Identification

Name
Asunaprevir
Accession Number
DB11586
Type
Small Molecule
Groups
Approved, Investigational, Withdrawn
Description

Asunaprevir, also named as BMS-650032, is a potent hepatitis C virus (HCV) NS3 protease inhibitor. It has been shown to have a very high efficacy in dual-combination regimens with daclatasvir in patients chronically infected with HCV genotype 1b.[2] It was developed by Bristol-Myers Squibb Canada and approved by Health Canada on April 22, 2016. The commercialization of asunaprevir was canceled one year later on October 16, 2017.[4]

Structure
Thumb
Synonyms
Not Available
External IDs
BMS 650032 / BMS-650032
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
SunvepraCapsule100 mgOralBristol Myers Squibb2016-04-22Not applicableCanada
Categories
UNII
S9X0KRJ00S
CAS number
630420-16-5
Weight
Average: 748.286
Monoisotopic: 747.270476492
Chemical Formula
C35H46ClN5O9S
InChI Key
XRWSZZJLZRKHHD-WVWIJVSJSA-N
InChI
InChI=1S/C35H46ClN5O9S/c1-9-19-16-35(19,31(44)40-51(46,47)22-11-12-22)39-28(42)25-15-21(49-29-24-14-20(36)10-13-23(24)26(48-8)17-37-29)18-41(25)30(43)27(33(2,3)4)38-32(45)50-34(5,6)7/h9-10,13-14,17,19,21-22,25,27H,1,11-12,15-16,18H2,2-8H3,(H,38,45)(H,39,42)(H,40,44)/t19-,21-,25+,27-,35-/m1/s1
IUPAC Name
tert-butyl N-[(2S)-1-[(2S,4R)-4-[(7-chloro-4-methoxyisoquinolin-1-yl)oxy]-2-{[(1R,2S)-1-[(cyclopropanesulfonyl)carbamoyl]-2-ethenylcyclopropyl]carbamoyl}pyrrolidin-1-yl]-3,3-dimethyl-1-oxobutan-2-yl]carbamate
SMILES
COC1=CN=C(O[C@@H]2C[C@H](N(C2)C(=O)[C@@H](NC(=O)OC(C)(C)C)C(C)(C)C)C(=O)N[C@@]2(C[C@H]2C=C)C(=O)NS(=O)(=O)C2CC2)C2=C1C=CC(Cl)=C2

Pharmacology

Indication

Asunaprevir is indicated in combination with other agents for the treatment of chronic hepatitis C in adult patients with hepatitis C virus genotypes 1 or 4 and compensated liver cirrhosis.[5]

Hepatitis C is a liver disease caused by the hepatitis C virus. The chronic state of this condition accounts for 60-80% of the cases from which the risk of cirrhosis of the liver within 20 years is of around 15-30%.[6] The genotype 1 is the most common type of hepatitis C in the United States and the most difficult to treat.[7]

Structured Indications
Pharmacodynamics

Studies in vitro demonstrated a significant antiviral activity in HCV replicon cell systems with an EC50 of 4nm and 1nm against the HCV genotype 1a and 1b respectively.[2] These studies showed a limited activity against the genotypes 2 and 3. This property makes asunaprevir a highly selective anti-HCV agent that is not effective against HCV closely related virus.[3] Asunaprevir produce robust declines in HCV RNA levels in patients with HCV genotype 1 infection.[1]In clinical studies, it has been shown that asunaprevir is well-tolerated and the mean maximum HCV RNA level reduction from baseline was of approximately 2.87 log10 IU/ml.[2]

Monotherapy clinical studies with asunaprevir showed a mean maximum decline of HCV RNA in the range of 0.28-2.87 log10 IU/ml when administered in increasing doses from 10-600 mg. When asunaprevir was used as a combination product, it was possible to obtain a sustained virological response (aviremia 24 weeks after completion of therapy) in 83-92% of the patients.[3]

Mechanism of action

Asunaprevir is a highly active HCV NS3 protease inhibitor.[1] The genome of HCV has a positive polarity which allows it to be translated into a protein in the host cell without further transformation steps. However, the resultant protein needs to be divided by the enzyme NS3 protease into single proteins in order to be able to exert its enzymatic activity or structural role. Therefore, due to NS3 vital importance for viral replication, the inhibiting action of asunaprevir causes a robust antiviral activity.[3]

TargetActionsOrganism
AHepatitis C virus NS3 protease/helicase
antagonist
Hepatitis C
Absorption

In preclinical studies, asunaprevir showed a high liver-to-plasma AUC ratio. It is rapidly absorbed within 30 minutes of administration.[5] Clinical pharmacokinetic studies showed a tmax of 2-4 hours.[3] The pharmacokinetic profile act in a dose-proportional manner and in a dose of 100 mg the steady-state Cmax and AUC was 572 ng/ml and 1887 ng.h/ml. The absolute bioavailability is reported to be 9.3%. The absorption of asunaprevir is increased if it is accompanied by a high-fat diet.[8]

Volume of distribution

The registered volume of distribution at steady state is 194 L.[8]

Protein binding

Protein binding of asunaprevir is very high and it can reach more than 99% of the administered dose independently of the dose. In vitro studies with human Caco-2 cells indicated that asunaprevir is a substrate of P-gp, OATP1B1 and OATP2B1.[8]

Metabolism

Asunaprevir is metabolized by the liver.[3] The metabolism is mainly marked by oxidative reactions mediated by the activity of CYP3A.[8] Asunaprevir seems to weakly induce its own metabolism and from the circulating dose, just about 5% of the administered dose is formed by metabolites.[5] The metabolites of asunaprevir are formed after mono- and bis-oxidation, N-dealkylation, loss of isoquinoline ring and O-demethylation. All the metabolic reactions form about 15 metabolites and studies have reported that the main metabolic activity is performed by CYP3A4 and CYP3A5 with some minor activity from CYP2A6, CYP2B6, CYP2C9, CYP2C19 and CYP2D6.[9]

Route of elimination

Asunaprevir is primarily eliminated via the feces.[3] From the administered dose, 84% is excreted by feces mainly as metabolites and less than 1% of the dose is recovered as metabolites in the urine. The proportion of unchanged asunaprevir recovered in feces represents only 7.5% of the dose.[8]

Half life

Clinical pharmacokinetic studies showed a mean terminal half-life of 15-20 hours.[3]

Clearance

Clinical pharmacokinetic studies showed a mean oral clearance of 302-491 L/h.[3]

Toxicity

Toxicity studies showed no carcinogenic nor genotoxic potential related to asunaprevir. In case of overdose, clinical studies reported no unexpected adverse events.[8]Asunaprevir had no effects on fertility in preclinical studies. It has been shown that asunaprevir gets localized in GI tract and liver and thus, increased in hepatic transaminases were observed as well as changes in iron metabolism, decreased in serum proteins. These effects are not progressive and asunaprevir was generally well tolerated.[5]

