Date of report 27 Feb 2020
Reported case interaction between
Atazanavir and Naringin
Atazanavir and Naringin
Drugs suspected to be involved in the DDI
Complete list of drugs taken by the patient
Naringin-copntaining CAM, sinetrol, fluoxetine, pseudoephedrine
Clinical case description
Patient failing antiretroviral therapy with atazanavir plus tenofovir/emtricitabine (mean HIV RNA: 149 copies/mL). He referred that he had recently started using a naringin‐containing supplement, claimed to be a fat‐burning accelerator. TDM revealed suboptimal atazanavir concentration during concomitant treatment with naringin that increased after discontinuation (85 versus 719 ng/mL). This case has been published by Cattaneo D, et al. in Obesity (Silver Spring). 2018 Aug;26(8):1251-1252.
Clinical Outcome
Drug Interaction Probability Scale (DIPS)
Editorial Comment
Weight-loss drugs should be used with caution in HIV-infected patients treated with antiretroviral drugs because of the risk of virologic failure. Naringin is a flavanone‐7‐O‐glycoside that inhibits the activity of carrier proteins (p‐glycoprotein and organic‐anion‐transporting polypeptide), ultimately resulting in impaired drug absorption (Shirasaka Y, Li Y, Shibue Y, et al. Concentration‐dependent effect of naringin on intestinal absorption of beta(1)‐adrenoceptor antagonist talinolol mediated by p‐glycoprotein and organic anion transporting polypeptide (OATP). Pharm Res 2009; 26: 560‐ 567.)