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Amprenavir
Also known as: 161814-49-9, Agenerase, Prozei, Vx-478, 141w94, Kvx-478
Molecular Formula
C25H35N3O6S
Molecular Weight
505.6  g/mol
InChI Key
YMARZQAQMVYCKC-OEMFJLHTSA-N
FDA UNII
5S0W860XNR

Amprenavir is a synthetic derivative of hydroxyethylamine sulfonamide that selectively binds to and inhibits human immunodeficiency virus (HIV) protease.
Amprenavir is a Protease Inhibitor. The mechanism of action of amprenavir is as a HIV Protease Inhibitor, and Cytochrome P450 3A4 Inhibitor, and Cytochrome P450 3A4 Inducer, and P-Glycoprotein Inducer.
1 2D Structure

Amprenavir

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
[(3S)-oxolan-3-yl] N-[(2S,3R)-4-[(4-aminophenyl)sulfonyl-(2-methylpropyl)amino]-3-hydroxy-1-phenylbutan-2-yl]carbamate
2.1.2 InChI
InChI=1S/C25H35N3O6S/c1-18(2)15-28(35(31,32)22-10-8-20(26)9-11-22)16-24(29)23(14-19-6-4-3-5-7-19)27-25(30)34-21-12-13-33-17-21/h3-11,18,21,23-24,29H,12-17,26H2,1-2H3,(H,27,30)/t21-,23-,24+/m0/s1
2.1.3 InChI Key
YMARZQAQMVYCKC-OEMFJLHTSA-N
2.1.4 Canonical SMILES
CC(C)CN(CC(C(CC1=CC=CC=C1)NC(=O)OC2CCOC2)O)S(=O)(=O)C3=CC=C(C=C3)N
2.1.5 Isomeric SMILES
CC(C)CN(C[C@H]([C@H](CC1=CC=CC=C1)NC(=O)O[C@H]2CCOC2)O)S(=O)(=O)C3=CC=C(C=C3)N
2.2 Other Identifiers
2.2.1 UNII
5S0W860XNR
2.3 Synonyms
2.3.1 MeSH Synonyms

1. (3s-(3r*(1r*,2s*)))-(3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl) Tetrahydro-3-furanyl Carbamate

2. Agenerase

3. Tetrahydro-3-furyl N-(3-(4-amino-n-isobutylbenzenesulfonamido)-1-benzyl-2-hydroxypropyl)carbamate

4. Vertex Vx478

5. Vx 478

6. Vx-478

2.3.2 Depositor-Supplied Synonyms

1. 161814-49-9

2. Agenerase

3. Prozei

4. Vx-478

5. 141w94

6. Kvx-478

7. Amprenavir (agenerase)

8. Vx 478

9. Chebi:40050

10. (3s)-tetrahydro-3-furanyl ((1s,2r)-3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl)carbamate

11. 5s0w860xnr

12. (3s-(3r*(1r*,2s*)))-(3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl) Tetrahydro-3-furanyl Carbamate

13. J05ae05

14. Vertex Vx478

15. 141 W94

16. Amv

17. Carbamic Acid, ((1s,2r)-3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl)-, (3s)-tetrahydro-3-furanyl Ester

18. Amprenavir [usan]

19. (3s)-oxolan-3-yl N-[(2s,3r)-3-hydroxy-4-[n-(2-methylpropyl)(4-aminobenzene)sulfonamido]-1-phenylbutan-2-yl]carbamate

20. [(3s)-oxolan-3-yl] N-[(2s,3r)-4-[(4-aminophenyl)sulfonyl-(2-methylpropyl)amino]-3-hydroxy-1-phenylbutan-2-yl]carbamate

21. {3-[(4-amino-benzenesulfonyl)-isobutyl-amino]-1-benzyl-2-hydroxy-propyl}-carbamic Acid Tetrahydro-furan-3-yl Ester

22. Drg-0258

23. Agenerase (tm)

24. Agenerase (tn)

25. (s)-tetrahydrofuran-3-yl (2s,3r)-4-(4-amino-n-isobutylphenylsulfonamido)-3-hydroxy-1-phenylbutan-2-ylcarbamate

26. [(3s)-tetrahydrofuran-3-yl] N-[(1s,2r)-3-[(4-aminophenyl)sulfonyl-isobutyl-amino]-1-benzyl-2-hydroxy-propyl]carbamate

