Description of Synthivan
Trade name: Synthivan
Active ingredients: Atazanavir sulfate and Ritonavir
Strength: Atazanavir sulfate 300mg and Ritonavir 100mg
Category: Anti retroviral agents
Synthivan Product description:
Synthivan an anti-retroviral agent which contains active ingredients like Atazanavir sulfate and Ritonavir
Both ingredients having anti-retroviral activity and it is protease inhibitors.
Protease enzyme which is essential for cell maturation and multiplication
Synthivan is a cipla product. It is not a curable but it reduce the progression of the infection
Pharmacology of Synthivan
Mechanism of action:
Atazanavir sulfate, it is an azapeptide HIV-1 protease inhibitor, active against human immunodeficiency virus type I
Generally protease enzyme is essential for proteolytic cleavage of viral polyprotein into functional proteins present in infectious HIV-1.
This atazanavir bounds to the active site of the protease enzyme and prohibits its activity.
This prohibition leads to prevent the separation of viral polyprotein; it concludes formation of immature cells and turns to non-infectious cells
Ritonavir, it is a peptidomimetic HIV protease inhibitor
Low dose of Ritonavir acts as pharmacokinetic booster of concomitantly used other anti-retroviral drug Atazanavir, it increase the plasma concentration of Atazanavir concurrently
Atazanavir is quickly absorbed with the Tmax of relatively 2.5 hours.
If Synthivan is taken with food, leads to increase bioavailability of atazanavir and depletes its pharmacokinetic variability
Oral bioavailability is around 60-68%
Atazanavir is highly bound to human serum protein nearly 86%.
It binds to alpha-1-acid glycoprotein and albumin (89% and 86%) respectively
The major biotransformation pathways like;
Synthivan is highly metabolized in liver
It is metabolized by CYP3A
The route of elimination is not known clearly
The terminal half life of Synthivan in healthy persons is around 7 hours
Hepatic impairment patients 12.1 hours
Indication of Synthivan
Synthivan tablet is a fixed dose regimen that involved in the treatment of HIV type I infected associated with AIDS.
Synthivan is used only for decreasing the progression of HIV virus maturation and multiplication
It is not cure or prevents the infectious condition
Dose & Dosage's of Synthivan
Synthivan tablet should be taken with food
The recommended dose of Synthivan based on the medical history of the patients
Synthivan is a prescription medicine; it is administered under the guidance of medical practitioner
The recommended dose of Synthivan for adult patients: One tablet should be taken orally with meals as a single dose.
One tablet should be taking once daily with food, if Synthivan is combined with any medicines like;
H2 receptor antagonist: The dose of H2 receptor antagonist like famotidine should not exceed 40mg two times a day. Synthivan tablet is administered concurrently with or 10 hours after the dose of famotidine.
Proton pump inhibitor: Omeprazole, a proton pump inhibitor it should not exceed to 20mg.
Omeprazole should be administered in 12 hours prior to the dose of Synthivan tablet
Dose recommendation for therapy experienced patients:
If H2 receptor antagonist co administered with Synthivan tablet, dose of famotidine should not exceed to 20mg twice daily.
Synthivan should be taken with food if co administered with famotidine
Synthivan should not be taken, if both tenofovir and H2 receptor antagonist has been taken together.
Proton pump inhibitor drugs should not taken, if treatment experienced patient taking Synthivan tablets
Efavirenz should not concomitant with Synthivan tablet; it leads to decrease the Synthivan exposure.
Synthivan tablet is a prescription medicine; if patient fail to administer the dose, advice them to take within a time. Otherwise the missed dose should be skipped and follow the regular drug schedule.
Side Effects of Synthivan
The serious effects that caused by Atazanavir;
Cardiac conduction abnormalities
Chronic kidney disease
Nephrolithiasis and cholelithiasis
Hepatic function abnormalities
Contraindication of Synthivan
Patients are highly contraindicated to the components that present in the Synthivan tablet
While Synthivan co administered with drugs which are highly dependent on CYP3A leads to increasing plasma concentration of interacting drugs causes life threatening conditions
Synthivan concomitant with strongly CYP3A inducers may causes loss of efficacy of atazanavir
List of medicines that are contraindicated;
Alfuzosin, rifampicin, Irinotecan, Lurasidone, Pimozide, Midazolam, st. johns wort, lovastatin, simvastatin, sildenafil, indinavir, nevirapine,
Drug Interaction of Synthivan
Atazanavir is a CYP3A4 substrate, drug which induce CYP3A4 may leads to decrease the plasma concentration and therapeutic effects of the atazanavir.
Co administration of Didanosine with Synthivan tablets leads to decrease the atazanavir exposure
Tenofovir with Synthivan: decrease the AUC and Cmin of atazanavir and increase the plasma concentration of tenofovir
Atazanavir combined with efavirenz: decrease the exposure of atazanavir
Some list of medicines;
Saquinavir, antacids, amiodarone, lidocaine, quinidine, carbamazepine, phenytoin, phenobarbitol etc
Precaution of Synthivan
Some drug interaction may have chance to get;
Severe skin reactions, Hyperbilirubinaemia, hepatoxicity, chronic kidney disease
If patient suggested for concomitant therapy, care should be taken to reduce life threatening conditions
Co administration of ritonavir with some other drugs like sedative, hypnotics, anti-arrhythmia may leads to severe life threatening adverse reactions.
Usage & Safety profile of Synthivan Pregnancy & Lactation
Pregnancy category: B
Chances of getting lactic acidosis syndrome, symptomatic hyperlactatemia occurs in pregnant women while using atazanavir with nucleoside analogues
Synthivan should not recommended for pregnant women and who become pregnant
Synthivan not recommended for breastfeeding mothers
Storage of Synthivan
Synthivan tablet container should be stored at 25°C (77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F).