

Administration with food reduces pharmacokinetic variability.
Food increases product absorption. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Atazanavir is extensively metabolized in humans, primarily by the liver. The major biotransformation pathways of atazanavir in humans consisted of monooxygenation and dioxygenation. Other minor biotransformation pathways for atazanavir or its metabolites consisted of glucuronidation, N-dealkylation, hydrolysis, and oxygenation with dehydrogenation. In vitro studies using human liver microsomes suggested that atazanavir is metabolized by CYP3A. (source: Drug Bank)

Protein Binding

86% bound to human serum proteins (alpha-1-acid glycoprotein and albumin). Protein binding is independent of concentration. (source: Drug Bank)

Absorption

Atazanavir is rapidly absorbed with a T<sub>max</sub> of approximately 2.5 hours. Administration of atazanavir with food enhances bioavailability and reduces pharmacokinetic variability. Oral bioavailability is 60-68%. (source: Drug Bank)

Isomeric SMILES Code:

CC(C)(C)[C@@H](C(=O)N[C@@H](CC1=CC=CC=C1)[C@H](CN(CC2=CC=C(C=C2)C3=CC=CC=N3)NC(=O)[C@H](C(C)(C)C)NC(=O)OC)O)NC(=O)OC (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
ABCB1
  •   
  •   
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
UGT1A1
  •   
  •   
  • PK
  •   
  • GN
Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
ABCB1 Uncurated Annotation (source: Drug Bank)

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
acenocoumarol Uncurated Annotation The protease inhibitor increase the anticoagulant effect (source: Drug Bank)
amiodarone Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
amitriptyline Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
amoxapine Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
atorvastatin Uncurated Annotation Increases the effect and toxicity of the statin (source: Drug Bank)
calcium Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
cimetidine Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
cisapride Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
clarithromycin Uncurated Annotation Increases levels of clarithromycin (source: Drug Bank)
clomipramine Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
cyclosporine Uncurated Annotation Increases the effect and toxicity of immunosuppressant (source: Drug Bank)
desipramine Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
dicumarol Uncurated Annotation The protease inhibitor increases the anticoagulant effect (source: Drug Bank)
diltiazem Uncurated Annotation Increases the effect and toxicity of diltiazem (source: Drug Bank)
doxepin Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
efavirenz Uncurated Annotation Efavirenz decreases the levels/effects of atazanavir (source: Drug Bank)
erlotinib Uncurated Annotation This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank)
esomeprazole Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
famotidine Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
imipramine Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
indinavir Uncurated Annotation Increased risk of hyperbilirubinemia with this association (source: Drug Bank)
irinotecan Uncurated Annotation Increases levels/effect of irinotecan (source: Drug Bank)
lansoprazole Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
lidocaine Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
lovastatin Uncurated Annotation Increased risk of myopathy/rhabdomyolysis (source: Drug Bank)
magnesium Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
magnesium oxide Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
magnesium sulfate Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
methylergonovine Uncurated Annotation Increases the effect and toxicity of ergot derivative (source: Drug Bank)
midazolam Uncurated Annotation Increases the effect and toxicity of benzodiazepine (source: Drug Bank)
nevirapine Uncurated Annotation Nevirapine decreases levels/effect of atazanavir (source: Drug Bank)
nortriptyline Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
omeprazole Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
pantoprazole Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
pimozide Uncurated Annotation The protease inhibitor increases the effect and toxicity of pimozide (source: Drug Bank)
protriptyline Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
quinidine Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
rabeprazole Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
ranitidine Uncurated Annotation This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank)
rifabutin Uncurated Annotation Increases levels/toxicity of rifabutin (source: Drug Bank)
rifampin Uncurated Annotation Rifampin reduces levels and efficacy of atazanavir (source: Drug Bank)
ritonavir Uncurated Annotation Association with dose adjustment (source: Drug Bank)
sildenafil Uncurated Annotation Increases the effect and toxicity of sildenafil (source: Drug Bank)
simvastatin Uncurated Annotation Increased risk of myopathy/rhabdomyolysis (source: Drug Bank)
sirolimus Uncurated Annotation Increases the effect and toxicity of immunosuppressant (source: Drug Bank)
sodium bicarbonate Uncurated Annotation This gastric pH modifier decreases the levels/effect of atazanavir (source: Drug Bank)
sunitinib Uncurated Annotation Possible increase in sunitinib levels (source: Drug Bank)
tacrolimus Uncurated Annotation Increases the effect and toxicity of immunosuppressant (source: Drug Bank)
tenofovir Uncurated Annotation Tenofovir decreases the levels/effects of atazanavir (source: Drug Bank)
triazolam Uncurated Annotation Increases the effect and toxicity of benzodiazepine (source: Drug Bank)
trimipramine Uncurated Annotation Increases the effect and toxicity of tricyclics (source: Drug Bank)
warfarin Uncurated Annotation The protease inhibitor increases the anticoagulant effect (source: Drug Bank)

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
Drug Toxicity
  • CO
  •   
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
HIV
  •   
  •   
  • PK
  •   
  • GN
Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. Genetic Variants in Protease Inhibitor associated Adverse Events

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB01072
KEGG Drug ID:
D01276
PubChem Compound ID:
148192
PubChem Substance ID:
725881

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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