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 | |
|---|---|---|---|
|
|
ABCB1 |
|
Publications |
|
|
UGT1A1 |
|
Publications |
A list of non-curated publications that mention this drug along with other genes is available.
Drug Targets
| Gene | Description | |
|---|---|---|
| ABCB1 |
|
(source: Drug Bank) |
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| acenocoumarol |
|
The protease inhibitor increase the anticoagulant effect (source: Drug Bank) |
| amiodarone |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| amitriptyline |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| amoxapine |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| atorvastatin |
|
Increases the effect and toxicity of the statin (source: Drug Bank) |
| calcium |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| cimetidine |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| cisapride |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| clarithromycin |
|
Increases levels of clarithromycin (source: Drug Bank) |
| clomipramine |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| cyclosporine |
|
Increases the effect and toxicity of immunosuppressant (source: Drug Bank) |
| desipramine |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| dicumarol |
|
The protease inhibitor increases the anticoagulant effect (source: Drug Bank) |
| diltiazem |
|
Increases the effect and toxicity of diltiazem (source: Drug Bank) |
| doxepin |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| efavirenz |
|
Efavirenz decreases the levels/effects of atazanavir (source: Drug Bank) |
| erlotinib |
|
This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank) |
| esomeprazole |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| famotidine |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| imipramine |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| indinavir |
|
Increased risk of hyperbilirubinemia with this association (source: Drug Bank) |
| irinotecan |
|
Increases levels/effect of irinotecan (source: Drug Bank) |
| lansoprazole |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| lidocaine |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| lovastatin |
|
Increased risk of myopathy/rhabdomyolysis (source: Drug Bank) |
| magnesium |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| magnesium oxide |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| magnesium sulfate |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| methylergonovine |
|
Increases the effect and toxicity of ergot derivative (source: Drug Bank) |
| midazolam |
|
Increases the effect and toxicity of benzodiazepine (source: Drug Bank) |
| nevirapine |
|
Nevirapine decreases levels/effect of atazanavir (source: Drug Bank) |
| nortriptyline |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| omeprazole |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| pantoprazole |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| pimozide |
|
The protease inhibitor increases the effect and toxicity of pimozide (source: Drug Bank) |
| protriptyline |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| quinidine |
|
Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| rabeprazole |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| ranitidine |
|
This gastric pH modifier decreases the levels/effects of atazanavir (source: Drug Bank) |
| rifabutin |
|
Increases levels/toxicity of rifabutin (source: Drug Bank) |
| rifampin |
|
Rifampin reduces levels and efficacy of atazanavir (source: Drug Bank) |
| ritonavir |
|
Association with dose adjustment (source: Drug Bank) |
| sildenafil |
|
Increases the effect and toxicity of sildenafil (source: Drug Bank) |
| simvastatin |
|
Increased risk of myopathy/rhabdomyolysis (source: Drug Bank) |
| sirolimus |
|
Increases the effect and toxicity of immunosuppressant (source: Drug Bank) |
| sodium bicarbonate |
|
This gastric pH modifier decreases the levels/effect of atazanavir (source: Drug Bank) |
| sunitinib |
|
Possible increase in sunitinib levels (source: Drug Bank) |
| tacrolimus |
|
Increases the effect and toxicity of immunosuppressant (source: Drug Bank) |
| tenofovir |
|
Tenofovir decreases the levels/effects of atazanavir (source: Drug Bank) |
| triazolam |
|
Increases the effect and toxicity of benzodiazepine (source: Drug Bank) |
| trimipramine |
|
Increases the effect and toxicity of tricyclics (source: Drug Bank) |
| warfarin |
|
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 | |
|---|---|---|---|
|
|
Drug Toxicity |
|
Publications |
|
|
HIV |
|
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.
LinkOuts
Common Searches
Search PubMed
Search Medline Plus
Search PubChem
Search CTD
Non-Curated Publications
A list of non-curated publications that mention this drug is available.
