| Drug Name: | Ritonavir (155213-67-5) |
|---|---|
| PubChem ID: | 392622 |
| SMILES: | CC(C)C1=NC(=CS1)CN(C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC2=CC=CC=C2)C[C@@H]([C@H](CC3=CC=CC=C3)NC(=O)OCC4=CN=CS4)O |
| InchiKey: | NCDNCNXCDXHOMX-XGKFQTDJSA-N |
| Therapeutic Category: | Anti-HIV Agents, Anti-Infective Agents, Anti-Retroviral Agents, Antiviral Agents, Cytochrome P-450 CYP3A Inhibitors, Cytochrome P-450 Enzyme Inhibitors, Enzyme Inhibitors, HIV Protease Inhibitors, Protease Inhibitors |
| Molecular Weight (dalton) | : | 720.962 |
| LogP | : | 5.9052 |
| Ring Count | : | 4 |
| Hydrogen Bond Acceptor Count | : | 9 |
| Hydrogen Bond Donor Count | : | 4 |
| Total Polar Surface Area | : | 145.78 |
This panel provides information on interacting drugs and their ADRs along with references
| Interacting drug | Toxicity | Interaction Type | Mechanism | Reference |
|---|---|---|---|---|
| Etoposide (33419-42-0) | Neutropenia | Synergistic | Protease inhibitors reducing the metabolism of CDE via inhibition of cytochrome P450 enzymes, or inhibition of P-glycoprotein. Inhibitors of CYP3A4 may increase toxicity with etoposide, | Protease inhibitors potentiate chemotherapy-induced neutropenia |
| 3,4-Methylenedioxymethamphetamine (42542-10-9) | Fatal Serotonergic Reaction | Antagonistic | Ritonavir inhibits the cytochrome P450 isoenzyme CYP2D6, which is responsible for the demethylenation of ecstasy, so concurrent use leads to a sharp rise in ecstasy plasma levels | A toxic interaction between mitomycin C and tamoxifen causing the haemolytic uraemic syndrome |
This panel provides drug-protein interaction and their ADRs along with references
| Toxicity | Interacting Protein | Mechanism | Reference |
|---|---|---|---|
| Abnormality Of Hepatic Steatosis | Sterol regulatory element-binding protein 1 (P36956) | Abnormality of hepatic steatosis after Ritonavir treatment is due to ritonavir-induced accumulation of the activated forms of sterol regulatory binding protein (SREBP)-1 in the nucleus of liver and adipose@ resulting in elevated expression of lipid metabolism genes [ ADR Type 1 ] | HIV protease inhibitor induces fatty acid and sterol biosynthesis in liver and adipose tissues due to the accumulation of activated sterol regulatory element-binding proteins in the nucleus |
| Abnormality Of Hepatic Steatosis | Sterol regulatory element-binding protein 2 (Q12772) | Abnormality of hepatic steatosis after Ritonavir treatment is due to ritonavir-induced accumulation of the activated forms of sterol regulatory binding protein (SREBP)-2 in the nucleus of liver and adipose@ resulting in elevated expression of lipid metabolism genes [ ADR Type 1 ] | HIV protease inhibitor induces fatty acid and sterol biosynthesis in liver and adipose tissues due to the accumulation of activated sterol regulatory element-binding proteins in the nucleus |
| Abnormality Of Hepatomegaly | Sterol regulatory element-binding protein 1 (P36956) | Abnormality of hepatomegaly after Ritonavir treatment is due to ritonavir-induced accumulation of the activated forms of sterol regulatory binding protein (SREBP)-1 in the nucleus of liver and adipose@ resulting in elevated expression of lipid metabolism genes [ ADR Type 1 ] | HIV protease inhibitor induces fatty acid and sterol biosynthesis in liver and adipose tissues due to the accumulation of activated sterol regulatory element-binding proteins in the nucleus |
| Abnormality Of Hepatomegaly | Sterol regulatory element-binding protein 2 (Q12772) | Abnormality of hepatomegaly after Ritonavir treatment is due to ritonavir-induced accumulation of the activated forms of sterol regulatory binding protein (SREBP)-2 in the nucleus of liver and adipose@ resulting in elevated expression of lipid metabolism genes [ ADR Type 1 ] | HIV protease inhibitor induces fatty acid and sterol biosynthesis in liver and adipose tissues due to the accumulation of activated sterol regulatory element-binding proteins in the nucleus |