Affected organisms
  • Hepatitis C Virus
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
AbacavirThe serum concentration of Abacavir can be decreased when it is combined with Asunaprevir.Approved, Investigational
AbirateroneThe serum concentration of Asunaprevir can be increased when it is combined with Abiraterone.Approved
AcetaminophenThe serum concentration of Asunaprevir can be decreased when it is combined with Acetaminophen.Approved
AcetazolamideThe serum concentration of Asunaprevir can be increased when it is combined with Acetazolamide.Approved, Vet Approved
Acetyl sulfisoxazoleThe serum concentration of Asunaprevir can be increased when it is combined with Acetyl sulfisoxazole.Approved, Vet Approved
AcetyldigoxinThe serum concentration of Acetyldigoxin can be increased when it is combined with Asunaprevir.Experimental
AlclometasoneThe serum concentration of Asunaprevir can be decreased when it is combined with Alclometasone.Approved
AldesleukinThe serum concentration of Asunaprevir can be increased when it is combined with Aldesleukin.Approved
AlfuzosinThe serum concentration of Alfuzosin can be increased when it is combined with Asunaprevir.Approved, Investigational
AlimemazineThe serum concentration of Asunaprevir can be decreased when it is combined with Alimemazine.Approved, Vet Approved
AlprazolamThe serum concentration of Alprazolam can be increased when it is combined with Asunaprevir.Approved, Illicit, Investigational
AmbroxolThe serum concentration of Asunaprevir can be increased when it is combined with Ambroxol.Approved, Investigational
Ambroxol acefyllinateThe serum concentration of Ambroxol acefyllinate can be decreased when it is combined with Asunaprevir.Experimental, Investigational
AmineptineThe serum concentration of Amineptine can be increased when it is combined with Asunaprevir.Illicit, Withdrawn
AminoglutethimideThe serum concentration of Asunaprevir can be decreased when it is combined with Aminoglutethimide.Approved, Investigational
AminophyllineThe serum concentration of Aminophylline can be decreased when it is combined with Asunaprevir.Approved
AmiodaroneThe serum concentration of Asunaprevir can be increased when it is combined with Amiodarone.Approved, Investigational
AmitriptylineThe serum concentration of Amitriptyline can be increased when it is combined with Asunaprevir.Approved
AmitriptylinoxideThe serum concentration of Amitriptylinoxide can be increased when it is combined with Asunaprevir.Approved, Investigational
AmlodipineThe serum concentration of Asunaprevir can be increased when it is combined with Amlodipine.Approved
AmoxapineThe serum concentration of Amoxapine can be increased when it is combined with Asunaprevir.Approved
AmprenavirThe serum concentration of Asunaprevir can be increased when it is combined with Amprenavir.Approved, Investigational
AnastrozoleThe serum concentration of Asunaprevir can be increased when it is combined with Anastrozole.Approved, Investigational
AntipyrineThe serum concentration of Asunaprevir can be increased when it is combined with Antipyrine.Approved, Investigational
ApalutamideThe serum concentration of Asunaprevir can be decreased when it is combined with Apalutamide.Approved, Investigational
AprepitantThe serum concentration of Asunaprevir can be increased when it is combined with Aprepitant.Approved, Investigational
ArmodafinilThe serum concentration of Asunaprevir can be decreased when it is combined with Armodafinil.Approved, Investigational
Arsenic trioxideThe serum concentration of Asunaprevir can be increased when it is combined with Arsenic trioxide.Approved, Investigational
ArtemetherThe serum concentration of Asunaprevir can be decreased when it is combined with Artemether.Approved
AstemizoleThe serum concentration of Asunaprevir can be increased when it is combined with Astemizole.Approved, Withdrawn
AtazanavirThe serum concentration of Asunaprevir can be increased when it is combined with Atazanavir.Approved, Investigational
AtomoxetineThe serum concentration of Asunaprevir can be increased when it is combined with Atomoxetine.Approved
AtorvastatinThe serum concentration of Atorvastatin can be increased when it is combined with Asunaprevir.Approved
AvasimibeThe serum concentration of Asunaprevir can be decreased when it is combined with Avasimibe.Investigational
AzatadineThe serum concentration of Asunaprevir can be decreased when it is combined with Azatadine.Approved
AzelastineThe serum concentration of Asunaprevir can be increased when it is combined with Azelastine.Approved
AzithromycinThe serum concentration of Asunaprevir can be increased when it is combined with Azithromycin.Approved
Beclomethasone dipropionateThe serum concentration of Asunaprevir can be decreased when it is combined with Beclomethasone dipropionate.Approved, Investigational
BetamethasoneThe serum concentration of Asunaprevir can be increased when it is combined with Betamethasone.Approved, Vet Approved
BetaxololThe metabolism of Asunaprevir can be decreased when combined with Betaxolol.Approved, Investigational
BexaroteneThe serum concentration of Asunaprevir can be decreased when it is combined with Bexarotene.Approved, Investigational
BicalutamideThe serum concentration of Asunaprevir can be increased when it is combined with Bicalutamide.Approved
BifonazoleThe serum concentration of Asunaprevir can be increased when it is combined with Bifonazole.Approved, Investigational
BoceprevirThe serum concentration of Asunaprevir can be decreased when it is combined with Boceprevir.Approved, Withdrawn
BortezomibThe serum concentration of Asunaprevir can be increased when it is combined with Bortezomib.Approved, Investigational
BosentanThe serum concentration of Asunaprevir can be decreased when it is combined with Bosentan.Approved, Investigational
Brentuximab vedotinThe serum concentration of Asunaprevir can be increased when it is combined with Brentuximab vedotin.Approved, Investigational
BromocriptineThe serum concentration of Asunaprevir can be increased when it is combined with Bromocriptine.Approved, Investigational
BuprenorphineThe serum concentration of Asunaprevir can be increased when it is combined with Buprenorphine.Approved, Illicit, Investigational, Vet Approved
BupropionThe metabolism of Asunaprevir can be decreased when combined with Bupropion.Approved
ButriptylineThe serum concentration of Butriptyline can be increased when it is combined with Asunaprevir.Approved
CabergolineThe serum concentration of Asunaprevir can be increased when it is combined with Cabergoline.Approved
CaffeineThe serum concentration of Asunaprevir can be increased when it is combined with Caffeine.Approved
CalcitriolThe serum concentration of Asunaprevir can be decreased when it is combined with Calcitriol.Approved, Nutraceutical
CapecitabineThe metabolism of Asunaprevir can be decreased when combined with Capecitabine.Approved, Investigational
CapsaicinThe serum concentration of Asunaprevir can be increased when it is combined with Capsaicin.Approved
CarbamazepineThe metabolism of Asunaprevir can be increased when combined with Carbamazepine.Approved, Investigational
CaspofunginThe serum concentration of Asunaprevir can be increased when it is combined with Caspofungin.Approved
CefradineThe serum concentration of Asunaprevir can be decreased when it is combined with Cefradine.Approved
CelecoxibThe metabolism of Asunaprevir can be decreased when combined with Celecoxib.Approved, Investigational
CeritinibThe serum concentration of Asunaprevir can be increased when it is combined with Ceritinib.Approved
CerivastatinThe serum concentration of Cerivastatin can be increased when it is combined with Asunaprevir.Approved, Withdrawn
ChloramphenicolThe serum concentration of Asunaprevir can be increased when it is combined with Chloramphenicol.Approved, Vet Approved
ChloroquineThe metabolism of Asunaprevir can be decreased when combined with Chloroquine.Approved, Investigational, Vet Approved
ChlorotrianiseneThe serum concentration of Chlorotrianisene can be decreased when it is combined with Asunaprevir.Investigational, Withdrawn
ChlorphenesinThe serum concentration of Asunaprevir can be decreased when it is combined with Chlorphenesin.Approved, Vet Approved, Withdrawn
ChlorpromazineThe metabolism of Asunaprevir can be decreased when combined with Chlorpromazine.Approved, Investigational, Vet Approved
ChlorzoxazoneThe serum concentration of Asunaprevir can be increased when it is combined with Chlorzoxazone.Approved
CholecalciferolThe metabolism of Asunaprevir can be decreased when combined with Cholecalciferol.Approved, Nutraceutical
CilostazolThe serum concentration of Asunaprevir can be increased when it is combined with Cilostazol.Approved, Investigational
CimetidineThe serum concentration of Asunaprevir can be increased when it is combined with Cimetidine.Approved, Investigational
Cimicifuga racemosaThe serum concentration of Asunaprevir can be increased when it is combined with Cimicifuga racemosa.Approved, Experimental
CinacalcetThe metabolism of Asunaprevir can be decreased when combined with Cinacalcet.Approved
CiprofloxacinThe serum concentration of Asunaprevir can be increased when it is combined with Ciprofloxacin.Approved, Investigational
CisaprideThe serum concentration of Asunaprevir can be increased when it is combined with Cisapride.Approved, Investigational, Withdrawn
