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Drug Interactions between Evotaz and Orbactiv

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

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Interactions between your drugs

Moderate

cobicistat oritavancin

Applies to: Evotaz (atazanavir / cobicistat) and Orbactiv (oritavancin)

GENERALLY AVOID: Coadministration with moderate or weak inducers of CYP450 3A4 may reduce the plasma concentrations of cobicistat, which is primarily metabolized by the isoenzyme. The clinical significance is unknown.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, concomitant use of antiretroviral regimens containing cobicistat with these inducers should be avoided. Alternative treatment combinations that do not include metabolic inducers should be considered whenever possible. If concomitant use is required, close clinical and laboratory monitoring of antiretroviral response is recommended.

References

  1. Smith DS, Fujimoto JM (1974) "Alterations produced by novobiocin during biliary excretion of morphine, morphine-3-glucuronide and other compounds." J Pharmacol Exp Ther, 188, p. 504-15
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  4. EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid
  5. Cerner Multum, Inc. "Australian Product Information."
  6. (2014) "Product Information. Tybost (cobicistat)." Gilead Sciences
  7. (2015) "Product Information. Genvoya (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences
View all 7 references

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Drug and food interactions

Moderate

atazanavir food

Applies to: Evotaz (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.


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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.