27. Gna & Amprenavir

28. Hha & Amprenavir

29. Hsdb 7157

30. Unii-5s0w860xnr

31. Amprenavir (jan/usan/inn)

32. Amprenavir [usan:inn:ban]

33. Tetrahydro-3-furyl N-(3-(4-amino-n-isobutylbenzenesulfonamido)-1-benzyl-2-hydroxypropyl)carbamate

34. 1hpv

35. 3ekp

36. 3ekv

37. 3nuj

38. 3nuo

39. Vx478

40. Ncgc00159461-02

41. 1t7j

42. 3nu3

43. 3nu4

44. 3nu5

45. 3nu6

46. 3nu9

47. 3sm2

48. Amprenavir [mi]

49. Amprenavir [inn]

50. Amprenavir [jan]

51. Amprenavir [hsdb]

52. Amprenavir [vandf]

53. Apv & Aag

54. Apv & Hsa

55. Chembl116

56. Amprenavir [mart.]

57. Amprenavir [who-dd]

58. Schembl34151

59. (3s)-tetrahydro-3-furyl ((alphas)-alpha-((1r-1-hydroxy-2-(n(sup 1)-isobutylsulfanilamido)ethyl)phenethyl)carbamate

60. Mls006011492

61. Amprenavir [ema Epar]

62. Bidd:gt0398

63. Amprenavir [orange Book]

64. Dtxsid5046061

65. Amprenavir & Human Serum Albumin

66. 3s43

67. 3s45

68. Hms2090n10

69. Zinc3809192

70. Bdbm50215393

71. Mfcd00934214

72. S1639

73. Amprenavir & Alpha1-acid Glycoprotein

74. Akos000280844

75. Am84544

76. Bcp9000297

77. Ccg-269742

78. Cs-1410

79. Db00701

80. Ncgc00159461-07

81. Ncgc00159461-08

82. (3s)-oxolan-3-yl N-[(2s,3r)-3-hydroxy-4-[n-(2-methylpropyl)4-aminobenzenesulfonamido]-1-phenylbutan-2-yl]carbamate

83. 4-amino-n-((2 Syn,3s)-2-hydroxy-4-phenyl-3-((s)-tetrahydrofuran-3-yloxycarbonylamino)-butyl)-n-isobutyl-benzenesulfonamide

84. Amprenavir 100 Microg/ml In Acetonitrile

85. As-30915

86. Carbamic Acid, ((1s,2r)-3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl)-, (3s)-tetrahydro-3-furanyl Ester & Galanthus Nivalis Agglutinin (gna)

87. Carbamic Acid, (3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl)-, Tetrahydro-3-furanyl Ester, (3s-(3r*(1s*,2r*)))-

88. Carbamic Acid, N-[(1s,2r)-3-[[(4-aminophenyl)sulfonyl](2-methylpropyl)amino]-2-hydroxy-1-(phenylmethyl)propyl]-, (3s)-tetrahydro-3-furanyl Ester

89. Hy-17430

90. Smr003885056

91. Bcp0726000051

92. Sw219687-1

93. C08086

94. D00894

95. Ab01275534-01

96. Ab01275534_02

97. 814a499

98. A810295

99. Q422198

100. Sr-05000001530

101. Sr-05000001530-1

102. Z1557399789

103. (3s)-tetrahydro-3-furyl ((.alpha.s)-.alpha.-((1r-1-hydroxy-2-(n1-isobutylsulfanilamido)ethyl)phenethyl)carbamate

104. (3s)-tetrahydrofuran-3-yl [(1s,2r)-3-{[(4-aminophenyl)sulfonyl](2-methylpropyl)amino}-1-benzyl-2-hydroxypropyl]carbamate

105. (3s)-tetrahydrofuran-3-yl [(2s,3r)-4-{[(4-aminophenyl)sulfonyl](2-methylpropyl)amino}-3-hydroxy-1-phenylbutan-2-yl]carbamate

106. [(3s)-oxolan-3-yl] N-[(2s,3r)-4-[(4-aminophenyl)sulfonyl-(2-methylpropyl)amino]-3-oxidanyl-1-phenyl-butan-2-yl]carbamate

107. Carbamic Acid, ((1s,2r)-3-(((4-aminophenyl)sulfonyl)(2-methylpropyl)amino)-2-hydroxy-1-(phenylmethyl)propyl)-, (3s)-tetrahydro-3-furanyl Ester & Hippeastrum Hybrid Agglutinin( Hha)

108. Carbamic Acid,[(1s,2r)-3-[[(4-aminophenyl)sulfonyl](2-methylpropyl)amino]-2-hydroxy-1-(phenylmethyl)propyl]-,(3s)-tetrahydro-3-furanyl Ester