CitalopramThe metabolism of Asunaprevir can be decreased when combined with Citalopram.Approved
ClarithromycinThe therapeutic efficacy of Clarithromycin can be decreased when used in combination with Asunaprevir.Approved
ClemastineThe serum concentration of Asunaprevir can be increased when it is combined with Clemastine.Approved, Investigational
ClevidipineThe serum concentration of Asunaprevir can be decreased when it is combined with Clevidipine.Approved, Investigational
ClindamycinThe serum concentration of Asunaprevir can be increased when it is combined with Clindamycin.Approved, Vet Approved
ClobazamThe serum concentration of Asunaprevir can be decreased when it is combined with Clobazam.Approved, Illicit
ClofazimineThe serum concentration of Asunaprevir can be increased when it is combined with Clofazimine.Approved, Investigational
ClofibrateThe serum concentration of Asunaprevir can be decreased when it is combined with Clofibrate.Approved, Investigational
ClomifeneThe serum concentration of Asunaprevir can be increased when it is combined with Clomifene.Approved, Investigational
ClomipramineThe serum concentration of Clomipramine can be increased when it is combined with Asunaprevir.Approved, Investigational, Vet Approved
ClopidogrelThe metabolism of Asunaprevir can be decreased when combined with Clopidogrel.Approved
ClotiazepamThe serum concentration of Asunaprevir can be increased when it is combined with Clotiazepam.Approved, Illicit
ClotrimazoleThe serum concentration of Asunaprevir can be decreased when it is combined with Clotrimazole.Approved, Vet Approved
ClozapineThe serum concentration of Asunaprevir can be decreased when it is combined with Clozapine.Approved
CobicistatThe serum concentration of Asunaprevir can be increased when it is combined with Cobicistat.Approved
CocaineThe serum concentration of Asunaprevir can be increased when it is combined with Cocaine.Approved, Illicit
ColchicineThe serum concentration of Asunaprevir can be decreased when it is combined with Colchicine.Approved
ConivaptanThe serum concentration of Conivaptan can be increased when it is combined with Asunaprevir.Approved, Investigational
Conjugated estrogensThe serum concentration of Conjugated estrogens can be decreased when it is combined with Asunaprevir.Approved
Cortisone acetateThe serum concentration of Asunaprevir can be increased when it is combined with Cortisone acetate.Approved, Investigational
CrisaboroleThe metabolism of Asunaprevir can be decreased when combined with Crisaborole.Approved, Investigational
CrizotinibThe serum concentration of Asunaprevir can be increased when it is combined with Crizotinib.Approved
CyclophosphamideThe serum concentration of Asunaprevir can be decreased when it is combined with Cyclophosphamide.Approved, Investigational
CyclosporineThe serum concentration of Cyclosporine can be increased when it is combined with Asunaprevir.Approved, Investigational, Vet Approved
Dabigatran etexilateThe serum concentration of Dabigatran etexilate can be increased when it is combined with Asunaprevir.Approved
DabrafenibThe serum concentration of Asunaprevir can be decreased when it is combined with Dabrafenib.Approved, Investigational
DalfopristinThe serum concentration of Asunaprevir can be increased when it is combined with Dalfopristin.Approved
DanazolThe serum concentration of Asunaprevir can be increased when it is combined with Danazol.Approved
DarifenacinThe metabolism of Asunaprevir can be decreased when combined with Darifenacin.Approved, Investigational
DarunavirThe serum concentration of Asunaprevir can be increased when it is combined with Darunavir.Approved
DasatinibThe serum concentration of Asunaprevir can be increased when it is combined with Dasatinib.Approved, Investigational
DaunorubicinThe serum concentration of Asunaprevir can be decreased when it is combined with Daunorubicin.Approved
DeferasiroxThe serum concentration of Asunaprevir can be decreased when it is combined with Deferasirox.Approved, Investigational
DelafloxacinThe serum concentration of Asunaprevir can be decreased when it is combined with Delafloxacin.Approved, Investigational
DelavirdineThe serum concentration of Delavirdine can be decreased when it is combined with Asunaprevir.Approved
DesipramineThe serum concentration of Desipramine can be increased when it is combined with Asunaprevir.Approved, Investigational
DesvenlafaxineThe serum concentration of Asunaprevir can be decreased when it is combined with Desvenlafaxine.Approved, Investigational
DexamethasoneThe serum concentration of Asunaprevir can be decreased when it is combined with Dexamethasone.Approved, Investigational, Vet Approved
DextromethorphanThe serum concentration of Dextromethorphan can be increased when it is combined with Asunaprevir.Approved
DextropropoxypheneThe serum concentration of Asunaprevir can be decreased when it is combined with Dextropropoxyphene.Approved, Illicit, Investigational, Withdrawn
DiacereinThe serum concentration of Asunaprevir can be increased when it is combined with Diacerein.Approved, Investigational
DiazepamThe serum concentration of Asunaprevir can be increased when it is combined with Diazepam.Approved, Illicit, Investigational, Vet Approved
DibenzepinThe serum concentration of Dibenzepin can be increased when it is combined with Asunaprevir.Experimental
DicloxacillinThe serum concentration of Asunaprevir can be decreased when it is combined with Dicloxacillin.Approved, Investigational, Vet Approved
DienestrolThe serum concentration of Dienestrol can be decreased when it is combined with Asunaprevir.Approved, Investigational
DienogestThe serum concentration of Dienogest can be decreased when it is combined with Asunaprevir.Approved
DiethylstilbestrolThe serum concentration of Asunaprevir can be increased when it is combined with Diethylstilbestrol.Approved, Investigational
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Asunaprevir.Approved
DihydroergotamineThe serum concentration of Asunaprevir can be increased when it is combined with Dihydroergotamine.Approved, Investigational
DiltiazemThe serum concentration of Asunaprevir can be increased when it is combined with Diltiazem.Approved, Investigational
DimetacrineThe serum concentration of Dimetacrine can be increased when it is combined with Asunaprevir.Approved, Withdrawn
Dimethyl sulfoxideThe serum concentration of Asunaprevir can be increased when it is combined with Dimethyl sulfoxide.Approved, Vet Approved
DiphenhydramineThe metabolism of Asunaprevir can be decreased when combined with Diphenhydramine.Approved, Investigational
DocetaxelThe serum concentration of Asunaprevir can be increased when it is combined with Docetaxel.Approved, Investigational
DosulepinThe serum concentration of Dosulepin can be increased when it is combined with Asunaprevir.Approved
DoxepinThe serum concentration of Doxepin can be increased when it is combined with Asunaprevir.Approved, Investigational
DoxorubicinThe serum concentration of Asunaprevir can be increased when it is combined with Doxorubicin.Approved, Investigational
DoxycyclineThe serum concentration of Asunaprevir can be increased when it is combined with Doxycycline.Approved, Investigational, Vet Approved
DronedaroneThe serum concentration of Asunaprevir can be increased when it is combined with Dronedarone.Approved
DrospirenoneThe serum concentration of Drospirenone can be decreased when it is combined with Asunaprevir.Approved
DuloxetineThe metabolism of Asunaprevir can be decreased when combined with Duloxetine.Approved
DyphyllineThe serum concentration of Dyphylline can be decreased when it is combined with Asunaprevir.Approved
EconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Econazole.Approved
EfavirenzThe serum concentration of Asunaprevir can be decreased when it is combined with Efavirenz.Approved, Investigational
EfonidipineThe serum concentration of Asunaprevir can be increased when it is combined with Efonidipine.Approved, Investigational
ElbasvirThe serum concentration of Asunaprevir can be increased when it is combined with Elbasvir.Approved
EletriptanThe serum concentration of Asunaprevir can be decreased when it is combined with Eletriptan.Approved, Investigational
EliglustatThe metabolism of Asunaprevir can be decreased when combined with Eliglustat.Approved
EltrombopagThe serum concentration of Asunaprevir can be increased when it is combined with Eltrombopag.Approved
EnasidenibThe serum concentration of Asunaprevir can be decreased when it is combined with Enasidenib.Approved, Investigational
EnfuvirtideThe serum concentration of Enfuvirtide can be increased when it is combined with Asunaprevir.Approved, Investigational
EnzalutamideThe serum concentration of Asunaprevir can be decreased when it is combined with Enzalutamide.Approved
EpinephrineThe serum concentration of Asunaprevir can be increased when it is combined with Epinephrine.Approved, Vet Approved
Ergoloid mesylateThe serum concentration of Ergoloid mesylate can be increased when it is combined with Asunaprevir.Approved
ErgonovineThe serum concentration of Asunaprevir can be increased when it is combined with Ergonovine.Approved
ErgotamineThe serum concentration of Asunaprevir can be increased when it is combined with Ergotamine.Approved
ErythromycinThe serum concentration of Asunaprevir can be increased when it is combined with Erythromycin.Approved, Investigational, Vet Approved
