DDInter1140 DDInter1607
Malaria is a protozoan disease that places an enormous burden on human health in endemic areas around the world. The 2020 World Health Organization malaria report indicates a 60% decrease in the global malaria fatality rate between 2000 to 2019. Despite this, malaria remains a significant cause of morbidity and mortality; 90% of deaths from malaria occur in Africa. Individuals at the highest risk for malaria are those in disease naïve populations, children under age 5, refugees in Central and Eastern Africa, nonimmune civilian and military travelers, pregnant women, and immigrants traveling to their place of origin. Mefloquine, commonly known as Lariam, is an antimalarial drug used for the prevention and treatment of malaria caused by infection with Plasmodium vivax and Plasmodium falciparum. The drug was initially discovered by the Walter Reed Army Institute of Research (WRAIR) during a malaria drug discovery program between 196
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].
Mefloquine {u} may lead to a major life threatening interaction when taken with {v} Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Ritonavir
Mefloquine {u} (Compound) causes {v} (Side Effect) Palpitations
Palpitations {u} (Side Effect) is caused by {v} (Compound) Ritonavir
Mefloquine {u} may lead to a major life threatening interaction when taken with {v} Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} (Compound) binds {v} (Gene) CYP2D6
CYP2D6 {u} (Gene) is bound by {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} (Compound) causes {v} (Side Effect) Palpitations
Palpitations {u} (Side Effect) is caused by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Mefloquine {u} (Compound) resembles {v} (Compound) Flecainide
Flecainide {u} (Compound) binds {v} (Gene) CYP2D6
CYP2D6 {u} (Gene) is bound by {v} (Compound) Ritonavir
Mefloquine may lead to a major life threatening interaction when taken with Atazanavir and Atazanavir (Compound) resembles Ritonavir (Compound)
Mefloquine may cause a moderate interaction that could exacerbate diseases when taken with Lopinavir and Lopinavir (Compound) resembles Ritonavir (Compound)
Mefloquine (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Ritonavir (Compound)
Mefloquine (Compound) causes Palpitations (Side Effect) and Palpitations (Side Effect) is caused by Ritonavir (Compound)
Mefloquine may lead to a major life threatening interaction when taken with Atazanavir and Atazanavir (Compound) resembles Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)
Mefloquine may cause a moderate interaction that could exacerbate diseases when taken with Lopinavir and Lopinavir (Compound) resembles Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Mefloquine (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Mefloquine (Compound) binds CYP2D6 (Gene) and CYP2D6 (Gene) is bound by Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)
Mefloquine (Compound) causes Palpitations (Side Effect) and Palpitations (Side Effect) is caused by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Mefloquine (Compound) resembles Flecainide (Compound) and Flecainide (Compound) binds CYP2D6 (Gene) and CYP2D6 (Gene) is bound by Ritonavir (Compound)