nevirapine + atazanavir + ritonavir

Nevirapine + atazanavir + ritonavir is a combination of three oral antiretroviral drugs used in the management of HIV-1 infection, typically as part of combination antiretroviral therapy (cART). Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that binds directly to reverse transcriptase, inhibiting viral RNA-dependent DNA polymerase activity. Atazanavir is a protease inhibitor (PI) that blocks the HIV-1 protease enzyme, preventing the cleavage of viral polyprotein precursors and thereby inhibiting virus maturation. Ritonavir acts as a pharmacokinetic booster, inhibiting cytochrome P450 3A (CYP3A)-mediated metabolism of atazanavir and other PIs, increasing their plasma concentrations and extending their efficacy. This triple-drug regimen is used in specific clinical scenarios, but is generally avoided due to significant drug–drug interactions—notably, nevirapine can induce cytochrome P450 enzymes, potentially lowering concentrations of atazanavir and ritonavir, therefore compromising efficacy and safety. This regimen is primarily used in HIV-1 infected adults where no other options are available, and clinical data comparing it to other antiretroviral combinations are limited[1][2].

Brand names

ViramuneReyatazNorvir

Other names

NVP + ATV/r