Eslicarbazepine acetateThe serum concentration of Asunaprevir can be decreased when it is combined with Eslicarbazepine acetate.Approved
EsomeprazoleThe metabolism of Asunaprevir can be decreased when combined with Esomeprazole.Approved, Investigational
EstradiolThe serum concentration of Asunaprevir can be decreased when it is combined with Estradiol.Approved, Investigational, Vet Approved
Estradiol acetateThe serum concentration of Asunaprevir can be decreased when it is combined with Estradiol acetate.Approved, Investigational, Vet Approved
Estradiol benzoateThe serum concentration of Asunaprevir can be decreased when it is combined with Estradiol benzoate.Approved, Investigational, Vet Approved
Estradiol cypionateThe serum concentration of Asunaprevir can be decreased when it is combined with Estradiol cypionate.Approved, Investigational, Vet Approved
Estradiol dienanthateThe serum concentration of Asunaprevir can be decreased when it is combined with Estradiol dienanthate.Approved, Investigational, Vet Approved
Estradiol valerateThe serum concentration of Asunaprevir can be decreased when it is combined with Estradiol valerate.Approved, Investigational, Vet Approved
EstramustineThe serum concentration of Estramustine can be decreased when it is combined with Asunaprevir.Approved, Investigational
Estrogens, esterifiedThe serum concentration of Estrogens, esterified can be decreased when it is combined with Asunaprevir.Approved
Estrone sulfateThe serum concentration of Estrone sulfate can be decreased when it is combined with Asunaprevir.Approved
EthanolThe serum concentration of Asunaprevir can be decreased when it is combined with Ethanol.Approved
Ethinyl EstradiolThe serum concentration of Ethinyl Estradiol can be decreased when it is combined with Asunaprevir.Approved
Ethynodiol diacetateThe serum concentration of Ethynodiol diacetate can be decreased when it is combined with Asunaprevir.Approved
EtonogestrelThe serum concentration of Etonogestrel can be decreased when it is combined with Asunaprevir.Approved, Investigational
EtoposideThe serum concentration of Asunaprevir can be decreased when it is combined with Etoposide.Approved
EtoricoxibThe serum concentration of Asunaprevir can be increased when it is combined with Etoricoxib.Approved, Investigational
EtravirineThe serum concentration of Asunaprevir can be decreased when it is combined with Etravirine.Approved
ExemestaneThe serum concentration of Asunaprevir can be decreased when it is combined with Exemestane.Approved, Investigational
EzetimibeThe serum concentration of Asunaprevir can be increased when it is combined with Ezetimibe.Approved
FelbamateThe serum concentration of Asunaprevir can be decreased when it is combined with Felbamate.Approved
FelodipineThe serum concentration of Asunaprevir can be increased when it is combined with Felodipine.Approved, Investigational
FentanylThe serum concentration of Asunaprevir can be increased when it is combined with Fentanyl.Approved, Illicit, Investigational, Vet Approved
FlecainideThe serum concentration of Flecainide can be increased when it is combined with Asunaprevir.Approved, Withdrawn
FloxuridineThe metabolism of Asunaprevir can be decreased when combined with Floxuridine.Approved
FlucloxacillinThe serum concentration of Asunaprevir can be decreased when it is combined with Flucloxacillin.Approved, Investigational
FluconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Fluconazole.Approved, Investigational
FluorometholoneThe serum concentration of Asunaprevir can be decreased when it is combined with Fluorometholone.Approved, Investigational
FluorouracilThe metabolism of Asunaprevir can be decreased when combined with Fluorouracil.Approved
FluoxetineThe serum concentration of Asunaprevir can be increased when it is combined with Fluoxetine.Approved, Vet Approved
Fluticasone propionateThe serum concentration of Asunaprevir can be increased when it is combined with Fluticasone propionate.Approved
FluvastatinThe serum concentration of Fluvastatin can be increased when it is combined with Asunaprevir.Approved
FluvoxamineThe serum concentration of Asunaprevir can be increased when it is combined with Fluvoxamine.Approved, Investigational
FosamprenavirThe serum concentration of Asunaprevir can be increased when it is combined with Fosamprenavir.Approved
FosaprepitantThe serum concentration of Asunaprevir can be decreased when it is combined with Fosaprepitant.Approved
FosnetupitantThe serum concentration of Asunaprevir can be increased when it is combined with Fosnetupitant.Approved
FosphenytoinThe serum concentration of Asunaprevir can be decreased when it is combined with Fosphenytoin.Approved, Investigational
Fusidic AcidThe serum concentration of Asunaprevir can be increased when it is combined with Fusidic Acid.Approved, Investigational
GarlicThe serum concentration of Asunaprevir can be decreased when it is combined with Garlic.Approved, Nutraceutical
GemfibrozilThe serum concentration of Asunaprevir can be decreased when it is combined with Gemfibrozil.Approved
GestodeneThe serum concentration of Gestodene can be decreased when it is combined with Asunaprevir.Approved, Investigational
GlecaprevirThe serum concentration of Asunaprevir can be increased when it is combined with Glecaprevir.Approved, Investigational
GlyburideThe serum concentration of Asunaprevir can be increased when it is combined with Glyburide.Approved
Glycerol PhenylbutyrateThe serum concentration of Asunaprevir can be increased when it is combined with Glycerol Phenylbutyrate.Approved
GriseofulvinThe serum concentration of Asunaprevir can be decreased when it is combined with Griseofulvin.Approved, Investigational, Vet Approved
GuanethidineThe serum concentration of Asunaprevir can be decreased when it is combined with Guanethidine.Approved
HaloperidolThe serum concentration of Asunaprevir can be increased when it is combined with Haloperidol.Approved
HexestrolThe serum concentration of Hexestrol can be decreased when it is combined with Asunaprevir.Withdrawn
HistamineThe serum concentration of Asunaprevir can be increased when it is combined with Histamine.Approved, Investigational
HydralazineThe serum concentration of Asunaprevir can be increased when it is combined with Hydralazine.Approved
HydrocortamateThe serum concentration of Asunaprevir can be decreased when it is combined with Hydrocortamate.Approved
HydrocortisoneThe serum concentration of Asunaprevir can be decreased when it is combined with Hydrocortisone.Approved, Vet Approved
IdelalisibThe serum concentration of Asunaprevir can be decreased when it is combined with Idelalisib.Approved
IfosfamideThe serum concentration of Asunaprevir can be decreased when it is combined with Ifosfamide.Approved
IloperidoneThe serum concentration of Asunaprevir can be increased when it is combined with Iloperidone.Approved
ImatinibThe serum concentration of Asunaprevir can be increased when it is combined with Imatinib.Approved
ImipramineThe serum concentration of Imipramine can be increased when it is combined with Asunaprevir.Approved
IndinavirThe serum concentration of Asunaprevir can be increased when it is combined with Indinavir.Approved
IndisulamThe serum concentration of Asunaprevir can be increased when it is combined with Indisulam.Investigational
IprindoleThe serum concentration of Iprindole can be increased when it is combined with Asunaprevir.Experimental
IrbesartanThe serum concentration of Asunaprevir can be increased when it is combined with Irbesartan.Approved, Investigational
IrinotecanThe serum concentration of Asunaprevir can be increased when it is combined with Irinotecan.Approved, Investigational
IsavuconazoleThe serum concentration of Asunaprevir can be decreased when it is combined with Isavuconazole.Approved, Investigational
IsavuconazoniumThe serum concentration of Asunaprevir can be decreased when it is combined with Isavuconazonium.Approved, Investigational
IsoniazidThe serum concentration of Asunaprevir can be increased when it is combined with Isoniazid.Approved, Investigational
IsradipineThe serum concentration of Asunaprevir can be increased when it is combined with Isradipine.Approved, Investigational
ItraconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Itraconazole.Approved, Investigational
IvacaftorThe serum concentration of Asunaprevir can be increased when it is combined with Ivacaftor.Approved
JosamycinThe serum concentration of Asunaprevir can be increased when it is combined with Josamycin.Approved, Investigational
KetazolamThe serum concentration of Asunaprevir can be increased when it is combined with Ketazolam.Approved
KetoconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Ketoconazole.Approved, Investigational
LansoprazoleThe serum concentration of Asunaprevir can be decreased when it is combined with Lansoprazole.Approved, Investigational
LapatinibThe serum concentration of Asunaprevir can be increased when it is combined with Lapatinib.Approved, Investigational
LeflunomideThe metabolism of Asunaprevir can be decreased when combined with Leflunomide.Approved, Investigational
LercanidipineThe serum concentration of Asunaprevir can be increased when it is combined with Lercanidipine.Approved, Investigational
LetermovirThe serum concentration of Asunaprevir can be increased when it is combined with Letermovir.Approved, Investigational
