No pharmaceutical opinion available for this interaction.
Oxcarbazepine can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Atazanavir / ritonavir.
3A4, P-gp/3A4 > 2D6, P-gp
Ritonavir: 1A2, 2C9, 2C19, UGT, 2B6, 3A4 (auto-induction)
3A4, UGT1A1, P-gp E et 2C8/3A4 > 2D6 > 2A6, 2E1, P-gp, MRP2
Possible decrease of clinical efficacy.
Monitor for signs and symptoms of therapeutic failure.
Dosage adjustment may be required.
Cytosolic system, UGT
3A4, P-gp, UGT
2C19 (mostly if > 1200 mg/d)
Avoid association. Choose an alternative.
Gabapentin, pregabalin, leviracetam.
Atazanavir plasma level
Viral load HIV
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.