Fosamprenavir

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<applet load="" size="480" color="" frame="true" spin="on" Scene ="" align="right" caption="Fosamprenavir, better known as Lexiva, ([[3nu4]])"/>
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<StructureSection load='' size='340' side='right' caption='Fosamprenavir, better known as Lexiva, ([[3nu4]])' scene='Fosamprenavir/Fosamprenavir/2'>
===Better Known as: Lexiva or Telzir===
===Better Known as: Lexiva or Telzir===
* Marketed By: Viiv Healthcare (Joint venture of Pfizer & GlaxoSmithKline)<br />
* Marketed By: Viiv Healthcare (Joint venture of Pfizer & GlaxoSmithKline)<br />
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* Drug Class: [[HIV Protease]] Inhibitor
* Drug Class: [[HIV Protease]] Inhibitor
* Date of FDA Approval (Discontinued): 2003 (2017) <br />
* Date of FDA Approval (Discontinued): 2003 (2017) <br />
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* 2004 Sales: ~$50 Million
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* 2007 Sales: $240 Million
* Importance: As a prodrug, It is rapidly metabolized by the liver into its active form, also known as [[Amprenavir]]. As a prodrug, it is a slow release form of Amprenavir, thus requiring less frequent dosing. It was one of the first instances of a successful drug stemming from joint ventures of major pharmaceutical companies.
* Importance: As a prodrug, It is rapidly metabolized by the liver into its active form, also known as [[Amprenavir]]. As a prodrug, it is a slow release form of Amprenavir, thus requiring less frequent dosing. It was one of the first instances of a successful drug stemming from joint ventures of major pharmaceutical companies.
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* The following is a list of Pharmacokinetic Parameters. See: [[Pharmaceutical Drugs]] for more information
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* See [[Pharmaceutical Drugs]] for more information about other drugs and diseases.
===Mechanism of Action===
===Mechanism of Action===
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Fosamprenavir is a prodrug. It is
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Fosamprenavir is a potent [[HIV Protease]] inhibitor. As a prodrug form of Amprenavir, it has an identical mechanism of action as [[Amprenavir]].
===Drug Resistance===
===Drug Resistance===
The biggest difficulty with treating [[HIV]] is the rapidity at which it mutates and becomes resistant to treatments. To view a comprehensive and interactive analysis of the mutations which confer drug resistance to [[HIV Protease]], See: [[HIV Protease Inhibitor Resistance Profile]]
The biggest difficulty with treating [[HIV]] is the rapidity at which it mutates and becomes resistant to treatments. To view a comprehensive and interactive analysis of the mutations which confer drug resistance to [[HIV Protease]], See: [[HIV Protease Inhibitor Resistance Profile]]
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</StructureSection>
===Pharmacokinetics===
===Pharmacokinetics===
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{| class="wikitable" border="1" width="52%" style="text-align:center"
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<table style="background: cellspacing="0px" align="" cellpadding="0px" width="42%">
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|-
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<tr>
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! colspan="12" align="center"| HIV Protease Inhibitor [[Pharmaceutical_Drugs#Pharmacokinetics_Translated|Pharmacokinetics]]<ref>PMID:20400409</ref><ref>Ferry et al, United States Patent US6147095, Pharmacia & Upjohn Company.</ref><ref>L. Veronese et al. Single-Dose Pharmacokinetics of Amprenavir, a Human Immunodeficiency Virus Type 1 Protease Inhibitor, in Subjects with Normal or Impaired Hepatic Function. Antimicrob Agents Chemother. 2000 April; 44(4): 821–826.</ref><ref>J. Ford, et al. Intracellular and Plasma Pharmacokinetics of Saquinavir-Ritonavir, Administered at 1,600/100 Milligrams Once Daily in Human Immunodeficiency Virus-Infected Patients. Antimicrob Agents Chemother. 2004 July; 48(7): 2388–2393.</ref><ref>PMID:10620574</ref><ref>PMID:16086644</ref><ref>PMID:19131522</ref><ref>PMID: 10952482</ref><ref>PMID:16338276</ref><ref>PMID:19729375</ref><ref>PMID:12668574</ref><ref>PMID:17255144</ref><ref>PMID:10858338</ref>
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<td style="width:100%; vertical-align:top;border-width:0px; border-style:inset">
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|-
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<div style="height:100%; width: 100%">
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! Parameter
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{{:HIV Protease Inhibitor Pharmacokinetics}}
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! [[Ritonavir]]
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</div>
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! [[Tipranavir]]
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</td>
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! [[Indinavir]]
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</tr>
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! [[Saquinavir]]
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</table>
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! [[Amprenavir]]
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! [[Fosamprenavir]]
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! [[Lopinavir]]
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! [[Darunavir]]
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! [[Atazanavir]]
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! [[Nelfinavir]]
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|-
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! [[Pharmaceutical_Drugs#Tmax|T<sub>max</sub>]] (hr)
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! 4.4
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! ~3
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! 1.5
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! 3.7
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! .98
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! 1.5-4
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! 2
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! .5
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! 2-4
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! 3.1
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|-
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! [[Pharmaceutical_Drugs#Cmax|C<sub>max</sub>]] (ng/ml)
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! 13120
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! 14600
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! 8100
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! 2297
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! 4901
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! 4820
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! 11.9
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! 2730
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! ~4393
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! 4701
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|-
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! [[Pharmaceutical_Drugs#Bioavailability_.28F.29|Bioavailability]] (%)
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! --
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! --
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! 65
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! 4
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! --
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! --
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! --
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! --
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! 68
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! 20-80
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|-
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! [[Pharmaceutical_Drugs#Protein_Binding|Protein Binding]] (%)
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! 99
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! >99
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! 61
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! 98
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! 90
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! 90
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! 99
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! 95
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! 86
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! 98
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|-
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! [[Pharmaceutical_Drugs#Half_Life_.28T1.2F2.29|T<sub>1/2</sub>]] (hr)
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! 4.8
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! 4.2
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! 1.2
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! 4.5
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! 5.5
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! 7.7
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! 6.1
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! 29.4
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! 5.3
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! 3.3
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|-
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! [[Pharmaceutical_Drugs#Area_Under_the_Curve_.28AUC.29|AUC]] (ng/ml/hr)
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! 128100
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! 46500
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! 20900
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! 13467
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! 11999
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! 35000
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! 117600
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! 4746
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! ~26045
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! 31906
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|-
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! [[Pharmaceutical_Drugs#Clearance_.28Cl.29|Clearance]] (L/h)
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! ~8.4
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! 32.4
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! 49.5
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! 36.7
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! 56.8
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! 84.4
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! 1.7
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! 32.8
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! 13.6
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! 37.3
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|-
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! Dosage (mg)
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! 600
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! 600
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! 800
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! 1000
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! 600
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! 1400
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! 280
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! 400
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! 400
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! 1250
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|-
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! Metabolism
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! Hepatic (CYP3A4 & CYP2C19)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4 & CYP3A5)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4)
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! Hepatic (CYP3A4)
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|}
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===References===
===References===