LevofloxacinThe serum concentration of Asunaprevir can be increased when it is combined with Levofloxacin.Approved, Investigational
LevonorgestrelThe serum concentration of Levonorgestrel can be decreased when it is combined with Asunaprevir.Approved, Investigational
LevosalbutamolThe serum concentration of Asunaprevir can be increased when it is combined with Levosalbutamol.Approved, Investigational
LidocaineThe serum concentration of Asunaprevir can be increased when it is combined with Lidocaine.Approved, Vet Approved
LinagliptinThe serum concentration of Asunaprevir can be increased when it is combined with Linagliptin.Approved
LobeglitazoneThe metabolism of Asunaprevir can be decreased when combined with Lobeglitazone.Approved, Investigational
LofepramineThe serum concentration of Lofepramine can be increased when it is combined with Asunaprevir.Experimental
LomitapideThe serum concentration of Asunaprevir can be increased when it is combined with Lomitapide.Approved, Investigational
LomustineThe serum concentration of Asunaprevir can be increased when it is combined with Lomustine.Approved, Investigational
LopinavirThe serum concentration of Asunaprevir can be decreased when it is combined with Lopinavir.Approved
LoratadineThe serum concentration of Asunaprevir can be decreased when it is combined with Loratadine.Approved, Investigational
LorcaserinThe metabolism of Asunaprevir can be decreased when combined with Lorcaserin.Approved
LorpiprazoleThe serum concentration of Asunaprevir can be increased when it is combined with Lorpiprazole.Approved
LosartanThe serum concentration of Asunaprevir can be increased when it is combined with Losartan.Approved
LovastatinThe serum concentration of Lovastatin can be increased when it is combined with Asunaprevir.Approved, Investigational
LuliconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Luliconazole.Approved
LumacaftorThe serum concentration of Asunaprevir can be decreased when it is combined with Lumacaftor.Approved
LumefantrineThe serum concentration of Asunaprevir can be decreased when it is combined with Lumefantrine.Approved
LurasidoneThe serum concentration of Asunaprevir can be increased when it is combined with Lurasidone.Approved, Investigational
LynestrenolThe serum concentration of Lynestrenol can be decreased when it is combined with Asunaprevir.Approved, Investigational
ManidipineThe serum concentration of Asunaprevir can be increased when it is combined with Manidipine.Approved, Investigational
Medroxyprogesterone acetateThe serum concentration of Asunaprevir can be decreased when it is combined with Medroxyprogesterone acetate.Approved, Investigational
MefloquineThe serum concentration of Asunaprevir can be increased when it is combined with Mefloquine.Approved, Investigational
Megestrol acetateThe serum concentration of Megestrol acetate can be decreased when it is combined with Asunaprevir.Approved, Investigational, Vet Approved
MelitracenThe serum concentration of Melitracen can be increased when it is combined with Asunaprevir.Experimental, Investigational
MequitazineThe serum concentration of Asunaprevir can be increased when it is combined with Mequitazine.Approved
MestranolThe serum concentration of Mestranol can be decreased when it is combined with Asunaprevir.Approved
MetamizoleThe serum concentration of Asunaprevir can be decreased when it is combined with Metamizole.Approved, Investigational, Withdrawn
MethadoneThe serum concentration of Asunaprevir can be decreased when it is combined with Methadone.Approved
MethallenestrilThe serum concentration of Methallenestril can be decreased when it is combined with Asunaprevir.Experimental
MethazolamideThe serum concentration of Asunaprevir can be increased when it is combined with Methazolamide.Approved
MethimazoleThe serum concentration of Asunaprevir can be increased when it is combined with Methimazole.Approved
MethotrimeprazineThe metabolism of Asunaprevir can be decreased when combined with Methotrimeprazine.Approved, Investigational
MethylergometrineThe serum concentration of Asunaprevir can be increased when it is combined with Methylergometrine.Approved
MethylprednisoloneThe serum concentration of Asunaprevir can be increased when it is combined with Methylprednisolone.Approved, Vet Approved
MetildigoxinThe serum concentration of Metildigoxin can be increased when it is combined with Asunaprevir.Experimental
MetoprololThe metabolism of Asunaprevir can be decreased when combined with Metoprolol.Approved, Investigational
MetronidazoleThe serum concentration of Asunaprevir can be increased when it is combined with Metronidazole.Approved
MetyraponeThe serum concentration of Asunaprevir can be decreased when it is combined with Metyrapone.Approved, Investigational
MevastatinThe serum concentration of Mevastatin can be increased when it is combined with Asunaprevir.Experimental
MibefradilThe serum concentration of Asunaprevir can be increased when it is combined with Mibefradil.Investigational, Withdrawn
MiconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Miconazole.Approved, Investigational, Vet Approved
MidazolamThe serum concentration of Midazolam can be decreased when it is combined with Asunaprevir.Approved, Illicit
MidostaurinThe serum concentration of Asunaprevir can be decreased when it is combined with Midostaurin.Approved, Investigational
MifepristoneThe serum concentration of Asunaprevir can be decreased when it is combined with Mifepristone.Approved, Investigational
MirabegronThe metabolism of Asunaprevir can be decreased when combined with Mirabegron.Approved
MirtazapineThe serum concentration of Asunaprevir can be increased when it is combined with Mirtazapine.Approved
MitotaneThe serum concentration of Asunaprevir can be decreased when it is combined with Mitotane.Approved
MitoxantroneThe serum concentration of Asunaprevir can be increased when it is combined with Mitoxantrone.Approved, Investigational
MoclobemideThe metabolism of Asunaprevir can be decreased when combined with Moclobemide.Approved, Investigational
ModafinilThe serum concentration of Asunaprevir can be decreased when it is combined with Modafinil.Approved, Investigational
MyrrhThe serum concentration of Asunaprevir can be decreased when it is combined with Myrrh.Approved
NabiloneThe serum concentration of Asunaprevir can be increased when it is combined with Nabilone.Approved, Investigational
NafcillinThe serum concentration of Asunaprevir can be decreased when it is combined with Nafcillin.Approved, Investigational
NefazodoneThe serum concentration of Nefazodone can be increased when it is combined with Asunaprevir.Approved, Withdrawn
NelfinavirThe serum concentration of Asunaprevir can be increased when it is combined with Nelfinavir.Approved
NetupitantThe serum concentration of Asunaprevir can be increased when it is combined with Netupitant.Approved, Investigational
NevirapineThe serum concentration of Asunaprevir can be decreased when it is combined with Nevirapine.Approved
NicardipineThe serum concentration of Asunaprevir can be decreased when it is combined with Nicardipine.Approved, Investigational
NicotinamideThe serum concentration of Asunaprevir can be increased when it is combined with Nicotinamide.Approved, Investigational
NicotineThe metabolism of Asunaprevir can be decreased when combined with Nicotine.Approved
NifedipineThe serum concentration of Asunaprevir can be decreased when it is combined with Nifedipine.Approved
NilotinibThe serum concentration of Asunaprevir can be increased when it is combined with Nilotinib.Approved, Investigational
NilvadipineThe serum concentration of Asunaprevir can be increased when it is combined with Nilvadipine.Approved, Investigational
NisoldipineThe serum concentration of Asunaprevir can be increased when it is combined with Nisoldipine.Approved
NitrendipineThe serum concentration of Asunaprevir can be increased when it is combined with Nitrendipine.Approved, Investigational
Nitric OxideThe serum concentration of Asunaprevir can be increased when it is combined with Nitric Oxide.Approved
NorelgestrominThe serum concentration of Norelgestromin can be decreased when it is combined with Asunaprevir.Approved, Investigational
NorethisteroneThe serum concentration of Norethisterone can be decreased when it is combined with Asunaprevir.Approved
NorfloxacinThe serum concentration of Asunaprevir can be increased when it is combined with Norfloxacin.Approved
NorgestimateThe serum concentration of Asunaprevir can be decreased when it is combined with Norgestimate.Approved, Investigational
NorgestrienoneThe serum concentration of Norgestrienone can be decreased when it is combined with Asunaprevir.Experimental
NortriptylineThe serum concentration of Nortriptyline can be increased when it is combined with Asunaprevir.Approved
NoscapineThe serum concentration of Asunaprevir can be increased when it is combined with Noscapine.Investigational
OlanzapineThe serum concentration of Asunaprevir can be increased when it is combined with Olanzapine.Approved, Investigational
OlaparibThe serum concentration of Asunaprevir can be increased when it is combined with Olaparib.Approved
OmeprazoleThe serum concentration of Asunaprevir can be decreased when it is combined with Omeprazole.Approved, Investigational, Vet Approved
OpipramolThe serum concentration of Opipramol can be increased when it is combined with Asunaprevir.Investigational