| Dizziness | Cytochrome P450 3A4 (P08684) | Concomitant use of trazodone and NORVIR increases plasma concentrations of trazodone. Adverse events of nausea@ dizziness@ hypotension and syncope have been observed following co-administration of trazodone and NORVIR. If trazodone is used with a CYP3A4 inhibitor such as ritonavir@ the combination should be used with caution and a lower dose of trazodone should be considered. [ ADR Type 4 ] | Use of terfenadine and contraindicated drugs |
| Hyperlipidemia | Adiponectin (Q15848) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Hyperlipidemia | Lipoprotein lipase precursor (P06858) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Hyperlipidemia | Transcription factor AP-2 alpha;AP-2 complex subunit alpha-2;AP-2 complex subunit beta-1 (P05549) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance. [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Hypotension | Cytochrome P450 3A4 (P08684) | Concomitant use of trazodone and NORVIR increases plasma concentrations of trazodone. Adverse events of nausea@ dizziness@ hypotension and syncope have been observed following co-administration of trazodone and NORVIR. If trazodone is used with a CYP3A4 inhibitor such as ritonavir@ the combination should be used with caution and a lower dose of trazodone should be considered. [ ADR Type 4 ] | Use of terfenadine and contraindicated drugs |
| Insulin Resistance | Adiponectin (Q15848) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Insulin Resistance | Lipoprotein lipase precursor (P06858) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Insulin Resistance | Transcription factor AP-2 alpha;AP-2 complex subunit alpha-2;AP-2 complex subunit beta-1 (P05549) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance. [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Lipodystrophy | Adiponectin (Q15848) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Lipodystrophy | Lipoprotein lipase precursor (P06858) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Lipodystrophy | Transcription factor AP-2 alpha;AP-2 complex subunit alpha-2;AP-2 complex subunit beta-1 (P05549) | Dose-responsive inhibition of adipogenesis by ritonavir was noted as measured by reduced triglyceride accumulation and attenuated induction of three differentiation marker genes -- aP2@ lipoprotein lipase@ and Adipo Q@which leads to a syndrome characterized by lipodystrophy (fat redistribution favoring the accumulation of abdominal and cervical adipose tissue)@ hyperlipidemia@ and insulin resistance. [ ADR Type 1 ] | Inhibition of adipocyte differentiation by HIV protease inhibitors |
| Nausea | Cytochrome P450 3A4 (P08684) | Concomitant use of trazodone and NORVIR increases plasma concentrations of trazodone. Adverse events of nausea@ dizziness@ hypotension and syncope have been observed following co-administration of trazodone and NORVIR. If trazodone is used with a CYP3A4 inhibitor such as ritonavir@ the combination should be used with caution and a lower dose of trazodone should be considered. [ ADR Type 4 ] | Use of terfenadine and contraindicated drugs |
| Syncope | Cytochrome P450 3A4 (P08684) | Concomitant use of trazodone and NORVIR increases plasma concentrations of trazodone. Adverse events of nausea@ dizziness@ hypotension and syncope have been observed following co-administration of trazodone and NORVIR. If trazodone is used with a CYP3A4 inhibitor such as ritonavir@ the combination should be used with caution and a lower dose of trazodone should be considered. [ ADR Type 4 ] | Use of terfenadine and contraindicated drugs |
This panel provides drug-food interactions and their ADRs along with references
| Food | Toxicity | Reference |
|---|---|---|
| Garlic | Reduce Bioavailability | http://ummedu/health/medical/altmed/herb-interaction/possible-interactions-with-garlic |
This panel provides information on metabolites and their ADRs along with references
| Metabolite | Toxicity | Place of Metabolism | Mechanism | Reference |
|---|
This panel provides information on drug category