Saquinavir tenofovir

Drugs that may be affected by atazanavir include the following antiarrhythmics, atenolol, benzodiazepines, calcium channel blockers, cisapride, clarithromycin, ergot derivatives, HMG-CoA reductase inhibitors, immunosuppressants, indinavir, irinotecan, itraconazole, ketoconazole, oral contraceptives, PDE5 inhibitors, pimozide, rifabutin, saquinavir, tenofovir, tricyclic antidepressants, voriconazole, warfarin. 

Etravirine Delavirdine, efavirenz, lopinavir/ritonavir, nevirapine, ritonavir, tipranavir Darunavir, saquinavir, tenofovir... 

Zidovudine Didanosine Stavudine Lamivudine Abacavir Tenofovir Emtricitabine Nevirapine Efavirenz TMC125 Saquinavir Indinavir Lopinavir Fosamprenavir Atazanavir Tipranavir Darunavir Raltegravir Elvitegravir Enluvirtide Maraviroc Vicriviroc Bevirimat... 

Tenofovir + Emtricitabine Zidovudine + Lamivudine Abacavir + Lamivudine Efavirenz or Nevirapine Lopinavir/r or Atazanavir/r or Eosamprenavir/r or Saquinavir/r... 

Atazanavir or fosamprenavir or nelfinavir or saquinavir/ ritonavir, and zidovudine or stavudine or tenofovir or abacavir or didanosine, and lamivudine or emtricitabine... 

Therapies not recommended for initial treatment due to poor potency or significant toxicity include delavirdine, nevirapine in patients with moderate to high CD4+ T-cell counts, indinavir or saquinavir used without ritonavir ( unboosted ), ritonavir used without another protease inhibitor, and tenofovir plus didanosine with an NNRTI. 

APV, amprenavir ATV, atazanavir CNS, central nervous system CVD, cardiovascular disease D/C, discontinue ddC, zalcitabine ddl, didanosine DEXA, dual-energy x-ray absorptiometry d4T, stavudine EFV, efavirenz HDL, high-density lipoprotein HIV, human immunodeficiency virus HTN, hypertension IDV, indinavir LDL, low-density lipoprotein LPV/r, lopinavir+ ritonavir MRI, magnetic resonance imaging NNRTI, nonnucleoside reverse transcriptase inhibitor NRTI, nucleoside reverse transcriptase inhibitor NVP, nevirapine PI, protease inhibitor RTV, ritonavir SQV, saquinavir TDF, tenofovir disoproxil fumarate TG, triglyceride TPV/r, tipranivir + ritonavir ZDV, zidovudine. 

TC Lamivudine ABC Abacavir d4T Stavudine ddC Zalcitabine ddl Didanosine TDF Tenofovir ZDV Zidovudine, also abbreviated as AZT FTC Emtricitabine NVP Nevirapine DLV Delavirdine EFV Efavirenz RTV, r Ritonavir Pl/r Ritonavir boosted protease inhibitor SQV Saquinavir IDV Indinavir LPV Lopinavir NEV Nelfinavir APV Amprenavir ATV Atazanavir DRV Darunavir... 

Saquinavir Atazanavir, delavirdine, indinavir, lopinavir, nelfinavir, tenofovir Efavirenz, nevirapine, tipranavir... 

ABBREVIATIONS EFV, efavirenz 3TC, lamivudine AZT, zidovudine TDF, tenofovir disoproxil fumarate d4T, stavudine LPV/r, lopinavir/ritonavir coformulation FTC, emtricitabine NVP, nevirapine ddl, didanosine ATV, atazanavir fosAPV, fosamprenavir RTV, ritonavir IDV, indinavir NFV, nelfinavir SQV, saquinavir. 

No clinically significant interaction appears to occur between adefovir and co-trimoxazole, didanosine, delavirdine, efavirenz, ibuprofen, indinavir, lamivudine, nelfinavir, nevirapine, paracetamol, tenofovir, or zidovudine. Adefovir possibly reduces saquinavir levels. 

In a placebo-controlled study in healthy subjects, efavirenz 600 mg once daily for 14 days reduced the steady-state AUC and maximum plasma level of maraviroc 100 mg twice daily by about 50%. Doubling the dose of maraviroc to 200 mg twice daily overcame this increase in metabolism, resulting in a minor 10% increase in AUC and 20% increase in maximum level, when compared with maraviroc 100 mg twice daily alone. Similarly, in another study, the AUC of a single 300-mg dose of maraviroc was about 50% lower in two groups of 8 patients one group taking efavirenz, lami vudine and zidovudine and the other taking efavirenz, didanosine and tenofovir. When efavirenz 600 mg daily was added to lopinavir/ritonavir 400/100 mg twice daily with maraviroc 300 mg twice daily, the increase in maraviroc AUC seen with these protease inhibitors , (p.780), was reduced from about 300% to about 150%, when compared with the AUC for maraviroc alone. Similarly, when efavirenz 600 mg daily was added to saquinavir/ritonavir 1000/100 mg twice daily with maraviroc 100 mg twice daily, the increase in maraviroc AUC seen with these protease inhibitors was reduced from 877% to 400%, when compared with the AUC for maraviroc alone. ... 

Atazanavir/ritonavir, darunavir/ritonavir and lopinavir/ritonavir modestly increased the levels of tenofovir, and there is at least one case report of nephrotoxicity with the combination of tenofovir, didanosine, and lopinavir/ritonavir. Saquinavir/ritonavir, ti-pranavir/ritonavir, and probably also fosamprenavir/ritonavir, have little effect on tenofovir levels. Tenofovir modestly decreased atazanavir levels, and this was minimised when ritonavir was also given. Tenofovir had no important effect on ritonavir-boosted darunavir, lopinavir, and tipranavir levels, and modestly increased those of ritonavir-boosted saquinavir in one of two studies. Indinavir and nelfinavir do not interact pharmacokineti-cally with tenofovir. 

Tenofovir disoproxil fumarate 300 mg once daily modestly increased the saquinavir AUC and minimum level by 29% and 47%, respectively, after administration of saquinavir/ritonavir 1000/100 mg twice daily in healthy subjects. The only change in tenofovir pharmacokinetics was a slight 23% increase in minimum level. In another study, mentioned hy the manufacturer of saquinavir, in 18 UTV-positive patients treated with saquinavir/ritonavir 1000/100 mg twice daily and tenofovir disoproxil fumarate 300 mg once daily, saquinavir AUC and maximum values were just 1% and 7% lower, respectively, than those seen with saquinavir/ritonavir alone. 

The decrease in atazanavir levels with tenofovir is not of clinical importance if ritonavir is also used, and this combination has been used successfully as part of antiretroviral therapy in clinical studies. Unboosted atazanavir should be used with caution or not given with tenofovir because of the potential for reduced etficacy and development of resistance. Ritonavir-boosted darunavir and lopinavir levels were not significantly affected by tenofovir, amprenavir levels were also unaffected following boosted fosamprenavir administration, and the increase in ritonavir-boosted saquinavir levels are not likely to be clinically relevant. The slight interaction between tenofovir and tipranavir/ritonavir is unlikely to be clinically relevant. There is no clinically relevant interaction between nelfinavir or indinavir and tenofovir. 

ChittickGE, Zong J, Blum MR, Sorbel JJ, Begley JA, AddaN, Kearney BP. Pharmacokinetics of tenofovir disoproxil fumarate and ritonavir-boosted saquinavir mesylate administered alone or in combination at steady state. Antimicrob Agents Chemo er (2006) 50,1304-10. 

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