109. N-[(1s,2r)-3-[[(4-aminophenyl)sulfonyl](2-methylpropyl)amino]-2-hydroxy-1-(phenylmethyl)propyl]carbamic Acid (3s)-tetrahydro-3-furanyl Ester

110. N-[(2s,3r)-4-[(4-aminophenyl)sulfonyl-(2-methylpropyl)amino]-3-hydroxy-1-phenylbutan-2-yl]carbamic Acid [(3s)-3-oxolanyl] Ester

2.4 Create Date
2005-06-24
3 Chemical and Physical Properties
Molecular Weight 505.6 g/mol
Molecular Formula C25H35N3O6S
XLogP32.9
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count8
Rotatable Bond Count12
Exact Mass505.22465702 g/mol
Monoisotopic Mass505.22465702 g/mol
Topological Polar Surface Area140 Ų
Heavy Atom Count35
Formal Charge0
Complexity745
Isotope Atom Count0
Defined Atom Stereocenter Count3
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Therapeutic Uses

Amprenavir is indicated in combination with other antiretroviral agents in the treatment of HIV-1 infection. /Included in US product labeling/

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 23rd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2003. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 118


Amprenavir is a human immunodeficiency virus (HIV)-protease inhibitor. The use of amprenavir for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in combination with other antiretrovirals is based on analyses of plasma HIV-RNA levels and CD4 cell counts in controlled studies of up to 24 weeks duration. Results from controlled trials evaluating the long-term suppression of HIV-RNA or disease progression with amprenavir have not yet been obtained.

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 23rd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2003. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 118


Amprenavir is a viral protease inhibitor with specificity for the HIV protease enzyme. The resistance profile of amprenavir appears to differ from that of other protease inhibitors such as saquinavir and indinavir. Twelve hours after single-dose administration of amprenavir 1200 mg to HIV-infected individuals, the mean plasma concentration of the drug was more than 10-fold greater than the 50% inhibitory concentration for HIV-1IIIB in peripheral blood lymphocytes. In a small nonblind study, amprenavir monotherapy increased CD4+ cell count and decreased viral load in 37 patients with HIV infection and no previous exposure to protease inhibitor therapy. Combination therapy comprising amprenavir and other antiretroviral agents (abacavir, zidovudine, lamivudine, indinavir, saquinavir or nelfinavir) decreased viral load and increased CD4+ cell counts in patients with HIV infection. Antiviral efficacy was maintained during up to 24 weeks' follow-up.

PMID:9617598 Adkins JC, Faulds D; Drugs 55 (6): 837-42 (1998)


4.2 Drug Warning

The usually recommended dosage of amprenavir oral solution (22.5 mg/kg twice daily) provides a propylene glycol intake of 1650 mg/kg daily; however, an acceptable intake of propylene glycol used as an excipient in pharmaceuticals has not been established to date. Propylene glycol is metabolized in the liver by the alcohol and aldehyde dehydrogenase enzyme pathway, and the possibility exists that young infants, patients with renal or hepatic impairment, and certain patient groups (females, Asians, Native Alaskans, Native Americans) may be at increased risk of propylene glycol-associated adverse effects if they receive amprenavir oral solution because of diminished ability to metabolize propylene glycol. Therefore, amprenavir oral solution is contraindicated during pregnancy; in infants younger than 4 years of age; in patients with renal or hepatic failure; and in patients receiving disulfiram or metronidazole. In addition, although metabolism of propylene glycol has not been specifically studied in these patient groups, the possibility that females may have lower concentrations of alcohol dehydrogenase compared with males and that certain ethnic populations (Asians, Native Alaskans, Native Americans) may have alcohol dehydrogenase polymorphism should be considered.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 626


Because amprenavir oral solution contains large amounts of propylene glycol and because young infants may be at increased risk of propylene glycol-associated adverse effects, the oral solution is contraindicated in pediatric patients younger than 4 years of age. Propylene glycol is metabolized in the liver by the alcohol and aldehyde dehydrogenase enzyme pathway. Although alcohol dehydrogenase is present in human fetal liver at 2 months of gestational age, this represent only about 3% of the activity reported in adults. Limited data indicate that alcohol dehydrogenase activity in infants 12-30 months of age is equal to or greater than that reported in adults. Oral or IV administration of various drugs (e.g., multivitamins) containing high concentrations of propylene glycol in pediatric patients has resulted in various propylene glycol-associated adverse effects, including hyperosmolality, lactic acidosis, respiratory depression, and seizures.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 627


Patients being treated with amprenavir oral solution should be closely monitored for propylene glycol associated side effects including hemolysis, hyperosmolality, lactic acidosis, renal toxicity, seizures, stupor, and tachycardia.

