Atazanavir

Atazanavir is an antiviral or antiretroviral medicine. It is used in the treatment of HIV infection. It stops the virus from producing new viruses and clears up your infection. Atazanavir should be taken with food, as this increases the absorption of the medicine into the body. You should take it in the dose and duration as advised by your doctor. Taking it at the same time every day will help you to remember to take it. Do not stop taking it until you have finished the complete course, even when you feel better. If you stop taking this medicine too early then infection may return or worsen. The most common side effects of this medicine include rash, headache, dizziness, and vomiting. These are usually mild but let your doctor know if they bother you or last more than a few days. Before using it, you should tell your doctor if you are allergic to any antibiotics or have any kidney or liver problems. You should also let your doctor know all other medicines you are taking as they may affect, or be affected by this medicine. Pregnant and breastfeeding mothers should consult their doctor before using it. Your doctor may monitor your liver function while taking this medication. Atazanavir is an anti-HIV medication. It works by interfering with an enzyme (protease), which is required by HIV-infected cells to make new viruses. This stops the production of new viruses.

• HIV infection

Atazanavir, a synthetic azapeptide, is a selective, competitive, and reversible HIV-1 protease inhibitor. It inhibits the cleavage of viral Gag and Gag-Pol polyprotein precursors into individual functional proteins, preventing the processing of the polyproteins into mature and infectious virions.

Adult Dose: Oral HIV-1 infection Adult: 300 mg once daily, given w/ ritonavir 100 mg. Alternatively, for treatment-naive patient: 400 mg once daily (if patient cannot tolerate ritonavir). Hepatic Impairment W/ ritonavir: Mild to severe: Contraindicated. W/o ritonavir (treatment-naive patient): Moderate (Child-Pugh category B): 300 mg daily. Severe (Child-Pugh category C): Contraindicated. Child Dose: Oral HIV-1 infection Child: >3 mth As powd: 5-6 yr As cap/powd: 15-40 kg: Same as adult dose. Renal Dose: Renal Impairment Treatment-experienced patient on haemodialysis: Contraindicated.

Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Atazanavir is to be taken with food.

Common: • Rash • Headache • Dizziness • Vomiting • Abdominal pain • Blood in urine • Cough • Crystals in urine • Diarrhea • Indigestion • Hypercholesterolemia (high cholesterol) • Increased liver enzymes • Increased triglyceride level in blood • Nausea • Paresthesia (tingling or pricking sensation) • Peripheral neuropathy (tingling and numbness of feet and hand) • Protein in urine • Taste change • Throat pain

[UNSAFE] Atazanavir may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur. Atazanavir should be taken with food. Do not skip any doses and finish the full course of treatment even if you feel better. Do not take antacids an hour before or two hours after taking Atazanavir. It may cause dizziness or sleepiness. Do not drive or do anything that requires concentration until you know how it affects you. Stop taking medications (prescribed for erectile dysfunction) like sildenafil or tadalafil while on treatment with this medicine. Your doctor may check your liver function regularly. Inform your doctor if you develop abdominal pain, loss of appetite darkened urine or yellowing of the eyes or skin (jaundice). Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.

Hypersensitivity. Treatment-experienced patient on haemodialysis. Mild to moderate (w/ ritonavir) and severe (w/ or w/o ritonavir) hepatic impairment. Lactation. Concomitant use w/ statins (e.g. simvastatin, lovastatin), antiarrhythmics (e.g. amiodarone, bepridil, quinidine, systemic lidocaine), antihistamines (e.g. astemizole, terfenadine), antipsychotics (e.g. pimozide, quetiapine), ergot derivatives (e.g. dihydroergotamine, ergometrine, ergotamine, methylergometrine), GI prokinetics (e.g. cisapride), sedative and hypnotics (e.g. triazolam, oral midazolam), alpha1-adrenergic antagonists (e.g. alfuzosin), sildenafil (for treatment of pulmonary arterial HTN), irinotecan, and indinavir.

Decreased concentration w/ PPIs, efavirenz, nevirapine, and rifampicin. May increase serum concentration of inhaled fluticasone and salmeterol. Potentially Fatal: Increased risk for myopathy (i.e. rhabdomyolysis) w/ simvastatin and lovastatin. Increased risk for cardiac arrhythmia w/ cisapride. May increase risk of hypotension w/ alfuzosin. May increase potential of serious AR of amiodarone, bepridil, quinidine, and systemic lidocaine. May increase serum concentration of astemizole, terfenadine, pimozide, quetiapine, dihydroergotamine, ergometrine, ergotamine, methylergometrine, triazolam, and oral midazolam. May increase risk for hypotension, visual changes, and priapism w/ sildenafil (when used for pulmonary arterial HTN). May inhibit UGT1A1 causing an increase toxicity of irinotecan. May cause indirect hyperbilirubinaemia w/ indinavir.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Atazanavir. Please consult your doctor.

[SAFE IF PRESCRIBED] Atazanavir is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.

[SAFE IF PRESCRIBED] Atazanavir is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[SAFE IF PRESCRIBED] Atazanavir is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Atazanavir may not be needed in these patients. Please consult your doctor. [CAUTION] Atazanavir should be used with caution in patients with liver disease. Dose adjustment of Atazanavir may be needed. Please consult your doctor. Use of Atazanavir is not recommended in patients with moderate and severe liver disease.