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Clin Pharmacol Ther. 2016 Apr;99(4):363-9. doi: 10.1002/cpt.269. Epub 2015 Nov 9.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for UGT1A1 and Atazanavir Prescribing.

Author information

1
Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
2
Individualized Medicine Program, Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA.
3
Division of Pharmaceutical Sciences, Fairleigh Dickinson University School of Pharmacy, Florham Park, New Jersey, USA.
4
Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
5
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
6
Department of Genetics, Stanford University, Stanford, California, USA.
7
Laval University CHU de Québec Research Center, Quebec, Quebec, Canada.
8
Division of Infectious Disease, Emory University School of Medicine, Atlanta, Georgia, USA.
9
Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
10
Center for Personalized Therapeutics, Comprehensive Cancer Center, The University of Chicago, Chicago, Illinois, USA.
11
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
12
Departments of Medicine, Pharmacology, Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Abstract

The antiretroviral protease inhibitor atazanavir inhibits hepatic uridine diphosphate glucuronosyltransferase (UGT) 1A1, thereby preventing the glucuronidation and elimination of bilirubin. Resultant indirect hyperbilirubinemia with jaundice can cause premature discontinuation of atazanavir. Risk for bilirubin-related discontinuation is highest among individuals who carry two UGT1A1 decreased function alleles (UGT1A1*28 or *37). We summarize published literature that supports this association and provide recommendations for atazanavir prescribing when UGT1A1 genotype is known (updates at www.pharmgkb.org).

PMID:
26417955
PMCID:
PMC4785051
DOI:
10.1002/cpt.269
[Indexed for MEDLINE]
Free PMC Article

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