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 23rd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2003. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 121


The pharmacokinetics of amprenavir do not differ between females and males or between Blacks and non-Blacks. However, amprenavir oral solution contains a large amount of propylene glycol and because Asians, Eskimos, Native Americans, and women have a decreased ability to metabolize this compound, they may have an increased risk of developing propylene glycol-associated side effects.

MICROMEDEX Thomson Health Care. USPDI - Drug Information for the Health Care Professional. 23rd ed. Volume 1. MICROMEDEX Thomson Health Care, Greenwood Village, CO. 2003. Content Reviewed and Approved by the U.S. Pharmacopeial Convention, Inc., p. 119


For more Drug Warnings (Complete) data for AMPRENAVIR (18 total), please visit the HSDB record page.


4.3 Drug Indication

For the treatment of HIV-1 infection in combination with other antiretroviral agents.


FDA Label


Agenerase, in combination with other antiretroviral agents, is indicated for the treatment of protease inhibitor (PI) experienced HIV-1 infected adults and children above the age of 4 years. Agenerase capsules should normally be administered with low dose ritonavir as a pharmacokinetic enhancer of amprenavir (see sections 4. 2 and 4. 5). The choice of amprenavir should be based on individual viral resistance testing and treatment history of patients (see section 5. 1).

The benefit of Agenerase boosted with ritonavir has not been demonstrated in PI nave patients (see section 5. 1)


5 Pharmacology and Biochemistry
5.1 Pharmacology

Amprenavir is a protease inhibitor with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Protease inhibitors block the part of HIV called protease. HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV-1. Amprenavir binds to the protease active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the viral polyproteins resulting in the formation of immature non-infectious viral particles. Protease inhibitors are almost always used in combination with at least two other anti-HIV drugs.


5.2 MeSH Pharmacological Classification

Antibiotics, Antitubercular

Substances obtained from various species of microorganisms that are, alone or in combination with other agents, of use in treating various forms of tuberculosis; most of these agents are merely bacteriostatic, induce resistance in the organisms, and may be toxic. (See all compounds classified as Antibiotics, Antitubercular.)


HIV Protease Inhibitors

Inhibitors of HIV PROTEASE, an enzyme required for production of proteins needed for viral assembly. (See all compounds classified as HIV Protease Inhibitors.)


Anti-HIV Agents

Agents used to treat AIDS and/or stop the spread of the HIV infection. These do not include drugs used to treat symptoms or opportunistic infections associated with AIDS. (See all compounds classified as Anti-HIV Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
AMPRENAVIR
5.3.2 FDA UNII
5S0W860XNR
5.3.3 Pharmacological Classes
Mechanisms of Action [MoA] - P-Glycoprotein Inducers
5.4 ATC Code

J05AE05


J - Antiinfectives for systemic use

J05 - Antivirals for systemic use

J05A - Direct acting antivirals

J05AE - Protease inhibitors

J05AE05 - Amprenavir


5.5 Absorption, Distribution and Excretion

Absorption

Rapidly absorbed after oral administration in HIV-1-infected patients with a time to peak concentration (Tmax) typically between 1 and 2 hours after a single oral dose. The absolute oral bioavailability of amprenavir in humans has not been established.


Amprenavir is absorbed rapidly after oral administration. Taking amprenavir with a standard meal reduces the plasma AUC by only about 13%, but high-fat meals may have greater effects and should be avoided.

Hardman, J.G., L.E. Limbird, P.B., A.G. Gilman. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill, 2001., p. 1371


Only minimal amounts of amprenavir are eliminated unchanged in urine or feces; less than 3% of a dose is eliminated unchanged in urine. Following a single oral dose of radiolabeled amprenavir, approximately 14% of the dose is eliminated in urine and 75% is eliminated in feces; 2 metabolites account for more than 90% of radioactivity in feces.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 632


Distribution of amprenavir into body tissues and fluids has not been fully characterized. Studies in rats indicate that amprenavir is distributed to a variety of tissues following oral administration. The apparent volume of distribution of amprenavir in healthy adults is approximately 430 L.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 631


