Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C38H52N6O7 |
| Molecular Weight | 704.8555 |
| Optical Activity | ( - ) |
| Defined Stereocenters | 4 / 4 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
COC(=O)N[C@H](C(=O)N[C@@H](CC1=CC=CC=C1)[C@@H](O)CN(CC2=CC=C(C=C2)C3=CC=CC=N3)NC(=O)[C@@H](NC(=O)OC)C(C)(C)C)C(C)(C)C
InChI
InChIKey=AXRYRYVKAWYZBR-GASGPIRDSA-N
InChI=1S/C38H52N6O7/c1-37(2,3)31(41-35(48)50-7)33(46)40-29(22-25-14-10-9-11-15-25)30(45)24-44(43-34(47)32(38(4,5)6)42-36(49)51-8)23-26-17-19-27(20-18-26)28-16-12-13-21-39-28/h9-21,29-32,45H,22-24H2,1-8H3,(H,40,46)(H,41,48)(H,42,49)(H,43,47)/t29-,30-,31+,32+/m0/s1
| Molecular Formula | C38H52N6O7 |
| Molecular Weight | 704.8555 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 4 / 4 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
Atazanavir is the first once-daily protease inhibitor for the treatment of human immunodeficiency virus type 1 infection and should be used only in combination therapy, as part of a highly active antiretroviral therapy (HAART) regimen. In addition to being the most potent protease inhibitor in vitro, atazanavir has a distinct cross-resistance profile that does not confer resistance to other protease inhibitors. However, resistance to other protease inhibitors often confers clinically relevant resistance to atazanavir.
CNS Activity
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL243 Sources: https://www.ncbi.nlm.nih.gov/pubmed/18006837 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Curative | REYATAZ Approved UseREYATAZ® (atazanavir sulfate) is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection. This indication is based on analyses of plasma HIV-1 RNA levels and CD4+ cell counts from controlled studies of 96 weeks duration in antiretroviral-naive and 48 weeks duration in antiretroviral-treatment-experienced adult and pediatric patients at least 6 years of age. The following points should be considered when initiating therapy with REYATAZ: In Study AI424-045, REYATAZ/ritonavir and lopinavir/ritonavir were similar for the primary efficacy outcome measure of time-averaged difference in change from baseline in HIV RNA level. This study was not large enough to reach a definitive conclusion that REYATAZ/ritonavir and lopinavir/ritonavir are equivalent on the secondary efficacy outcome measure of proportions below the HIV RNA lower limit of detection [see Clinical Studies (14.2) Launch Date2003 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
5199 ng/mL |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
2298 ng/mL |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
6129 ng/mL |
300 mg 1 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: RITONAVIR |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
4422 ng/mL |
300 mg 1 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: RITONAVIR |
ATAZANAVIR plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
28132 ng × h/mL |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
14874 ng × h/mL |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
57039 ng × h/mL |
300 mg 1 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: RITONAVIR |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
46073 ng × h/mL |
300 mg 1 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: RITONAVIR |
ATAZANAVIR plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
7.9 h |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
6.5 h |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
18.1 h |
300 mg 1 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: RITONAVIR |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
|
8.6 h |
300 mg 1 times / day steady-state, oral dose: 300 mg route of administration: Oral experiment type: STEADY-STATE co-administered: RITONAVIR |
ATAZANAVIR plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: FED |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
14% |
400 mg 1 times / day steady-state, oral dose: 400 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
ATAZANAVIR plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: FED |
Doses
| Dose | Population | Adverse events |
|---|---|---|
30 g single, oral Overdose |
unhealthy, 40 years |
Other AEs: Monomorphic ventricular tachycardia... |
400 mg 1 times / day steady, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: steady Dose: 400 mg, 1 times / day Sources: |
unhealthy, adult |
Disc. AE: Jaundice... Other AEs: Blood bilirubin indirect... AEs leading to discontinuation/dose reduction: Jaundice (7%) Other AEs:Blood bilirubin indirect (33%) Sources: |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Monomorphic ventricular tachycardia | 30 g single, oral Overdose |
unhealthy, 40 years |
|
| Blood bilirubin indirect | 33% | 400 mg 1 times / day steady, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: steady Dose: 400 mg, 1 times / day Sources: |
unhealthy, adult |
| Jaundice | 7% Disc. AE |
400 mg 1 times / day steady, oral Recommended Dose: 400 mg, 1 times / day Route: oral Route: steady Dose: 400 mg, 1 times / day Sources: |
unhealthy, adult |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
Drug as victim
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
PubMed
| Title | Date | PubMed |
|---|---|---|
| Determination of the new HIV-protease inhibitor atazanavir by liquid chromatography after solid-phase extraction. | 2004-10-15 |
|
| Atazanavir. | 2004-10 |
|
| Pseudoaneurysm of the femoral artery in a HIV-infected man. | 2004-10 |
|
| Gateways to clinical trials. | 2004-09-07 |
|
| HIV-chemotherapy and -prophylaxis: new drugs, leads and approaches. | 2004-09 |
|
