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|Atazanavir sulfate Atazanavir Sulfate

Atazanavir sulfate

Generic name: Atazanavir sulfate
Brand names: Reyataz

Why is Atazanavir sulfate prescribed?

Atazanavir sulfate is used with other medications to treat human immunodeficiency virus (HIV) infection. HIV causes the immune system to break down so that it can no longer fight off other infections. This leads to acquired immune deficiency syndrome (AIDS).

HIV thrives by taking over the immune system"s vital CD4 cells (white blood cells) and using their inner workings to make additional copies of itself. Atazanavir sulfate belongs to a class of HIV drugs called protease inhibitors, which work by interfering with an important step in the virus"s reproductive cycle.

Atazanavir sulfate is approved for used only in combination with other anti-HIV medications.

Most important fact about Atazanavir sulfate

Atazanavir sulfate must be taken exactly as your doctor prescribes. Like many anti-HIV drugs, Atazanavir sulfate can affect the action of other medications. Before you start taking Atazanavir sulfate, make sure your doctor knows about all the medicines you take, including over-the-counter drugs. Do not start a new medication without talking to your doctor, and also alert him or her when you stop taking any medication.

How should you take Atazanavir sulfate?

Take Atazanavir sulfate exactly as prescribed by your doctor. Do not change your dose or stop taking Atazanavir sulfate without first talking to your doctor.

The amount of HIV in your blood may increase if you stop taking Atazanavir sulfate even for a short time. Be careful not to miss any doses of Atazanavir sulfate or other anti-HIV medications. It"s also important to renew the medication promptly when your supply of pills starts to run low.

Always take Atazanavir sulfate with a meal or snack to increase absorption of the drug. Do not open the capsules; swallow them whole.

If you are taking antacids or Videx, take Atazanavir sulfate either 2 hours before or 1 hour after those medications.

--If you miss a dose...

Take the forgotten dose as soon as you remember, then take the next scheduled dose at its regular time. If you are scheduled to take your next dose in 6 hours or less, do not take the missed dose. Just wait and take the next dose at its scheduled time. Do not take two doses at once.

--Storage instructions...

Store at room temperature and protect from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue using Atazanavir sulfate.

• More common side effects may include:
  Abdominal pain, burning of hands or feet, depression, diarrhea, difficulty sleeping, dizziness, fever, headache, heartbeat irregularities, muscle numbness, nausea, pain, rash, redistribution of body fat, tingling, vomiting, yellow skin or eyes

Why should Atazanavir sulfate not be prescribed?

You cannot take Atazanavir sulfate if you develop an allergic reaction to the drug. If you take certain other medications you should not use Atazanavir sulfate (see "Possible food and drug interactions").

Special warnings about Atazanavir sulfate

Atazanavir sulfate is not a cure for HIV infection or AIDS. It also does not reduce your chance of passing HIV infection to others through sexual contact or through contact with your blood. Therefore, you should still continue to avoid practices that could spread HIV.

You could develop a rash while taking Atazanavir sulfate. If the rash becomes severe, let your doctor know; you may have to stop taking Atazanavir sulfate.

If you have ever had liver problems, use Atazanavir sulfate with caution. The drug can worsen existing liver disease, especially if you have a history of hepatitis.

Treatment with HIV drugs such as Atazanavir sulfate sometimes causes a redistribution of body fat, resulting in added weight around the waist, a "buffalo hump" of fat on the upper back, breast enlargement, and wasting of the face, arms, and legs. It"s not known why this occurs, or what long-term effects it might have.

You may develop a condition called immune reconstitution syndrome, which is a reaction of your immune system that causes your body to develop an inflammatory response to certain secondary infections. If you suspect that you may have a secondary infection, contact your doctor immediately.

Some people taking HIV drugs such as Atazanavir sulfate develop diabetes or high blood sugar. Those who already have diabetes may experience a worsening of their symptoms. If you"re taking a diabetes medication, your doctor may have to adjust your dosage.

