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Drug Interactions between atazanavir / cobicistat and zavegepant

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

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Interactions between your drugs

Moderate

cobicistat zavegepant

Applies to: atazanavir / cobicistat and zavegepant

GENERALLY AVOID: Coadministration with inhibitors of the organic anion transporting polypeptide (OATP) 1B3 hepatic uptake transporter and/or the hepatic bile acid uptake transporter sodium taurocholate co-transporting polypeptide (NTCP) may significantly increase the plasma concentrations and effects of zavegepant, which is a substrate of these transporters. When single-dose oral zavegepant (100 mg) was administered with the OATP 1B3 and NTCP inhibitor and strong CYP450 3A4 inducer, rifampin, at steady state, zavegepant peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 2.2- and 2.3-fold, respectively.

MANAGEMENT: Concomitant use of zavegepant with OATP 1B3 and/or NTCP inhibitors should generally be avoided.

References (4)
  1. (2023) "Product Information. Zavzpret (zavegepant)." Pfizer U.S. Pharmaceuticals Group
  2. Dong Z, Ekins S, Polli J.E (2013) "Structure activity relationship for FDA approved drugs as inhibitors of the human sodium taurocholate co-transporting polypeptide (NTCP)" Mol Pharm, 10, p. 1008-1019
  3. Solvo Biotechnology (2023) Human Transporters: NTCP (sodium/taurocholate cotransporting polypeptide) https://www.solvobiotech.com/transporters/ntcp
  4. (2022) "Product Information. HEPCLUDEX (bulevirtid)." Gilead Sciences Sweden AB, 1

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

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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