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Drug Interactions between atazanavir and medroxyprogesterone

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

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Interactions between your drugs

Moderate

medroxyPROGESTERone atazanavir

Applies to: medroxyprogesterone and atazanavir

GENERALLY AVOID: Coadministration with atazanavir may increase the plasma concentrations of ethinyl estradiol and norethindrone and possibly other contraceptive hormones. The mechanism is atazanavir inhibition of CYP450 3A4 and UGT1A1, the enzymes responsible for the metabolic clearance of contraceptive hormones. In 19 study subjects, atazanavir (400 mg once a day for 14 days) increased the mean steady-state peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and trough plasma concentration (Cmin) of ethinyl estradiol (Ortho-Novum 7/7/7) by 15%, 48% and 91%, respectively, compared to administration of the oral contraceptive alone. The Cmax, AUC and Cmin of norethindrone were increased by 67%, 110% and 262%, respectively. Decreased HDL or increased insulin resistance may be associated with elevated plasma concentrations of norethindrone.

MANAGEMENT: The manufacturer recommends alternate methods of nonhormonal contraception during atazanavir or atazanavir-ritonavir therapy.

References

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

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Drug and food interactions

Moderate

atazanavir food

Applies to: atazanavir

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

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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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