Atazanavir Rifampin

Protease inhibitors (amprenavir, atazanavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir) Rifampin... 

Drugs that may affect atazanavir include the following antacids and buffered medications, clarithromycin, didanosine (buffered formulation only), efavirenz, H2-receptor antagonists, indinavir, itraconazole, ketoconazole, nevirapine, proton pump inhibitors, rifampin, ritonavir, St. John s wort, tenofovir, voriconazole. 

Others Acetaminophen, amiodarone, carbamazepine, delavirdine, efavirenz, nevirapine, quinidine, repaglinide, sildenafil, tadalafil, trazodone, vardenafil Amiodarone, amprenavir, atazanavir, ciprofloxacin, cisapride, clarithromycin, diltiozem, erythromycin, fluconazole, fluvoxamine, grapefruit juice (in high ingestion), indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, norfloxacin, ritonavir, telithromycin, troleandomycin, verapamil, voriconazole Carbamazepine, efavirenz, glucocorticoids, macrolide antibiotics, nevirapine, phenytoin, phenobarbital, rifabutin, rifapentine, rifampin, St. John s wort... 

Ethinyl estradiol, buprenorphine ferulic acid, genistein naltrexone (low), naloxone (low), SN-38 (active metabolite of irinotecan) alizarin, quinalizarin, retigabine Bilirubin, chloropheno- Atazanavir, indinavir, xypropionic acid, chrysin, ketoconazole (AT, = 3 pM) clofibrate, 3-MC, oltipraz, phenylpropionic acid, phenobarbital, clotrimazole, rifampin, and St. John s wort. WY-14643 Response elements for AhR, CAR, GR, PPAR-a, PXR, Nrf2 (antioxidant response element) have been identified... 

A4/3A5 Midazolam, buspirone, felodipine, lovastatin, eletriptan, sildenafil, simvastatin, triazolam Atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin Rifampin, carbamazepine... 

Allergic interstitial nephritis Penicillins, rifampin, sulfonamides, thiazides, cimetidine.phenytoin, allopurinol, furosemide, NSAIDS, ciprofloxacin, pantoprazole, omeprazole, atazanavir, bevacizumab Rash, fever, eosinophilia, eosinophiluria, pyuria... 

Clinically important, potentially hazardous interactions with atazanavir, carbamazepine, clarithromycin, CYP3A4 inhibitors, dexamethasone, grapefruit juice, indinavir, itraconazole, nefazodone, nelfinavir, phenobarbital, phenytoin, rifabutin, rifampin, rifapentin, ritonavir, saquinavir, St John s wort, telithromycin, voriconazole. The concomitant use of strong CYP3A4 inducers should be avoided... 

Clinically important, potentially hazardous interactions with alfentanil, alfuzosin, alprazolam, amiodarone, amprenavir, aprepitant, astemizole, atazanavir, bepridil, buprenorphine, bupropion, carbamazepine, chlordiazepoxide, ciclesonide, clozapine, conivaptan, cyclosporine, cyproterone, dasatinib, diazepam, dihydroergotamine, ergot alkaloids, estazolam, eszopidone, etravirine, ezetimibe, fentanyl, fesoterodine, flecainide, flurazepam, fluticasone, halazepam, ivabradine, ixabepilone, ketoconazole, lapatinib, levothyroxine, meperidine, meptazinol, methysergide, midazolam, nifedipine, nilotinib, oral contraceptives, phenytoin, pimozide, piroxicam, propafenone, propoxyphene, quazepam, quinidine, ranolazine, rifabutin, rifampin, rifapentine, rimonabant, rivaroxaban, saquinavir, sildenafil, silodosin, simvastatin, solifenacin, St John s wort, tadalafil, temsirolimus, trabectedin, triazolam, vardenafil, voriconazole, zolpidem... 

HIV-1 infection. Like indinavir, atazanavir frequently causes unconjugated hyperbilirubinemia, although this is mainly a cosmetic side effect and is not associated with other hepatotoxicity. Because atazanavir is metabolized by cytochrome (CYP3A4), concomitant administration of agents that induce this enzyme (e.g., rifampin) is contraindicated. 

Rifampicin (rifampin) bioavaiiabiiity is increased by indinavir, but amprenavir has no effect. Rifampicin markedly reduces the bioavailability of amprenavir, atazanavir/ritonavir, indinavir, indinavir with ritonavir, iopinavir/ritonavir, nelfinavir and saquinavir, but oniy modestiy reduces that of ritonavir. The effects of rifampicin on iopinavir/ritonavir and saquinavir/ritona-vir can be overcome by increasing the protease inhibitor dose, but this appears to increase adverse effects (hepatotoxicity). 

Rifampicin (Rifampin). When rifampicin 600 mg daily was given with atazanavir/ritonavir 300/100 mg once daily, the AUC and minimum levels of atazanavir were markedly reduced, by 72% and 98%, respectively. ... 

Haas DW, Koletar SL, Laughlin L, Kendall MA, Suckow C, Gerber JG, Zolopa AR, Berfz R, Child MJ, Hosey L, Alston-Smith B, Acosta EP. Hepatotoxicity and gastrointestinal intolerance when healthy volunteers taking rifampin add twice-daily atazanavir and ritonavir. J Acquir Immune Defic Syndr 2009 50(3) 290-3. 

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