Atazanavir Cobicistat

Atazanavir Cobicistat Brand Name– EVOTAZ

What is Atazanavir Cobicistat

Atazanavir cobicistat is a fixed-dose combination product containing a protease inhibitor (atazanavir) and a pharmacokinetic enhancer (cobicistat).

The drug is indicated for use in combination with other antiretroviral agents to treat HIV-1 infection in both treatment-naive and treatment-experienced adults.

Approval was based on the results of a single active-controlled study, in which 692 treatment-naive adults were randomized to receive either atazanavir; cobicistat or atazanavir plus ritonavir (both in combination with emtricitabine; tenofovir).

After 144 weeks of treatment, 72% of atazanavir; cobicistat recipients achieved HIV-1 RNA concentrations less than 50 copies/mL, compared to 74% in the atazanavir plus ritonavir group.

Studies in treatment-experienced patients are not available, and the manufacturer recommends use in this population be guided by the number of baseline primary protease inhibitor resistant substitutions.

Atazanavir cobicistat was approved by the FDA in January 2015.

Indications

  • human immunodeficiency virus (HIV)
  • human immunodeficiency virus (HIV) infection

Side Effects

  1. abdominal pain
  2. AV block
  3. bleeding
  4. breast enlargement
  5. cholelithiasis
  6. Cushingoid features
  7. depression
  8. diabetes mellitus
  9. diabetic ketoacidosis
  10. diarrhea
  11. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  12. elevated hepatic enzymes
  13. eosinophilia
  14. erythema multiforme
  15. Fanconi syndrome
  16. fatigue
  17. folliculitis
  18. glycosuria
  19. gynecomastia
  20. headache
  21. hematoma
  22. hematuria
  23. hyperamylasemia
  24. hyperbilirubinemia
  25. hypercholesterolemia
  26. hyperglycemia
  27. hypertriglyceridemia
  28. insomnia
  29. jaundice
  30. lipodystrophy
  31. maculopapular rash
  32. nausea
  33. nephrolithiasis
  34. PR prolongation
  35. pruritus
  36. rash
  37. renal failure (unspecified)
  38. rhabdomyolysis
  39. Stevens-Johnson syndrome
  40. urticaria
  41. vomiting

Monitoring Parameters

  • blood glucose
  • CBC with differential
  • CD4+ T cell count
  • ECG
  • hepatitis B serology
  • LFTs
  • plasma hepatitis C RNA
  • plasma HIV RNA
  • pregnancy testing
  • serum bilirubin (total and direct)
  • serum cholesterol
  • serum creatinine/BUN
  • serum lipid profile
  • serum phosphate
  • serum triglycerides
  • urinalysis

Contraindications

  • autoimmune disease
  • AV block
  • bleeding
  • breast-feeding
  • cholelithiasis
  • diabetes mellitus
  • diabetic ketoacidosis
  • dialysis
  • females
  • Graves’ disease
  • Guillain-Barre syndrome
  • hemophilia
  • hepatic disease
  • hepatitis
  • hepatitis B and HIV coinfection
  • hepatitis C and HIV coinfection
  • human immunodeficiency virus (HIV) infection resistance
  • hypercholesterolemia
  • hyperglycemia
  • hyperlipidemia
  • hypertriglyceridemia
  • immune reconstitution syndrome
  • infants
  • jaundice
  • lactic acidosis
  • neonates
  • nephrolithiasis
  • obesity
  • pancreatitis
  • pregnancy
  • renal failure
  • renal impairment
  • serious rash

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abemaciclib
  • Acalabrutinib
  • Acarbose
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Tramadol
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  • Aliskiren; Valsartan
  • Almotriptan
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  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
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  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
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  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
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  • Chlorpheniramine; Hydrocodone
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  • Empagliflozin
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  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
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  • Ethosuximide
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  • Fentanyl
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  • Fexofenadine; Pseudoephedrine
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  • Fluoxetine
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  • food
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  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Granisetron
  • grapefruit juice
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanfacine
  • H2-blockers
  • Halofantrine
  • Haloperidol
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydroxyprogesterone
  • Ibrutinib
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  • Thiazolidinediones
  • Thioridazine
  • Thiotepa
  • Tiagabine
  • Ticagrelor
  • Timolol
  • Tinidazole
  • Tipranavir
  • Tofacitinib
  • Tolterodine
  • Tolvaptan
  • Topiramate
  • Topotecan
  • Toremifene
  • Trabectedin
  • Tramadol
  • Trandolapril; Verapamil
  • Trazodone
  • Triamcinolone
  • Triazolam
  • Tricyclic antidepressants
  • Trimetrexate
  • Trimipramine
  • Tucatinib
  • Ubrogepant
  • Ulipristal
  • Umeclidinium; Vilanterol
  • Upadacitinib
  • Valbenazine
  • Valproic Acid, Divalproex Sodium
  • Valsartan
  • Vardenafil
  • Vemurafenib
  • Venetoclax
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Liposomal
  • Vinorelbine
  • Vorapaxar
  • Voriconazole
  • Voxelotor
  • Warfarin
  • Yohimbine
  • Zafirlukast
  • Zalcitabine, ddC
  • Zaleplon
  • Zanubrutinib
  • Zileuton
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem
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