Atazanavir / ritonavir

Oxcarbazepine

Not recommended association.

No pharmaceutical opinion available for this interaction.

Mechanism

Oxcarbazepine can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Atazanavir / ritonavir.

Atazanavir / ritonavir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Monitor for signs and symptoms of therapeutic failure.

Dosage adjustment may be required.

Alternative solution(s)

Oxcarbazepine

Pharmacodynamic effects

Recommendations

Avoid association. Choose an alternative.

Alternative solution(s)

Gabapentin, pregabalin, leviracetam.

Monitor

Tests

Atazanavir plasma level

CD4+

Viral load HIV

Pharmacokinetic parameters

Comment

Ref #3570: TDM data were evaluated 11 HIV-positive patients treated concomitantly with carbamazepine or oxcarbazepine and antiretrovirals for at least 3 months. All the TDM evaluations for carbamazepine and oxcarbazepine were within therapeutic ranges. Conversely, trough concentrations for atazanavir demonstrated significantly lower values (- 65%) when compared with values usually measured in HIV-infected patients not treated with antiepileptic drugs.

Reference
  • 122
    Ritonavir (Norvir), Corporation AbbVie, Quebec, Canada, 5 juillet 2021.
  • 3141
    Oxcarbazepine (Trileptal), Novartis, Québec, Canada, 18 mars 2015.