Navir
Summary
Suffix '-navir' identifies HIV protease inhibitors (e.g., ritonavir, atazanavir, darunavir, lopinavir, indinavir, saquinavir). They block cleavage of the gag-pol polyprotein, preventing maturation of HIV virions.
Detail
Mechanism: inhibit HIV-1 protease, an aspartate protease that cleaves the gag-pol polyprotein into functional viral enzymes and structural proteins; without cleavage, immature, noninfectious virions are released. Ritonavir is most often used as a pharmacokinetic 'booster' because it inhibits CYP3A4, raising levels of other protease inhibitors. Class adverse effects include hyperglycemia/insulin resistance, lipodystrophy, dyslipidemia, and GI intolerance; indinavir specifically causes nephrolithiasis (crystalluria) and atazanavir causes unconjugated hyperbilirubinemia (inhibits UGT1A1, mimics Gilbert). Numerous drug interactions occur via CYP3A4 inhibition.
Sources
- First Aid for USMLE Step 1 2024
- Sketchy Pharm
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