If you have the blood-clotting disorder hemophilia, you may have more bleeding problems when taking Atazanavir sulfate.

Possible food and drug interactions when taking Atazanavir sulfate

If you take the following medications, you should not use Atazanavir sulfate. The combination may cause reduced effectiveness, resistance to Atazanavir sulfate or other HIV drugs, serious or life-threatening side effects, or even death.

Cisapride
Ergot-based drugs such as Cafergot and Methergine
Indinavir (Crixivan)
Irinotecan (Camptosar)
Lovastatin (Mevacor)
Midazolam (Versed)
Pimozide (Orap)
Proton pump inhibitors such as esomeprazole (Nexium), omeprazole (Prilosec), and pantoprazole (Protonix)
Rifampin (Rifadin, Rifater, Rifamate, Rimactane)
Simvastatin (Zocor)
St. John"s wort
Triazolam (Halcion)

If Atazanavir sulfate is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Atazanavir sulfate with the following:

Antiarrhythmic drugs that correct abnormal heart rhythms, such as amiodarone (Cordarone), bepridil (Vascor), quinidine, and lidocaine
Antidepressants such as amitriptyline (Elavil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), protriptyline (Vivactil), or trimipramine (Surmontil)
Antifungal medications such as ketoconazole (Nizoral) and itraconazole (Sporanox)
Anti-ulcer drugs such as nizatidine (Axid), famotidine (Pepcid AC), cimetidine (Tagamet), or ranitidine (Zantac)
Atorvastatin (Lipitor)
Beta blockers such as atenolol (Tenormin)
Calcium channel blockers such as diltiazem (Cardizem), felodipine (Plendil), nifedipine (Procardia), nicardipine (Cardene), and verapamil (Isoptin SR)
Clarithromycin (Biaxin)
Cyclosporine (Sandimmune, Neoral)
Didanosine (Videx)
Efavirenz (Sustiva)
Erectile dysfunction drugs such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
HIV drugs known as protease inhibitors, such as fosamprenavir (Lexiva), indinavir (Crixivan), and ritonavir (Norvir)
Nevirapine (Viramune)
Oral contraceptives containing ethinyl estradiol and norethindrone
Rifabutin (Mycobutin)
Saquinavir (Invirase, Fortovase)
Sirolimus (Rapamune)
Tacrolimus (Prograf)
Tenofovir (Viread)
Warfarin (Coumadin)

Voriconazole (VFend) should not be taken if you are using Atazanavir sulfate and Norvir together.

Atazanavir sulfate should be taken 2 hours before or 1 hour after antacids (Maalox, Mylanta) or buffered medications (Videx).

Be sure to tell your doctor and pharmacist about all medications you take, both prescription and over-the-counter. Alert them when you stop taking a medication too.

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. The effects of Atazanavir sulfate during pregnancy have not been well studied.

You should not breastfeed if you have HIV, since the virus appears in breast milk and can infect a nursing infant.

Recommended dosage

ADULTS

For Adults Who Have Never Taken HIV Medications

The recommended dose of Atazanavir sulfate is two 200-milligram capsules once a day, for a total of 400 milligrams.

For Adults Who Have Taken HIV Medications

The recommended once-daily dose of Atazanavir sulfate is two 150-milligram capsules (for a total of 300 milligrams) plus 100 milligrams of ritonavir (Norvir).

If you take Sustiva or a buffered formulation of Videx, your doctor may tell you to use a different dosage.

Adults with Reduced Liver Function

If you have moderate liver problems, your doctor may reduce your dosage to 300 milligrams once a day.

CHILDREN

Because Atazanavir sulfate has not been well studied in children under age 16, there isn"t enough information to recommend a dose. The drug is not recommended for use in babies under the age of 3 months.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency treatment immediately. A possible sign of Atazanavir sulfate overdose may include yellowing of the skin or whites of the eyes.