DDInter1164 DDInter1607
Metformin is a biguanide antihyperglycemic agent and first-line pharmacotherapy used in the management of type II diabetes.[L12207,A176173] Metformin is considered an antihyperglycemic drug because it lowers blood glucose concentrations in type II diabetes without causing hypoglycemia. It is commonly described as an "insulin sensitizer", leading to a decrease in insulin resistance and a clinically significant reduction of plasma fasting insulin levels. Another well-known benefit of this drug is modest weight loss, making it an effective choice for obese patients type II diabetes. Metformin was first approved in Canada in 1972, and received subsequent FDA approval in the US in 1995.
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].
Metformin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Metformin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Lopinavir
Lopinavir {u} (Compound) resembles {v} (Compound) Ritonavir
Metformin {u} (Compound) binds {v} (Gene) SLC47A1
SLC47A1 {u} (Gene) is bound by {v} (Compound) Ritonavir
Metformin {u} (Compound) causes {v} (Side Effect) Palpitations
Palpitations {u} (Side Effect) is caused by {v} (Compound) Ritonavir
Metformin {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
Metformin {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
Metformin {u} (Compound) causes {v} (Side Effect) Palpitations
Palpitations {u} (Side Effect) is caused by {v} (Compound) Atazanavir
Atazanavir {u} (Compound) resembles {v} (Compound) Ritonavir
Metformin {u} (Compound) treats {v} (Disease) type 2 diabetes mellitus
type 2 diabetes mellitus {u} (Disease) is associated with {v} (Gene) CYP2E1
CYP2E1 {u} (Gene) is bound by {v} (Compound) Ritonavir
Metformin {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
Metformin {u} (Compound) binds {v} (Gene) NDUFAF4
NDUFAF4 {u} (Gene) regulates {v} (Gene) NT5DC2
NT5DC2 {u} (Gene) is downregulated by {v} (Compound) Ritonavir
Metformin may cause a moderate interaction that could exacerbate diseases when taken with Atazanavir and Atazanavir (Compound) resembles Ritonavir (Compound)
Metformin may cause a moderate interaction that could exacerbate diseases when taken with Lopinavir and Lopinavir (Compound) resembles Ritonavir (Compound)
Metformin (Compound) binds SLC47A1 (Gene) and SLC47A1 (Gene) is bound by Ritonavir (Compound)
Metformin (Compound) causes Palpitations (Side Effect) and Palpitations (Side Effect) is caused by Ritonavir (Compound)
Metformin 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)
Metformin 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)
Metformin (Compound) causes Palpitations (Side Effect) and Palpitations (Side Effect) is caused by Atazanavir (Compound) and Atazanavir (Compound) resembles Ritonavir (Compound)
Metformin (Compound) treats type 2 diabetes mellitus (Disease) and type 2 diabetes mellitus (Disease) is associated with CYP2E1 (Gene) and CYP2E1 (Gene) is bound by Ritonavir (Compound)
Metformin 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)
Metformin (Compound) binds NDUFAF4 (Gene) and NDUFAF4 (Gene) regulates NT5DC2 (Gene) and NT5DC2 (Gene) is downregulated by Ritonavir (Compound)