DDInter1557 DDInter1607
An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood.
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].
Quinine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine {u} (Compound) binds {v} (Gene) SLCO1A2
SLCO1A2 {u} (Gene) is bound by {v} (Compound) Ritonavir
Quinine {u} (Compound) causes {v} (Side Effect) Palpitations
Palpitations {u} (Side Effect) is caused by {v} (Compound) Ritonavir
Quinine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine {u} (Compound) binds {v} (Gene) CYP1A2
CYP1A2 {u} (Gene) is bound by {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine {u} (Compound) causes {v} (Side Effect) Palpitations
Palpitations {u} (Side Effect) is caused by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine {u} may lead to a major life threatening interaction when taken with {v} Saquinavir
Saquinavir {u} (Compound) resembles {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Atazanavir
Atazanavir {u} (Compound) binds {v} (Gene) ABCC1
ABCC1 {u} (Gene) is bound by {v} (Compound) Ritonavir
Quinine {u} may lead to a major life threatening interaction when taken with {v} Saquinavir
Saquinavir {u} (Compound) resembles {v} (Compound) Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Quinine may cause a moderate interaction that could exacerbate diseases when taken with Atazanavir and Atazanavir (Compound) resembles Ritonavir (Compound)
Quinine (Compound) binds SLCO1A2 (Gene) and SLCO1A2 (Gene) is bound by Ritonavir (Compound)
Quinine (Compound) causes Palpitations (Side Effect) and Palpitations (Side Effect) is caused by Ritonavir (Compound)
Quinine may cause a moderate interaction that could exacerbate diseases when taken with Atazanavir and Atazanavir (Compound) resembles Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)
Quinine (Compound) binds CYP1A2 (Gene) and CYP1A2 (Gene) is bound by Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)
Quinine (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Quinine (Compound) causes Palpitations (Side Effect) and Palpitations (Side Effect) is caused by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Quinine may lead to a major life threatening interaction when taken with Saquinavir and Saquinavir (Compound) resembles Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Quinine may cause a moderate interaction that could exacerbate diseases when taken with Atazanavir and Atazanavir (Compound) binds ABCC1 (Gene) and ABCC1 (Gene) is bound by Ritonavir (Compound)
Quinine may lead to a major life threatening interaction when taken with Saquinavir and Saquinavir (Compound) resembles Lopinavir (Compound) and Lopinavir (Compound) resembles Ritonavir (Compound)