It is not known whether amprenavir crosses the human placenta; however, the drug crosses the placenta in rats. Information from an ex vivo human placental model for transplacental passage indicates that amprenavir crosses the human placenta. Although it is not known whether amprenavir is distributed in human milk, the drug is distributed into milk in rats.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 631


In patients with hepatic impairment, the peak plasma concentration and AUC of amprenavir may be increased. In adults with moderate cirrhosis who received a single 600-mg oral dose of amprenavir given as liquid-filled capsules, the AUC (0-4 hours) of the drug averaged 25.76 ug hour/mL compared with 12 ug hour/ml in healthy adults. In adults with severe cirrhosis who received the same dose, peak plasma concentrations averaged 9.43 ug/ml and the AUC (0-4 hours) averaged 38.66 ug hour/ml compared with 4.9 ug/ml or 12 ug hour/ml, respectively, in healthy adults.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 631


5.6 Metabolism/Metabolites

Hepatic. Amprenavir is metabolized in the liver by the cytochrome P450 3A4 (CYP3A4) enzyme system. The 2 major metabolites result from oxidation of the tetrahydrofuran and aniline moieties. Glucuronide conjugates of oxidized metabolites have been identified as minor metabolites in urine and feces.


The metabolic fate of amprenavir has not been fully determined, but the drug is metabolized in the liver. Amprenavir is metabolized principally by the cytochrome P450 (CYP) isoenzyme 3A4. The 2 major metabolites of the drug result from oxidation of the tetrahydrofuran and aniline moieties; glucuronide conjugates of oxidized metabolites have been identified as minor metabolites in urine and feces.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 632


5.7 Biological Half-Life

7.1-10.6 hours


The plasma elimination half-life of amprenavir in HIV-infected adults with normal renal and hepatic function ranges from 7.1-10.6 hours.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 632


5.8 Mechanism of Action

Amprenavir inhibits the HIV viral proteinase enzyme which prevents cleavage of the gag-pol polyprotein, resulting in noninfectious, immature viral particles.


Amprenavir acts by reversibly binding to the active site of HIV protease. This prevents polypeptide processing and subsequent viral maturation.

Hardman, J.G., L.E. Limbird, P.B., A.G. Gilman. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill, 2001., p. 1371


Although the complete mechanism(s) of antiviral activity of amprenavir has not been fully elucidated, amprenavir apparently inhibits replication of human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) by interfering with HIV protease. The drug, therefore, exerts a virustatic effect against retroviruses by acting as an HIV protease inhibitor.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 630


Amprenavir is a selective, competitive, reversible inhibitor of HIV protease. HIV protease, an aspartic endopeptidase that functions as a homodimer, plays an essential role in the HIV replication cycle and the formation of infectious virus. During HIV replication, HIV protease cleaves viral polypeptide products of the gag and gag-pol genes (i.e., p55 and p160) to form structural proteins of the virion core (i.e., p17, p24, p9, and p7) and essential viral enzymes (i.e., reverse transcriptase, integrase, protease). By interfering with the formation of these essential proteins and enzymes, amprenavir blocks maturation of the virus and causes the formation of nonfunctional, immature, noninfectious virions. Amprenavir is active in both acutely and chronically infected cells since it targets the HIV replication cycle after translation and before assembly. Thus, the drug is active in a subset of chronically infected cells (e.g., monocytes, macrophages) that generally are not affected by nucleoside reverse transcriptase inhibitors (e.g., abacavir, didanosine, lamivudine, stavudine, zalcitabine, zidovudine). Amprenavir does not affect early stages of the HIV replication cycle; however, the drug interferes with the production of infectious HIV and limits further infectious spread of the virus.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 630


Unlike nucleoside reverse transcriptase inhibitors, the antiretroviral activity of amprenavir does not depend on intracellular conversion to an active metabolite. Amprenavir and other HIV protease inhibitors (e.g., indinavir, lopinavir, nelfinavir, ritonavir, saquinavir) act at a different stage of the HIV replication cycle than other currently available antiretroviral agents, including nucleoside reverse transcriptase inhibitors and nonnucleoside reverse transcriptase inhibitors.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 630


Amprenavir is a highly specific inhibitor of HIV protease. Amprenavir has low affinity for human aspartic endopeptidases such as pepsin, renin, gastricin, cathepsin D, and cathepsin E. Results of in vitro studies using MT-4 cells indicate that amprenavir is not cytotoxic at concentrations up to 100 um.

McEvoy, G.K. (ed.). American Hospital Formulary Service - Drug Information 2003. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 2003 (Plus Supplements)., p. 630


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