Synthivan (Atazanavir and Ritonavir)
Description of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Synthivan (Atazanavir 300mg + Ritonavir 100mg) belongs to anti-retroviral agent which includes active ingredients like Atazanavir sulfate and Ritonavir. Both components having anti-retroviral activity and it is protease inhibitors. Protease enzyme which is Specific for cell maturation and proliferation. Synthivan (Atazanavir 300mg + Ritonavir 100mg) is not a curable but it decrease the progression of the infection.
Medical use /Indication of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet is a fixed dose combination which indicated for the treatment of HIV type I infected associated with AIDS. Synthivan (Atazanavir 300mg + Ritonavir 100mg) is used only for reducing the progression of HIV virus maturation and replications It is not cure or prevents the infectious condition
Mechanism of Action Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Atazanavir sulfate, belongs to azapeptide HIV-1 protease inhibitor, which show activity against HIV virus type I Normally protease enzyme is specific for proteolytic cleavage of viral polyprotein into functional proteins present in infectious HIV-1. This atazanavir bounds to the active site of the protease enzyme and prohibits its activity. This inhibition causes to prevent the different of viral polyprotein; it concludes formation of immature cells and turns to non-infectious cells Ritonavir, it is a peptidomimetic HIV protease inhibitor. Low dose of Ritonavir acts as pharmacokinetic booster of concomitantly used other anti-retroviral drug Atazanavir, it increase the plasma concentration of Atazanavir concurrently
Absorption of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Atazanavir is fastly absorbed , high plasma concentration is 2.5 hours. If Synthivan (Atazanavir 300mg + Ritonavir 100mg) is taken with food, Oral bioavailability is 60-68%
Distribution of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Atazanavir is highly bound to human serum protein nearly 86%. It bounds to alpha-1-acid glycoprotein and albumin (89% and 86%) respectively.
Metabolism of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
The major biotransformation pathways like; Monooxygenation Dioxygenation Synthivan (Atazanavir 300mg + Ritonavir 100mg) is highly metabolized in liver. It is metabolized by CYP3A.
Elimination of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
The route of elimination is not known clearly. The Synthivan (Atazanavir 300mg + Ritonavir 100mg) in healthy persons terminal half life is 7 hours.
Side effects of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
The serious effects that caused by Atazanavir :
Cardiac conduction abnormalities
Rashes
Hyperbilirubinaemia
Chronic kidney disease
Nephrolithiasis and cholelithiasis
Nausea
Jaundice/scleral icterus
Diarrhea, edema
Fever
Depression
Myalgia
Hepatic function abnormalities
Alopecia
Arthralgia
Pancreatitis
QTc prolongation.
Precaution of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Some drug interaction may have chance to get; Severe skin reactions, Hyperbilirubinaemia, hepatoxicity, chronic kidney disease If patient suggested for concomitant therapy, care should be taken to reduce life threatening conditions Combination of ritonavir with some other drugs like sedative, hypnotics, anti-arrhythmia may leads to severe life threatening adverse reactions.
Drug interaction of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Atazanavir is a CYP3A4 substrate, drug which induce CYP3A4 may cause to reduce the serum concentration and therapeutic effects of the atazanavir. Concomitant use of Didanosine with Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablets leads to decrease the atazanavir exposure Interaction of Tenofovir with Synthivan (Atazanavir 300mg + Ritonavir 100mg): decrease the AUC and Cmin of atazanavir and increase the plasma concentration of tenofovir While Atazanavir combined with efavirenz: decrease the exposure of atazanavir Some list of medicines; Saquinavir, antacids, amiodarone, lidocaine, quinidine, carbamazepine, phenytoin, phenobarbitol etc
Contraindication of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Patients are highly contraindicated to the components that present in the Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet While Synthivan (Atazanavir 300mg + Ritonavir 100mg) co administered with drugs which are highly dependent on CYP3A leads to increasing plasma concentration of interacting drugs causes life threatening conditions Synthivan (Atazanavir 300mg + Ritonavir 100mg) concomitant with strongly CYP3A inducers may causes loss of efficacy of atazanavir List of medicines that are contraindicated; Alfuzosin, rifampicin, Irinotecan, Lurasidone, Pimozide, Midazolam, st. johns wort, lovastatin, simvastatin, sildenafil, indinavir, nevirapine,
Pregnancy & Lactation of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Pregnancy category C
Pregnancy category: B Chances of getting lactic acidosis syndrome, symptomatic hyperlactatemia occurs in pregnant women while using atazanavir with nucleoside analogues
Synthivan (Atazanavir 300mg + Ritonavir 100mg) should not recommended for pregnant women and who become pregnant. Synthivan (Atazanavir 300mg + Ritonavir 100mg) not recommended for breastfeeding mothers
Dosage of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet should be taken with food The recommended dose of Synthivan (Atazanavir 300mg + Ritonavir 100mg) based on the medical history of the patients Synthivan (Atazanavir 300mg + Ritonavir 100mg) is a prescription medicine; it is administered under the guidance of medical practitioner The recommended dose of Synthivan (Atazanavir 300mg + Ritonavir 100mg) for adult patients: One tablet should be taken orally with meals as a single dose.
Combination therapy : One tablet should be taking once daily with food, if Synthivan (Atazanavir 300mg + Ritonavir 100mg) is combined with any medicines like; Tenofovir H2 receptor antagonist: The dose of H2 receptor antagonist like famotidine should not exceed 40mg two times a day. Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet is administered concurrently with or 10 hours after the dose of famotidine. Proton pump inhibitor: Omeprazole, a proton pump inhibitor it should not exceed to 20mg. Omeprazole should be administered in 12 hours prior to the dose of Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet.
Dose recommendation for therapy experienced patients :
If H2 receptor antagonist co administered with Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet, dose of famotidine should not exceed to 20mg twice daily. Synthivan (Atazanavir 300mg + Ritonavir 100mg) should be taken with food if co administered with famotidine Synthivan (Atazanavir 300mg + Ritonavir 100mg) should not be taken, if both tenofovir and H2 receptor antagonist has been taken together. Proton pump inhibitor drugs should not taken, if treatment experienced patient taking Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablets Efavirenz should not concomitant with Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet; it leads to decrease the Synthivan (Atazanavir 300mg + Ritonavir 100mg) exposure.
Storage of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
Synthivan (Atazanavir 300mg + Ritonavir 100mg) tablet container should be stored at 25℃ (77℃); excursions are permitted between 15℃ and 30℃ (59℃ and 86℃).
Missed dose of Synthivan (Atazanavir 300mg + Ritonavir 100mg)
if patient fail to administer the dose, advice them to take within a time. Or the missed dose should be swap and follow the regular drug schedule.
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