OritavancinThe serum concentration of Asunaprevir can be decreased when it is combined with Oritavancin.Approved, Investigational
OrlistatThe serum concentration of Asunaprevir can be decreased when it is combined with Orlistat.Approved, Investigational
OsimertinibThe serum concentration of Asunaprevir can be decreased when it is combined with Osimertinib.Approved
OxcarbazepineThe serum concentration of Asunaprevir can be decreased when it is combined with Oxcarbazepine.Approved
OxiconazoleThe serum concentration of Asunaprevir can be decreased when it is combined with Oxiconazole.Approved
OxybutyninThe serum concentration of Asunaprevir can be increased when it is combined with Oxybutynin.Approved, Investigational
OxymetholoneThe serum concentration of Asunaprevir can be increased when it is combined with Oxymetholone.Approved, Illicit
PaclitaxelThe serum concentration of Asunaprevir can be decreased when it is combined with Paclitaxel.Approved, Vet Approved
PalbociclibThe serum concentration of Asunaprevir can be increased when it is combined with Palbociclib.Approved, Investigational
PanobinostatThe serum concentration of Asunaprevir can be increased when it is combined with Panobinostat.Approved, Investigational
PantoprazoleThe serum concentration of Asunaprevir can be decreased when it is combined with Pantoprazole.Approved
ParamethasoneThe serum concentration of Asunaprevir can be increased when it is combined with Paramethasone.Approved
ParoxetineThe metabolism of Asunaprevir can be decreased when combined with Paroxetine.Approved, Investigational
PazopanibThe serum concentration of Asunaprevir can be increased when it is combined with Pazopanib.Approved
Peginterferon alfa-2bThe serum concentration of Asunaprevir can be decreased when it is combined with Peginterferon alfa-2b.Approved
PegvisomantThe serum concentration of Asunaprevir can be decreased when it is combined with Pegvisomant.Approved
PentobarbitalThe serum concentration of Asunaprevir can be decreased when it is combined with Pentobarbital.Approved, Investigational, Vet Approved
Peppermint oilThe serum concentration of Asunaprevir can be increased when it is combined with Peppermint oil.Approved, Investigational
PerampanelThe serum concentration of Asunaprevir can be decreased when it is combined with Perampanel.Approved
PergolideThe serum concentration of Asunaprevir can be increased when it is combined with Pergolide.Approved, Investigational, Vet Approved, Withdrawn
PethidineThe risk or severity of adverse effects can be increased when Asunaprevir is combined with Pethidine.Approved
PhenelzineThe serum concentration of Asunaprevir can be increased when it is combined with Phenelzine.Approved
PhenobarbitalThe serum concentration of Asunaprevir can be decreased when it is combined with Phenobarbital.Approved, Investigational
PhenylbutazoneThe serum concentration of Asunaprevir can be decreased when it is combined with Phenylbutazone.Approved, Vet Approved
PhenytoinThe serum concentration of Asunaprevir can be decreased when it is combined with Phenytoin.Approved, Vet Approved
PibrentasvirThe serum concentration of Asunaprevir can be increased when it is combined with Pibrentasvir.Approved, Investigational
PilocarpineThe serum concentration of Asunaprevir can be increased when it is combined with Pilocarpine.Approved, Investigational
PimozideThe serum concentration of Asunaprevir can be increased when it is combined with Pimozide.Approved
PioglitazoneThe serum concentration of Asunaprevir can be decreased when it is combined with Pioglitazone.Approved, Investigational
PiperaquineThe serum concentration of Asunaprevir can be increased when it is combined with Piperaquine.Approved, Investigational
PitavastatinThe serum concentration of Pitavastatin can be increased when it is combined with Asunaprevir.Approved
PitolisantThe serum concentration of Asunaprevir can be decreased when it is combined with Pitolisant.Approved, Investigational
PosaconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Posaconazole.Approved, Investigational, Vet Approved
PrasteroneThe serum concentration of Asunaprevir can be increased when it is combined with Prasterone.Approved, Investigational, Nutraceutical
PravastatinThe serum concentration of Pravastatin can be increased when it is combined with Asunaprevir.Approved
PrednisoloneThe serum concentration of Asunaprevir can be increased when it is combined with Prednisolone.Approved, Vet Approved
PrednisoneThe serum concentration of Asunaprevir can be decreased when it is combined with Prednisone.Approved, Vet Approved
PrimaquineThe serum concentration of Asunaprevir can be increased when it is combined with Primaquine.Approved
PrimidoneThe serum concentration of Asunaprevir can be decreased when it is combined with Primidone.Approved, Vet Approved
ProbenecidThe serum concentration of Asunaprevir can be decreased when it is combined with Probenecid.Approved, Investigational
ProgesteroneThe serum concentration of Asunaprevir can be decreased when it is combined with Progesterone.Approved, Vet Approved
PromazineThe metabolism of Asunaprevir can be decreased when combined with Promazine.Approved, Vet Approved
PropofolThe serum concentration of Asunaprevir can be increased when it is combined with Propofol.Approved, Investigational, Vet Approved
ProtriptylineThe serum concentration of Protriptyline can be increased when it is combined with Asunaprevir.Approved
PyridostigmineThe serum concentration of Asunaprevir can be decreased when it is combined with Pyridostigmine.Approved, Investigational
PyrimethamineThe metabolism of Asunaprevir can be decreased when combined with Pyrimethamine.Approved, Investigational, Vet Approved
QuazepamThe serum concentration of Asunaprevir can be increased when it is combined with Quazepam.Approved, Illicit
QuingestanolThe serum concentration of Quingestanol can be decreased when it is combined with Asunaprevir.Experimental
QuinidineThe serum concentration of Asunaprevir can be decreased when it is combined with Quinidine.Approved, Investigational
QuinineThe serum concentration of Asunaprevir can be decreased when it is combined with Quinine.Approved
QuinupristinThe serum concentration of Asunaprevir can be increased when it is combined with Quinupristin.Approved
RabeprazoleThe serum concentration of Asunaprevir can be increased when it is combined with Rabeprazole.Approved, Investigational
RaloxifeneThe serum concentration of Asunaprevir can be increased when it is combined with Raloxifene.Approved, Investigational
RanitidineThe serum concentration of Asunaprevir can be increased when it is combined with Ranitidine.Approved
RanolazineThe serum concentration of Asunaprevir can be increased when it is combined with Ranolazine.Approved, Investigational
RegorafenibThe serum concentration of Asunaprevir can be increased when it is combined with Regorafenib.Approved
RepaglinideThe serum concentration of Asunaprevir can be increased when it is combined with Repaglinide.Approved, Investigational
ReserpineThe serum concentration of Asunaprevir can be decreased when it is combined with Reserpine.Approved, Investigational
ResveratrolThe serum concentration of Asunaprevir can be increased when it is combined with Resveratrol.Approved, Experimental, Investigational
RheinThe serum concentration of Asunaprevir can be increased when it is combined with Rhein.Experimental
RifabutinThe serum concentration of Asunaprevir can be decreased when it is combined with Rifabutin.Approved, Investigational
RifampicinThe serum concentration of Asunaprevir can be decreased when it is combined with Rifampicin.Approved
RifapentineThe serum concentration of Asunaprevir can be decreased when it is combined with Rifapentine.Approved, Investigational
RifaximinThe serum concentration of Asunaprevir can be decreased when it is combined with Rifaximin.Approved, Investigational
RilpivirineThe serum concentration of Asunaprevir can be decreased when it is combined with Rilpivirine.Approved
RiociguatThe serum concentration of Riociguat can be increased when it is combined with Asunaprevir.Approved
RisperidoneThe serum concentration of Asunaprevir can be increased when it is combined with Risperidone.Approved, Investigational
RitonavirThe serum concentration of Asunaprevir can be decreased when it is combined with Ritonavir.Approved, Investigational
RivastigmineThe serum concentration of Asunaprevir can be increased when it is combined with Rivastigmine.Approved, Investigational
RofecoxibThe serum concentration of Asunaprevir can be decreased when it is combined with Rofecoxib.Approved, Investigational, Withdrawn
RolapitantThe metabolism of Asunaprevir can be decreased when combined with Rolapitant.Approved, Investigational
RolitetracyclineThe serum concentration of Asunaprevir can be increased when it is combined with Rolitetracycline.Approved
RopiniroleThe metabolism of Asunaprevir can be decreased when combined with Ropinirole.Approved, Investigational
RosuvastatinThe serum concentration of Rosuvastatin can be increased when it is combined with Asunaprevir.Approved
RoxithromycinThe serum concentration of Asunaprevir can be increased when it is combined with Roxithromycin.Approved, Investigational, Withdrawn
RucaparibThe serum concentration of Asunaprevir can be increased when it is combined with Rucaparib.Approved, Investigational
RufinamideThe serum concentration of Asunaprevir can be decreased when it is combined with Rufinamide.Approved
