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Drug Interactions between atazanavir / cobicistat and daclatasvir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

cobicistat daclatasvir

Applies to: atazanavir / cobicistat and daclatasvir

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of daclatasvir, which is primarily metabolized by the isoenzyme. When a single 10 mg dose of daclatasvir was administered following pretreatment with the potent CYP450 3A4 inhibitor ketoconazole (400 mg once daily), daclatasvir peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 1.6- and 3-fold, respectively.

MANAGEMENT: A reduction in the dosage of daclatasvir to 30 mg once daily is recommended when used with potent CYP450 3A4 inhibitors.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2015) "Product Information. Daklinza (daclatasvir)." Bristol-Myers Squibb

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Moderate

atazanavir daclatasvir

Applies to: atazanavir / cobicistat and daclatasvir

MONITOR: Coadministration with moderate inhibitors of CYP450 3A4 may increase the plasma concentrations of daclatasvir, which is primarily metabolized by the isoenzyme. When a single 10 mg dose of daclatasvir was administered following pretreatment with the potent CYP450 3A4 inhibitor ketoconazole (400 mg once daily), daclatasvir peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 1.6- and 3-fold, respectively. No data are available for other, less potent CYP450 3A4 inhibitors.

MANAGEMENT: Caution is advised when daclatasvir is used with moderate CYP450 3A4 inhibitors; however, according to the manufacturer, dose adjustments are not required. Patients should be monitored for adverse effects such as headache, fatigue, nausea, diarrhea, and serum lipase elevations.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2015) "Product Information. Daklinza (daclatasvir)." Bristol-Myers Squibb

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Drug and food interactions

Moderate

atazanavir food

Applies to: atazanavir / cobicistat

ADJUST DOSING INTERVAL: Administration of atazanavir with food enhances oral bioavailability and reduces pharmacokinetic variability. According to the manufacturer, administration with a light meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single 400 mg dose of atazanavir by 57% and 70%, respectively, relative to the fasting state. Administration with a high-fat meal resulted in a mean increase of 35% in atazanavir AUC and no change in Cmax compared to fasting. The coefficient of variation of AUC and Cmax decreased by approximately one-half when given with either a light or high-fat meal compared to the fasting state.

MANAGEMENT: To ensure maximal oral absorption, atazanavir should be administered with or immediately after a meal.

References

  1. (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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