DDInter458 DDInter1607
Cyclosporine is a calcineurin inhibitor known for its immunomodulatory properties that prevent organ transplant rejection and treat various inflammatory and autoimmune conditions. It is isolated from the fungus _Beauveria nivea_. Initially manufactured by Sandoz and approved for use by the FDA in 1983, cyclosporine is now available in various products by Novartis (previously known as Sandoz).[L11097,L3734,L11118]
Ritonavir is an HIV protease inhibitor that interferes with the reproductive cycle of HIV. Although it was initially developed as an independent antiviral agent, it has been shown to possess advantageous properties in combination regimens with low-dose ritonavir and other protease inhibitors. It is now more commonly used as a booster of other protease inhibitors and is available in both liquid formulations and as capsules. While ritonavir is not an active antiviral agent against hepatitis C virus (HCV) infection, it is added in combination therapies indicated for the treatment of HCV infections as a booster. Ritonavir is a potent CYP3A inhibitor that increases peak and trough plasma drug concentrations of other protease inhibitors such as and overall drug exposure. American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) guidelines recommend ritonavir-boosted combination therapies as first-line therapy for HCV Genotype 1a/b and 4 treatment-naïve patients with or without cirrhosis. Ritonavir is found in a fixed-dose combination product with , , and as the FDA-approved product Viekira Pak. First approved in December 2014, Viekira Pak is indicated for the treatment of HCV genotype 1b without cirrhosis or with compensated cirrhosis, and when combined with Ribavirin for the treatment of HCV genotype 1a without cirrhosis or with compensated cirrhosis. Ritonavir is also available as a fixed-dose combination product with and as the FDA- and Health Canada-approved product Technivie. First approved in July 2015, Technivie is indicated in combination with Ribavirin for the treatment of patients with genotype 4 chronic hepatitis C virus (HCV) infection without cirrhosis or with compensated cirrhosis. In Canada, ritonavir is also available as a fixed-dose combination product with , , and as the Health Canada-approved, commercially available product Holkira Pak. First approved in January 2015, Holkira Pak is indicated for the treatment of HCV genotype 1b with or without cirrhosis, and when combined with Ribavirin for the treatment of HCV genotype 1a with or without cirrhosis. The inclusion of ritonavir can select for HIV-1 protease inhibitor resistance-associated substitutions. Any HCV/HIV-1 co-infected patients treated with ritonavir-containing combination therapies should also be on a suppressive antiretroviral drug regimen to reduce the risk of HIV-1 protease inhibitor drug resistance. Ritonavir is combined with other drugs to treat coronavirus disease 2019 (COVID-19) in patients at risk for progressing into a severe form of the disease, such as [nirmatrelvir].
Cyclosporine {u} (Compound) binds {v} (Gene) SLCO1A2
SLCO1A2 {u} (Gene) is bound by {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) is included by {v} (Pharmacologic Class) P-Glycoprotein Inhibitors
P-Glycoprotein Inhibitors {u} (Pharmacologic Class) includes {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) causes {v} (Side Effect) Blood triglycerides increased
Blood triglycerides increased {u} (Side Effect) is caused by {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) binds {v} (Gene) ABCC1
ABCC1 {u} (Gene) is bound by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) binds {v} (Gene) ABCG2
ABCG2 {u} (Gene) regulates {v} (Gene) AGR2
AGR2 {u} (Gene) is upregulated by {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) binds {v} (Gene) CYP2D6
CYP2D6 {u} (Gene) is bound by {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) is included by {v} (Pharmacologic Class) P-Glycoprotein Inhibitors
P-Glycoprotein Inhibitors {u} (Pharmacologic Class) includes {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) is included by {v} (Pharmacologic Class) Cytochrome P450 3A4 Inhibitors
Cytochrome P450 3A4 Inhibitors {u} (Pharmacologic Class) includes {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) causes {v} (Side Effect) Blood triglycerides increased
Blood triglycerides increased {u} (Side Effect) is caused by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Cyclosporine {u} (Compound) upregulates {v} (Gene) EDEM1
EDEM1 {u} (Gene) is upregulated by {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Cyclosporine (Compound) binds SLCO1A2 (Gene) and SLCO1A2 (Gene) is bound by Ritonavir (Compound)
Cyclosporine (Compound) is included by P-Glycoprotein Inhibitors (Pharmacologic Class) and P-Glycoprotein Inhibitors (Pharmacologic Class) includes Ritonavir (Compound)
Cyclosporine (Compound) causes Blood triglycerides increased (Side Effect) and Blood triglycerides increased (Side Effect) is caused by Ritonavir (Compound)
Cyclosporine (Compound) binds ABCC1 (Gene) and ABCC1 (Gene) is bound by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Cyclosporine (Compound) binds ABCG2 (Gene) and ABCG2 (Gene) regulates AGR2 (Gene) and AGR2 (Gene) is upregulated by Ritonavir (Compound)
Cyclosporine (Compound) binds CYP2D6 (Gene) and CYP2D6 (Gene) is bound by Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)
Cyclosporine (Compound) is included by P-Glycoprotein Inhibitors (Pharmacologic Class) and P-Glycoprotein Inhibitors (Pharmacologic Class) includes Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)
Cyclosporine (Compound) is included by Cytochrome P450 3A4 Inhibitors (Pharmacologic Class) and Cytochrome P450 3A4 Inhibitors (Pharmacologic Class) includes Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Cyclosporine (Compound) causes Blood triglycerides increased (Side Effect) and Blood triglycerides increased (Side Effect) is caused by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Cyclosporine (Compound) upregulates EDEM1 (Gene) and EDEM1 (Gene) is upregulated by Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)