Current revision

Fosamprenavir, better known as Lexiva, (3nu4)

Drag the structure with the mouse to rotate

Pharmacokinetics

HIV Protease Inhibitor Pharmacokinetics
Parameter Ritonavir Tipranavir Indinavir Saquinavir Amprenavir Fosamprenavir Lopinavir Darunavir Atazanavir Nelfinavir
Tmax (hr) 4.4 ~3 1.5 3.7 .98 1.5-4 2 .5 2-4 3.1
Cmax (ng/ml) 13120 14600 8100 2297 4901 4820 11.9 2730 ~4393 4701
Bioavailability (%) -- -- 65 4 -- -- -- -- 68 20-80
Protein Binding (%) 99 >99 61 98 90 90 99 95 86 98
T1/2 (hr) 4.8 4.2 1.2 4.5 5.5 7.7 6.1 29.4 5.3 3.3
AUC (ng/ml/hr) 128100 46500 20900 13467 11999 35000 117600 4746 ~26045 31906
Clearance (L/h) ~8.4 32.4 49.5 36.7 56.8 84.4 1.7 32.8 13.6 37.3
Dosage (mg) 600 600 800 1000 600 1400 280 400 400 1250
Metabolism Hepatic (CYP3A4 & CYP2C19) Hepatic (CYP3A4) Hepatic (CYP3A4) Hepatic (CYP3A4 & CYP3A5) Hepatic (CYP3A4) Hepatic (CYP3A4) Hepatic (CYP3A4) Hepatic (CYP3A4) Hepatic (CYP3A4) Hepatic (CYP3A4)

For Pharmacokinetic Data References, See: References

References


Proteopedia Page Contributors and Editors (what is this?)

David Canner, Alexander Berchansky

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