Comparative Pharmacology
Head-to-head clinical analysis: ATMEKSI versus FINASTERIDE AND TADALAFIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ATMEKSI versus FINASTERIDE AND TADALAFIL.
ATMEKSI vs FINASTERIDE AND TADALAFIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ATMEKSI (atazanavir/cobicistat) is a fixed-dose combination of atazanavir, an HIV-1 protease inhibitor that inhibits viral protease, preventing cleavage of viral polyproteins and resulting in immature non-infectious virions, and cobicistat, a pharmacokinetic enhancer that inhibits CYP3A, increasing atazanavir exposure.
Finasteride is a 5α-reductase inhibitor that inhibits conversion of testosterone to dihydrotestosterone (DHT). Tadalafil is a phosphodiesterase-5 (PDE5) inhibitor that enhances nitric oxide-mediated vasodilation by increasing cyclic guanosine monophosphate (cGMP) in smooth muscle.
1.5 mg/kg IV every 4 weeks
One capsule containing finasteride 5 mg and tadalafil 5 mg orally once daily.
None Documented
None Documented
Terminal elimination half-life is 12 hours; renally impaired patients have prolonged half-life up to 24 hours.
Finasteride: 6-8 hours (elderly ~8 hours); Tadalafil: 17.5 hours (enables once-daily dosing).
Primarily renal (80% unchanged) and biliary/fecal (15% as metabolites).
Finasteride: 57% feces, 39% urine (metabolites); Tadalafil: 36% urine, 61% feces (mostly metabolites).
Category C
Category A/B
PDE5 Inhibitor
PDE5 Inhibitor