Atazanavir

Atazanavir Brand Name– Reyataz

What is Atazanavir

Atazanavir is a protease inhibitor for the treatment of human immunodeficiency virus (HIV) infection.

It is the first drug in its class to be given once daily.

Also, it has a unique chemical structure (azapeptide) and resistance profile compared with other available peptidomimetic protease inhibitors.

In comparison to other protease inhibitors, atazanavir does not appear to have a significant adverse effect on lipoprotein concentrations.

Like other protease inhibitors, it should be used in combination with other antiretroviral drugs.

Atazanavir is approved for use in adults and children at least 3 months of age and weighing at least 5 kg.

Atazanavir was originally approved by the FDA in June 2003.

Indications

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

NOTE: HIV guidelines recommend atazanavir be administered concurrently with a pharmacokinetic enhancer (i.e., cobicistat or low dose ritonavir) to increase virologic potency. Atazanavir and cobicistat are available as a co-formulated combination product.

Side Effects

  1. abdominal pain
  2. alopecia
  3. anemia
  4. angioedema
  5. arthralgia
  6. AV block
  7. bleeding
  8. breast enlargement
  9. bundle-branch block
  10. cholecystitis
  11. cholelithiasis
  12. cholestasis
  13. cough
  14. Cushingoid features
  15. depression
  16. diabetes mellitus
  17. diabetic ketoacidosis
  18. diarrhea
  19. dizziness
  20. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  21. edema
  22. elevated hepatic enzymes
  23. erythema multiforme
  24. fever
  25. gynecomastia
  26. headache
  27. hematoma
  28. hyperamylasemia
  29. hyperbilirubinemia
  30. hypercholesterolemia
  31. hyperglycemia
  32. hypertriglyceridemia
  33. insomnia
  34. interstitial nephritis
  35. jaundice
  36. lipodystrophy
  37. maculopapular rash
  38. myalgia
  39. nausea
  40. nephrolithiasis
  41. neutropenia
  42. pancreatitis
  43. PR prolongation
  44. pruritus
  45. QT prolongation
  46. rash
  47. rhinorrhea
  48. Stevens-Johnson syndrome
  49. thrombocytopenia
  50. 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 triglycerides
  • urinalysis

Contraindications

  • autoimmune disease
  • AV block
  • bleeding
  • breast-feeding
  • cholelithiasis
  • diabetes mellitus
  • diabetic ketoacidosis
  • dialysis
  • females
  • geriatric
  • 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
  • phenylketonuria
  • pregnancy
  • renal disease
  • renal impairment
  • serious rash

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abemaciclib
  • Acalabrutinib
  • Acarbose
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Adefovir
  • Ado-Trastuzumab emtansine
  • Aldesleukin, IL-2
  • Alfentanil
  • Alfuzosin
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Almotriptan
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alosetron
  • Alpha-glucosidase Inhibitors
  • Alprazolam
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  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
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  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Omeprazole
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  • Empagliflozin
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  • Eszopiclone
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  • food
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  • grapefruit juice
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