| Comparison of once-daily atazanavir with efavirenz, each in combination with fixed-dose zidovudine and lamivudine, as initial therapy for patients infected with HIV. | 2004-08-15 |
|
| Resistance to HIV protease inhibitors: mechanisms and clinical consequences. | 2004-08 |
|
| Acute hepatic cytolysis in an HIV-infected patient taking atazanavir. | 2004-07-23 |
|
| Atazanavir: a new protease inhibitor to treat HIV infection. | 2004-07-01 |
|
| Atazanavir enhances saquinavir hard-gel concentrations in a ritonavir-boosted once-daily regimen. | 2004-06-18 |
|
| Long-term efficacy and safety of atazanavir with stavudine and lamivudine in patients previously treated with nelfinavir or atazanavir. | 2004-06-01 |
|
| Atazanavir: new option for treatment of HIV infection. | 2004-06-01 |
|
| The influence of protease inhibitor resistance profiles on selection of HIV therapy in treatment-naive patients. | 2004-06 |
|
| Antiviral drugs in current clinical use. | 2004-06 |
|
| Simultaneous quantification of the new HIV protease inhibitors atazanavir and tipranavir in human plasma by high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry. | 2004-05-25 |
|
| Identification of I50L as the signature atazanavir (ATV)-resistance mutation in treatment-naive HIV-1-infected patients receiving ATV-containing regimens. | 2004-05-15 |
|
| [New treatment options for HIV-infected patients]. | 2004-05-07 |
|
| Boosted Reyataz: 48-week results. | 2004-05-04 |
|
| Gateways to clinical trials. | 2004-05 |
|
| Does atazanavir cause lipodystrophy? | 2004-05 |
|
| Initial therapy for human immunodeficiency virus: broadening the options. | 2004-04-30 |
|
| [Atazanavir protects lipid metabolism. New PI with favorable metabolic profile]. | 2004-04-26 |
|
| [Good experiences with saquinavir. Double boosting of protease inhibitors gains significance]. | 2004-04-26 |
|
| [Interview with Professor Jürgen Rockstroh, director of the Bonn University Clinic. Atazanavir in general practice]. | 2004-04-26 |
|
| [Long-term tolerance. Favorable lipid profile--favorable effect on development of lipodystrophy?]. | 2004-04-26 |
|
| [Simplified HIV therapy. Atazanavir: the first protease inhibitor with once daily administration]. | 2004-04-26 |
|
| New drugs of 2003. | 2004-04-22 |
|
| Regression of lipodystrophy in HIV-infected patients under therapy with the new protease inhibitor atazanavir. | 2004-04-09 |
|
| Cross-resistance patterns among HIV protease inhibitors. | 2004-04 |
|
| Atazanavir (Reyataz): new recommendations if combined with tenofovir (Viread) -- and warning on Viagra, Cialis, and Levitra. | 2004-03-26 |
|
| Kinetic and thermodynamic characterization of HIV-1 protease inhibitors. | 2004-03-18 |
|
| Optimizing dosing strategies for the combination of atazanavir plus saquinavir. | 2004-03-05 |
|
| Drug-induced liver injury associated with antiretroviral therapy that includes HIV-1 protease inhibitors. | 2004-03-01 |
|
| Tenofovir disoproxil fumarate: clinical pharmacology and pharmacokinetics. | 2004 |
|
| Peptidomimetic inhibitors of HIV protease. | 2004 |
|
| Three new drugs approved by FDA. | 2003-12-31 |
|
| [Are all boosted protease inhibitors the same? Previously treated patients profit too from lopinavir/r]. | 2003-12-11 |
|
| Pharmacokinetics of amprenavir given once or twice a day when combined with atazanavir in heavily pre-treated HIV-positive patients. | 2003-12-05 |
|
| Dose-ranging, randomized, clinical trial of atazanavir with lamivudine and stavudine in antiretroviral-naive subjects: 48-week results. | 2003-12-05 |
|
| The continuing evolution of HIV therapy. | 2003-12 |
|
| Gateways to clinical trials. | 2003-12 |
|
| New anti-HIV protease inhibitors provide more treatment options. | 2003-11 |
|
| Atazanavir sulphate. | 2003-11 |
|
| Atazanavir (Reyataz). | 2003-10 |
|
| FDA notifications. Reyataz is approved for HIV treatment. | 2003-09 |
|
| Drug profile: atazanavir (Reyataz, ATV). | 2003-07 |
|
| Atazanavir: clinical use. | 2003-07 |
|
| ["Once daily" drugs simplify therapy. Rp. HAART once daily]. | 2003-04-28 |
|
| [Highly effective drug without modifying the lipid profile. Atazanavir, the protease inhibitor for "once daily" administration]. | 2003-04-28 |
|
| [Antiretroviral therapy 2003. The current status]. | 2003-04-28 |
Patents
Sample Use Guides
The recommended dose of REYATAZ ((atazanavir sulfate) capsules) is 400 mg (two 200-mg capsules) once daily taken with food. When coadministered with efavirenz, it is recommended that REYATAZ 300 mg and ritonavir 100 mg be given with efavirenz 600 mg (all as a single daily dose with food). REYATAZ without ritonavir should not be coadministered with efavirenz. When coadministered with didanosine buffered formulations, 589 REYATAZ should be given (with food) 2 hours before or 1 hour after didanosine.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/15764714
It was investigated the effect of atazanavir on P-glycoprotein (P-gp) expression and activity, as well as its inhibitory potency against CYP3A activity. Induction of P-gp activity and expression was studied using LS180V cells. P-gp inhibition was studied using both LS180V cells and Caco-2 cells. Extended (3-day) exposure of LS180V cells to 30 microM atazanavir caused a 2.5-fold increase in immunoreactive P-gp expression as well as a concentration-dependent decrease of intracellular Rh123 to a mean 45% (S.D. 5.2%) of control. Acute exposure (2 h) of LS180V cells to atazanavir increased intracellular Rh123 concentrations up to 300% of control at 100 microM atazanavir. At 30 microM and above, acute atazanavir exposure reversed P-gp induction caused by 3-day pretreatment with 10 microM ritonavir. P-gp inhibition was also observed in Caco-2 cells, causing an effect comparable to that observed for the known P-gp inhibitor verapamil (50% of control). In HLM, atazanavir was an inhibitor of triazolam hydroxylation, with inhibitory potency greatly increased by preincubation. IC50 values with and without preincubation were 0.31 microM (S.D. 0.13) and 5.7 microM (S.D. 4.1), respectively.
