Drug interactions
Atazanavir + Mifepristone
Severity: Major
Atazanavir and Mifepristone: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir is a strong CYP3A4 inhibitor and increases mifepristone exposure, while mifepristone inhibits CYP3A4 and may raise atazanavir levels. Both effects increase toxicity risk, including QT prolongation and hyperbilirubinemia.
What this interaction means in plain words
Atazanavir and Mifepristone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Mifepristone belongs to Endocrine.
Why it happens
Mutual inhibition of CYP3A4-mediated metabolism.
What to do
Keep mifepristone at or below 300 mg/day for Cushing syndrome when given with strong CYP3A4 inhibitors. Monitor ECG, bilirubin and antiretroviral tolerability.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Mifepristone?
MediHelp rates the interaction as major. Atazanavir and Mifepristone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir is a strong CYP3A4 inhibitor and increases mifepristone exposure, while mifepristone inhibits CYP3A4 and may raise atazanavir levels. Both effects increase toxicity risk, including QT prolongation and hyperbilirubinemia.
How serious is the interaction between Atazanavir and Mifepristone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep mifepristone at or below 300 mg/day for Cushing syndrome when given with strong CYP3A4 inhibitors. Monitor ECG, bilirubin and antiretroviral tolerability.
What other medicines interact with Mifepristone?
MediHelp also lists interactions of Mifepristone with, for example, Apixaban, Argatroban, Cisapride. The full list is on the Mifepristone page.
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