Interaction Checker
Potential Interaction
Atazanavir + ritonavir (ATV/r)
Valproate semisodium (Divalproex sodium)
Quality of Evidence: Very Low
Summary:
Coadministration with valproate semisodium (divalproex semisodium) has not been studied. Valproate semisodium (divalproex semisodium) is a stable coordination compound comprised of sodium valproate and valproic acid and dissociates to the valproate ion in the gastrointestinal tract. Valproate is mainly glucuronidated by UGTs 1A6, 1A9 and 2B7 and metabolized by CYP2C9 and CYP2C19. There is no evidence that atazanavir inhibits or induces these UGTs and CYPs, however concentrations of valproate may decrease due to induction of UGTs and CYP2C9/19 by ritonavir. Careful monitoring of valproate concentrations and/or therapeutic effect is recommended. When atazanavir/ritonavir was administered with minocycline or minocycline plus valproic acid, there was no evidence of an effect of valproate on atazanavir exposure.
Description:
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