| Substance Class |
Chemical
Created
by
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on
Edited
Wed Apr 02 06:51:57 GMT 2025
by
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| Record UNII |
QZU4H47A3S
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| Record Status |
Validated (UNII)
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| Record Version |
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WHO-ATC |
J05AR15
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WHO-VATC |
QJ05AE08
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WHO-ESSENTIAL MEDICINES LIST |
6.4.2.3
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WHO-ATC |
J05AR23
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NCI_THESAURUS |
C97366
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LIVERTOX |
NBK547918
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NDF-RT |
N0000000246
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WHO-ATC |
J05AE08
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NDF-RT |
N0000175889
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148192
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C413408
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198904-31-3
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QZU4H47A3S
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PRIMARY | |||
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N0000191269
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PRIMARY | UDP Glucuronosyltransferases Inhibitors [MoA] | ||
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ATAZANAVIR
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SUB16398MIG
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C66872
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PRIMARY | |||
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37924
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N0000182141
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PRIMARY | Cytochrome P450 3A4 Inhibitors [MoA] | ||
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254
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N0000187062
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PRIMARY | Cytochrome P450 2C8 Inhibitors [MoA] | ||
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8181
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DB01072
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m2119
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PRIMARY | Merck Index | ||
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Atazanavir
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343047
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PRIMARY | RxNorm | ||
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7339
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DTXSID9048691
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QZU4H47A3S
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CHEMBL1163
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100000089517
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N0000190114
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PRIMARY | Cytochrome P450 3A Inhibitors [MoA] | ||
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N0000191272
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PRIMARY | UGT1A1 Inhibitors [MoA] |
| Related Record | Type | Details | ||
|---|---|---|---|---|
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TRANSPORTER -> INHIBITOR | |||
|
METABOLIC ENZYME -> INHIBITOR |
IC50
|
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|
TRANSPORTER -> INHIBITOR |
WEAK
IC50
|
||
|
METABOLIC ENZYME -> INHIBITOR |
COMPETITIVE INHIBITOR
Ki
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METABOLIC ENZYME -> INHIBITOR |
COMPETITIVE INHIBITOR
Ki
|
||
|
TRANSPORTER -> INHIBITOR | |||
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METABOLIC ENZYME -> INHIBITOR |
COMPETITIVE INHIBITOR
Ki
|
||
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BINDER->LIGAND |
BINDING
|
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METABOLIC ENZYME -> SUBSTRATE | |||
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METABOLIC ENZYME -> SUBSTRATE |
MAJOR
|
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|
ENANTIOMER -> ENANTIOMER |
|
||
|
TARGET ORGANISM->INHIBITOR |
EC50
|
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TRANSPORTER -> INHIBITOR | |||
|
|
METABOLIC ENZYME -> INHIBITOR |
IC50
|
||
|
EXCRETED UNCHANGED |
FECAL
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|
EXCRETED UNCHANGED |
URINE
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SALT/SOLVATE -> PARENT |
|
| Related Record | Type | Details | ||
|---|---|---|---|---|
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METABOLITE -> PARENT |
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|
METABOLITE -> PARENT |
| Related Record | Type | Details | ||
|---|---|---|---|---|
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ACTIVE MOIETY |
|
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
|---|---|---|---|---|---|---|
| Tmax | PHARMACOKINETIC |
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IN HEALTHY SUBJECTS |
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| Biological Half-life | PHARMACOKINETIC |
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| Volume of Distribution | PHARMACOKINETIC |
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