RutinThe serum concentration of Asunaprevir can be increased when it is combined with Rutin.Experimental, Investigational
SalbutamolThe serum concentration of Asunaprevir can be increased when it is combined with Salbutamol.Approved, Vet Approved
SaquinavirThe serum concentration of Asunaprevir can be increased when it is combined with Saquinavir.Approved, Investigational
SarilumabThe serum concentration of Asunaprevir can be increased when it is combined with Sarilumab.Approved, Investigational
SecobarbitalThe metabolism of Asunaprevir can be increased when combined with Secobarbital.Approved, Vet Approved
SeproxetineThe serum concentration of Asunaprevir can be increased when it is combined with Seproxetine.Investigational
SeratrodastThe serum concentration of Asunaprevir can be decreased when it is combined with Seratrodast.Approved
SertralineThe serum concentration of Asunaprevir can be increased when it is combined with Sertraline.Approved
SildenafilThe serum concentration of Sildenafil can be increased when it is combined with Asunaprevir.Approved, Investigational
SiltuximabThe serum concentration of Asunaprevir can be decreased when it is combined with Siltuximab.Approved, Investigational
SimeprevirThe serum concentration of Asunaprevir can be increased when it is combined with Simeprevir.Approved
SimvastatinThe serum concentration of Simvastatin can be increased when it is combined with Asunaprevir.Approved
SirolimusThe serum concentration of Asunaprevir can be increased when it is combined with Sirolimus.Approved, Investigational
SitaxentanThe serum concentration of Asunaprevir can be increased when it is combined with Sitaxentan.Approved, Investigational, Withdrawn
SorafenibThe serum concentration of Asunaprevir can be increased when it is combined with Sorafenib.Approved, Investigational
St. John's WortThe metabolism of Asunaprevir can be increased when combined with St. John's Wort.Approved, Investigational, Nutraceutical
StiripentolThe serum concentration of Asunaprevir can be increased when it is combined with Stiripentol.Approved
SulfadiazineThe metabolism of Asunaprevir can be decreased when combined with Sulfadiazine.Approved, Investigational, Vet Approved
SulfamethoxazoleThe serum concentration of Asunaprevir can be increased when it is combined with Sulfamethoxazole.Approved
SulfanilamideThe serum concentration of Asunaprevir can be increased when it is combined with Sulfanilamide.Approved
SulfinpyrazoneThe serum concentration of Asunaprevir can be decreased when it is combined with Sulfinpyrazone.Approved
SulfisoxazoleThe serum concentration of Asunaprevir can be increased when it is combined with Sulfisoxazole.Approved, Vet Approved
Synthetic Conjugated Estrogens, AThe serum concentration of Synthetic Conjugated Estrogens, A can be decreased when it is combined with Asunaprevir.Approved
TacrolimusThe metabolism of Tacrolimus can be decreased when combined with Asunaprevir.Approved, Investigational
TadalafilThe serum concentration of Asunaprevir can be increased when it is combined with Tadalafil.Approved, Investigational
TamoxifenThe serum concentration of Asunaprevir can be decreased when it is combined with Tamoxifen.Approved
TelaprevirThe serum concentration of Asunaprevir can be increased when it is combined with Telaprevir.Approved, Withdrawn
TelithromycinThe serum concentration of Asunaprevir can be increased when it is combined with Telithromycin.Approved
TemozolomideThe serum concentration of Asunaprevir can be decreased when it is combined with Temozolomide.Approved, Investigational
TemsirolimusThe risk or severity of adverse effects can be increased when Asunaprevir is combined with Temsirolimus.Approved
TeniposideThe serum concentration of Asunaprevir can be increased when it is combined with Teniposide.Approved
TerbinafineThe serum concentration of Asunaprevir can be decreased when it is combined with Terbinafine.Approved, Investigational, Vet Approved
TerfenadineThe serum concentration of Asunaprevir can be decreased when it is combined with Terfenadine.Approved, Withdrawn
TeriflunomideThe serum concentration of Asunaprevir can be increased when it is combined with Teriflunomide.Approved
TesmilifeneThe serum concentration of Asunaprevir can be decreased when it is combined with Tesmilifene.Investigational
TestosteroneThe serum concentration of Asunaprevir can be decreased when it is combined with Testosterone.Approved, Investigational
Testosterone cypionateThe serum concentration of Asunaprevir can be decreased when it is combined with Testosterone cypionate.Approved
Testosterone enanthateThe serum concentration of Asunaprevir can be decreased when it is combined with Testosterone enanthate.Approved
Testosterone undecanoateThe serum concentration of Asunaprevir can be decreased when it is combined with Testosterone undecanoate.Approved, Investigational
TetracyclineThe serum concentration of Asunaprevir can be increased when it is combined with Tetracycline.Approved, Vet Approved
ThalidomideThe serum concentration of Asunaprevir can be decreased when it is combined with Thalidomide.Approved, Investigational, Withdrawn
TheophyllineThe serum concentration of Theophylline can be decreased when it is combined with Asunaprevir.Approved
ThiopentalThe serum concentration of Asunaprevir can be increased when it is combined with Thiopental.Approved, Vet Approved
ThioridazineThe metabolism of Asunaprevir can be decreased when combined with Thioridazine.Approved, Withdrawn
ThiotepaThe metabolism of Asunaprevir can be decreased when combined with Thiotepa.Approved, Investigational
TianeptineThe serum concentration of Tianeptine can be increased when it is combined with Asunaprevir.Approved, Investigational
TicagrelorThe serum concentration of Asunaprevir can be increased when it is combined with Ticagrelor.Approved
TiclopidineThe serum concentration of Asunaprevir can be increased when it is combined with Ticlopidine.Approved
TioconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Tioconazole.Approved
TipranavirThe serum concentration of Asunaprevir can be decreased when it is combined with Tipranavir.Approved, Investigational
TocilizumabThe serum concentration of Asunaprevir can be decreased when it is combined with Tocilizumab.Approved
TofisopamThe serum concentration of Asunaprevir can be increased when it is combined with Tofisopam.Approved
TolbutamideThe metabolism of Asunaprevir can be decreased when combined with Tolbutamide.Approved, Investigational
TopiramateThe serum concentration of Asunaprevir can be decreased when it is combined with Topiramate.Approved
TopiroxostatThe serum concentration of Asunaprevir can be increased when it is combined with Topiroxostat.Approved, Investigational
TopotecanThe serum concentration of Asunaprevir can be decreased when it is combined with Topotecan.Approved, Investigational
TramadolThe serum concentration of Asunaprevir can be increased when it is combined with Tramadol.Approved, Investigational
TrametinibThe serum concentration of Asunaprevir can be decreased when it is combined with Trametinib.Approved
TranylcypromineThe serum concentration of Asunaprevir can be increased when it is combined with Tranylcypromine.Approved, Investigational
TriazolamThe serum concentration of Triazolam can be increased when it is combined with Asunaprevir.Approved, Investigational
TrimethoprimThe metabolism of Asunaprevir can be decreased when combined with Trimethoprim.Approved, Vet Approved
TrimipramineThe serum concentration of Trimipramine can be increased when it is combined with Asunaprevir.Approved
TroglitazoneThe serum concentration of Asunaprevir can be decreased when it is combined with Troglitazone.Investigational, Withdrawn
TroleandomycinThe serum concentration of Asunaprevir can be increased when it is combined with Troleandomycin.Approved
Valproic AcidThe serum concentration of Asunaprevir can be increased when it is combined with Valproic Acid.Approved, Investigational
ValsartanThe metabolism of Asunaprevir can be decreased when combined with Valsartan.Approved, Investigational
VemurafenibThe serum concentration of Asunaprevir can be decreased when it is combined with Vemurafenib.Approved
VenlafaxineThe serum concentration of Asunaprevir can be increased when it is combined with Venlafaxine.Approved
VerapamilThe serum concentration of Asunaprevir can be increased when it is combined with Verapamil.Approved
VinblastineThe serum concentration of Asunaprevir can be increased when it is combined with Vinblastine.Approved
VincristineThe serum concentration of Asunaprevir can be increased when it is combined with Vincristine.Approved, Investigational
VinorelbineThe serum concentration of Asunaprevir can be increased when it is combined with Vinorelbine.Approved, Investigational
VoriconazoleThe serum concentration of Asunaprevir can be increased when it is combined with Voriconazole.Approved, Investigational
ZafirlukastThe serum concentration of Asunaprevir can be increased when it is combined with Zafirlukast.Approved, Investigational
ZidovudineThe serum concentration of Zidovudine can be decreased when it is combined with Asunaprevir.Approved
ZiprasidoneThe serum concentration of Asunaprevir can be increased when it is combined with Ziprasidone.Approved
ZucapsaicinThe serum concentration of Asunaprevir can be increased when it is combined with Zucapsaicin.Approved, Investigational
Food Interactions
Not Available

