DDInter1607 DDInter1622
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
Rosuvastatin, also known as the brand name product Crestor, is a lipid-lowering drug that belongs to the statin class of medications, which are used to lower the risk of cardiovascular disease and manage elevated lipid levels by inhibiting the endogenous production of cholesterol in the liver. More specifically, statin medications competitively inhibit the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) Reductase, which catalyzes the conversion of HMG-CoA to mevalonic acid and is the third step in a sequence of metabolic reactions involved in the production of several compounds involved in lipid metabolism and transport including cholesterol, low-density lipoprotein (LDL) (sometimes referred to as "bad cholesterol"), and very low-density lipoprotein (VLDL). Prescribing of statin medications is considered standard practice following any cardiovascular events and for people with a moderate to high risk of development of CVD, such as those with Type 2 Diabetes. The clear evidence of the benefit of statin use coupled with very minimal side effects or long term effects has resulted in this class becoming one of the most widely prescribed medications in North America.[A181087, A181406] Rosuvastatin and other drugs from the statin class of medications including [atorvastatin], [pravastatin], [simvastatin], [fluvastatin], and [lovastatin] are considered first-line options for the treatment of dyslipidemia.[A181087, A181406] This is largely due to the fact that cardiovascular disease (CVD), which includes heart attack, atherosclerosis, angina, peripheral artery disease, and stroke, has become a leading cause of death in high-income countries and a major cause of morbidity around the world. Elevated cholesterol levels, and in particular, elevated low-density lipoprotein (LDL) levels, are an important risk factor for the development of CVD.[A181087,A181553] Use of statins to target and reduce LDL levels has been shown in a number of landmark studies to significantly reduce the risk of development of CVD and all-cause mortality.[A181090,A181093,A181096,A181427,A181475,A181538] Statins are considered a cost-effective treatment option for CVD due to their evidence of reducing all-cause mortality including fatal and non-fatal CVD as well as the need for surgical revascularization or angioplasty following a heart attack.[A181087, A181406] Evidence has shown that even for low-risk individuals (with <10% risk of a major vascular event occurring within 5 years) statins cause a 20%-22% relative reduction in major cardiovascular events (heart attack, stroke, coronary revascularization, and coronary death) for every 1 mmol/L reduction in LDL without any significant side effects or risks.[A181397, A181403] While all statin medications are considered equally effective from a clinical standpoint, rosuvastatin is considered the most potent; doses of 10 to 40mg rosuvastatin per day were found in clinical studies to result in a 45.8% to 54.6% decreases in LDL cholesterol levels, which is about three-fold more potent than [atorvastatin]'s effects on LDL cholesterol.[A181409,A1793] However, the results of the SATURN trial concluded that despite this difference in potency, there was no difference in their effect on the progression of coronary atherosclerosis. Rosuvastatin is also a unique member of the class of statins due to its high hydrophilicity which increases hepatic uptake at the site of action, low bioavailability, and minimal metabolism via the Cytochrome P450 system. This last point results in less risk of drug-drug interactions compared to [atorvastatin], [lovastatin], and [simvastatin], which are all extensively metabolized by Cytochrome P450 (CYP) 3A4, an enzyme involved in the metabolism of many commonly used drugs. Drugs such as [ciclosporin], [gemfibrozil], and some antiretrovirals are more likely to interact with this statin through antagonism of OATP1B1 organic anion transporter protein 1B1-mediated hepatic uptake of rosuvastatin.[F4649, F4652]
Ritonavir {u} (Compound) binds {v} (Gene) ABCC1
ABCC1 {u} (Gene) is bound by {v} (Compound) Rosuvastatin
Ritonavir {u} (Compound) causes {v} (Side Effect) Influenza
Influenza {u} (Side Effect) is caused by {v} (Compound) Rosuvastatin
Ritonavir {u} (Compound) resembles {v} (Compound) Carfilzomib
Carfilzomib {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Rosuvastatin
Ritonavir {u} (Compound) resembles {v} (Compound) Lopinavir
Lopinavir {u} may lead to a major life threatening interaction when taken with {v} Rosuvastatin
Ritonavir {u} (Compound) resembles {v} (Compound) Atazanavir
Atazanavir {u} may lead to a major life threatening interaction when taken with {v} Rosuvastatin
Ritonavir {u} (Compound) binds {v} (Gene) ABCC1
ABCC1 {u} (Gene) is bound by {v} (Compound) Atorvastatin
Atorvastatin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Rosuvastatin
Ritonavir {u} (Compound) binds {v} (Gene) ABCG2
ABCG2 {u} (Gene) regulates {v} (Gene) HDAC2
HDAC2 {u} (Gene) is downregulated by {v} (Compound) Rosuvastatin
Ritonavir {u} (Compound) causes {v} (Side Effect) Influenza
Influenza {u} (Side Effect) is caused by {v} (Compound) Fluvastatin
Fluvastatin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Rosuvastatin
Ritonavir {u} (Compound) causes {v} (Side Effect) Sleep disorder
Sleep disorder {u} (Side Effect) is caused by {v} (Compound) Etravirine
Etravirine {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Rosuvastatin
Ritonavir {u} (Compound) causes {v} (Side Effect) Jaundice
Jaundice {u} (Side Effect) is caused by {v} (Compound) Fluconazole
Fluconazole {u} may cause a minor interaction that can limit clinical effects when taken with {v} Rosuvastatin
Ritonavir (Compound) binds ABCC1 (Gene) and ABCC1 (Gene) is bound by Rosuvastatin (Compound)
Ritonavir (Compound) causes Influenza (Side Effect) and Influenza (Side Effect) is caused by Rosuvastatin (Compound)
Ritonavir (Compound) resembles Carfilzomib (Compound) and Carfilzomib may cause a moderate interaction that could exacerbate diseases when taken with Rosuvastatin
Ritonavir (Compound) resembles Lopinavir (Compound) and Lopinavir may lead to a major life threatening interaction when taken with Rosuvastatin
Ritonavir (Compound) resembles Atazanavir (Compound) and Atazanavir may lead to a major life threatening interaction when taken with Rosuvastatin
Ritonavir (Compound) binds ABCC1 (Gene) and ABCC1 (Gene) is bound by Atorvastatin (Compound) and Atorvastatin may cause a moderate interaction that could exacerbate diseases when taken with Rosuvastatin
Ritonavir (Compound) binds ABCG2 (Gene) and ABCG2 (Gene) regulates HDAC2 (Gene) and HDAC2 (Gene) is downregulated by Rosuvastatin (Compound)
Ritonavir (Compound) causes Influenza (Side Effect) and Influenza (Side Effect) is caused by Fluvastatin (Compound) and Fluvastatin may cause a moderate interaction that could exacerbate diseases when taken with Rosuvastatin
Ritonavir (Compound) causes Sleep disorder (Side Effect) and Sleep disorder (Side Effect) is caused by Etravirine (Compound) and Etravirine may cause a moderate interaction that could exacerbate diseases when taken with Rosuvastatin
Ritonavir (Compound) causes Jaundice (Side Effect) and Jaundice (Side Effect) is caused by Fluconazole (Compound) and Fluconazole may cause a minor interaction that can limit clinical effects when taken with Rosuvastatin