Fortovase (saquinavir) and Alcohol / Food Interactions
There are 2 alcohol/food/lifestyle interactions with Fortovase (saquinavir) which include:
Moderate Food Interaction
ADJUST DOSING INTERVAL: Food significantly increases the absorption of saquinavir.
GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of saquinavir. The primary mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. In eight healthy volunteers, ingestion of 400 mL of grapefruit juice prior to administration of a 600 mg dose of saquinavir mesylate increased the area under the plasma concentration-time curve and oral bioavailability of saquinavir by 50% and 100%, respectively, compared to water. A high degree of intersubject variability in the grapefruit juice effect was observed. The extent to which this interaction may occur with the saquinavir free base soft gelatin capsule is unknown. Presumably, it should be of a lesser magnitude based on the enhanced bioavailability of the free base over the mesylate salt formulation.
MANAGEMENT: Both the mesylate salt (hard gelatin capsule) and free base (soft gelatin capsule) formulations of saquinavir should be taken with meals or within 2 hours after eating to enhance bioavailability. Although grapefruit juice can also enhance the bioavailability of saquinavir, patients should be advised to avoid the consumption of large amounts of grapefruit and grapefruit juice during saquinavir therapy unless otherwise directed by their physician, as the interaction is unreliable and subject to a high degree of interpatient variation.
High Cholesterol (Hyperlipoproteinemia, Hypertriglyceridemia, Sitosterolemia)
Moderate Potential Hazard, High plausibility
PIs - hyperlipidemia
Hyperlipidemia have been observed in 10% of patients receiving ritonavir during clinical trials. Increases of 30% to 40% from baseline have been reported for total cholesterol and 200% to 300% or more for triglycerides. These effects have also been reported during postmarketing experience with other protease inhibitors (PIs) but may be the most dramatic with ritonavir. The clinical significance of these elevations is unclear. Severe hyperlipidemia is known to sometimes cause pancreatitis. In addition, some patients have reportedly developed symptomatic atherosclerosis and coronary artery disease after initiating PI treatment. Patients with preexisting hyperlipidemia may require closer monitoring during PI therapy, and adjustments made accordingly in their lipid-lowering regimen. PI therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.You should also know about...
Fortovase (saquinavir) drug Interactions
There are 549 drug interactions with Fortovase (saquinavir)
Fortovase (saquinavir) disease Interactions
There are 4 disease interactions with Fortovase (saquinavir) which include:
See also...
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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