References

General References
  1. Lok AS, Gardiner DF, Lawitz E, Martorell C, Everson GT, Ghalib R, Reindollar R, Rustgi V, McPhee F, Wind-Rotolo M, Persson A, Zhu K, Dimitrova DI, Eley T, Guo T, Grasela DM, Pasquinelli C: Preliminary study of two antiviral agents for hepatitis C genotype 1. N Engl J Med. 2012 Jan 19;366(3):216-24. doi: 10.1056/NEJMoa1104430. [PubMed:22256805]
  2. McPhee F, Friborg J, Levine S, Chen C, Falk P, Yu F, Hernandez D, Lee MS, Chaniewski S, Sheaffer AK, Pasquinelli C: Resistance analysis of the hepatitis C virus NS3 protease inhibitor asunaprevir. Antimicrob Agents Chemother. 2012 Jul;56(7):3670-81. doi: 10.1128/AAC.00308-12. Epub 2012 Apr 16. [PubMed:22508297]
  3. Gentile I, Buonomo AR, Zappulo E, Minei G, Morisco F, Borrelli F, Coppola N, Borgia G: Asunaprevir, a protease inhibitor for the treatment of hepatitis C infection. Ther Clin Risk Manag. 2014 Jun 26;10:493-504. doi: 10.2147/TCRM.S66731. eCollection 2014. [PubMed:25061308]
  4. Health Canada [Link]
  5. Health Canada monograph [Link]
  6. WHO [Link]
  7. HepatitisCentral [Link]
  8. Sunvepra [Link]
  9. Autralian Public Assessment [Link]
External Links
PubChem Compound
16076883
PubChem Substance
347827994
ChemSpider
17235944
ChEBI
134723
ChEMBL
CHEMBL2105735
PharmGKB
PA166128168
HET
2R9
Wikipedia
Asunaprevir
ATC Codes
J05AE15 — Asunaprevir
AHFS Codes
  • 08:18.40.20 — HCV Protease Inhibitors
PDB Entries
4nwl / 4wf8 / 4wh6 / 5eqs
MSDS
Download (23.7 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedNot AvailableHepatic Insufficiency1
1CompletedNot AvailableHepatitis C Viral Infection3
1CompletedNot AvailableHepatitis C Virus (HCV)1
1CompletedBasic ScienceHepatitis C Infection1
1, 2CompletedTreatmentChronic Hepatitis C Virus (HCV) Infection1
2CompletedDiagnosticHCV-HIV Co-Infection1
2CompletedTreatmentChronic Hepatitis C Virus (HCV) Infection4
2CompletedTreatmentHIV-HCV1
2CompletedTreatmentHepatitis C Infection1
2CompletedTreatmentHepatitis C Viral Infection1
2CompletedTreatmentHepatitis C Virus (HCV)1
2CompletedTreatmentHepatitis C Virus (HCV) / Hepatitis C Virus Infection1
2CompletedTreatmentHepatitis C Virus Genotype 4 Infection1
2RecruitingTreatmentChronic Hepatitis C Virus (HCV) Infection1
2WithdrawnTreatmentHepatitis C Virus Genotype 4 Infection1
3CompletedBasic ScienceChronic Hepatitis C Virus (HCV) Infection1
3CompletedTreatmentHepatitis C Viral Infection4
3CompletedTreatmentHepatitis C Virus (HCV)2
3CompletedTreatmentHepatitis C Virus Infection2
3RecruitingTreatmentHepatitis C Viral Infection1
4RecruitingTreatmentChronic Hepatitis C Virus (HCV) Infection1
4WithdrawnTreatmentChronic Hepatitis C Virus (HCV) Infection1
Not AvailableNot Yet RecruitingNot AvailableChronic Hepatitis C Virus (HCV) Infection1
Not AvailableWithdrawnNot AvailableHepatitis C Viral Infection1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
CapsuleOral100 mg
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)145-155 ºC'MSDS
water solubility<50 mg/LAustralian Public Assessment
Predicted Properties
PropertyValueSource
Water Solubility0.00299 mg/mLALOGPS
logP3.12ALOGPS
logP3.37ChemAxon
logS-5.4ALOGPS
pKa (Strongest Acidic)3.77ChemAxon
pKa (Strongest Basic)1.85ChemAxon
Physiological Charge-1ChemAxon
Hydrogen Acceptor Count9ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area182.33 Å2ChemAxon
Rotatable Bond Count13ChemAxon
Refractivity186.82 m3·mol-1ChemAxon
Polarizability76.14 Å3ChemAxon
Number of Rings5ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as oligopeptides. These are organic compounds containing a sequence of between three and ten alpha-amino acids joined by peptide bonds.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Amino acids, peptides, and analogues
Direct Parent
Oligopeptides
Alternative Parents
Valine and derivatives / Proline and derivatives / N-acyl-alpha amino acids and derivatives / Alpha amino acid amides / Isoquinolines and derivatives / Pyrrolidinecarboxamides / N-acylpyrrolidines / Alkyl aryl ethers / Pyridines and derivatives / Aryl chlorides
show 16 more
Substituents
Alpha-oligopeptide / N-acyl-alpha amino acid or derivatives / Valine or derivatives / Proline or derivatives / Alpha-amino acid amide / Alpha-amino acid or derivatives / Isoquinoline / N-acylpyrrolidine / Pyrrolidine carboxylic acid or derivatives / Pyrrolidine-2-carboxamide
show 32 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Hepatitis C
Pharmacological action
Yes
Actions
Antagonist
General Function
Not Available
Specific Function
Atp binding
Gene Name
NS3
Uniprot ID
A3EZI9
Uniprot Name
Genome polyprotein
Molecular Weight
67061.0 Da
References
  1. Gentile I, Buonomo AR, Zappulo E, Minei G, Morisco F, Borrelli F, Coppola N, Borgia G: Asunaprevir, a protease inhibitor for the treatment of hepatitis C infection. Ther Clin Risk Manag. 2014 Jun 26;10:493-504. doi: 10.2147/TCRM.S66731. eCollection 2014. [PubMed:25061308]

Enzymes

Kind
Protein group
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...

Components:
References
  1. Sunvepra [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Autralian Public Assessment [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Oxygen binding
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP3A5
Uniprot ID
P20815
Uniprot Name
Cytochrome P450 3A5
Molecular Weight
57108.065 Da
References
  1. Autralian Public Assessment [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Exhibits a high coumarin 7-hydroxylase activity. Can act in the hydroxylation of the anti-cancer drugs cyclophosphamide and ifosphamide. Competent in the metabolic activation of aflatoxin B1. Const...
Gene Name
CYP2A6
Uniprot ID
P11509
Uniprot Name
Cytochrome P450 2A6
Molecular Weight
56501.005 Da
References
  1. Autralian Public Assessment [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2B6
Uniprot ID
P20813
Uniprot Name
Cytochrome P450 2B6
Molecular Weight
56277.81 Da
References
  1. Autralian Public Assessment [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C9
Uniprot ID
P11712
Uniprot Name
Cytochrome P450 2C9
Molecular Weight
55627.365 Da
References
  1. Autralian Public Assessment [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and im...
Gene Name
CYP2C19
Uniprot ID
P33261
Uniprot Name
Cytochrome P450 2C19
Molecular Weight
55930.545 Da
References
  1. Autralian Public Assessment [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic...
Gene Name
CYP2D6
Uniprot ID
P10635
Uniprot Name
Cytochrome P450 2D6
Molecular Weight
55768.94 Da
References
  1. Autralian Public Assessment [Link]

Carriers

Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
References
  1. Sunvepra [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent uptake of organic anions such as pravastatin, taurocholate, methotrexate, dehydroepiandrosterone sulfate, 17-beta-glucuronosyl estradiol, estrone sulfate, prostagland...
Gene Name
SLCO1B1
Uniprot ID
Q9Y6L6
Uniprot Name
Solute carrier organic anion transporter family member 1B1
Molecular Weight
76447.99 Da
References
  1. Sunvepra [Link]
Kind
Protein
Organism
Human
Pharmacological action
No
Actions
Substrate
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent transport of organic anions such as taurocholate, the prostaglandins PGD2, PGE1, PGE2, leukotriene C4, thromboxane B2 and iloprost.
Gene Name
SLCO2B1
Uniprot ID
O94956
Uniprot Name
Solute carrier organic anion transporter family member 2B1
Molecular Weight
76709.98 Da
References
  1. Sunvepra [Link]

Drug created on April 27, 2016 17:10 / Updated on May 26, 2018 09:01