Atazanavir

The recommended adult dose of atazanavir is 300 mg taken once daily with food, along with 100 mg of ritonavir. If ritonavir is not tolerated, the dose of atazanavir should be increased to 400 mg once daily with food. should be taken at the same time each day and swallowed whole (do not open the capsules) with a glass of water.

Atazanavir should never be used alone and should always be used in combination with other HIV medications. Your doctor may choose other doses of atazanavir, depending on which other HIV medications you are taking.

The recommended dose for children ages 6 to 18 is based on body weight and calculated by the doctor.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible with food and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store at room temperature, protect from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause mood changes and, occasionally, may lead to depression; it may cause diarrhea; it may cause spots or redness of the skin; it may cause nausea and vomiting; it may cause a redistribution of body fat (lipodystrophy). Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

150 mg
Each hard-shell gelatin capsule with a greenish-blue opaque cap and blue opaque body, axially printed with "MYLAN" over "AR150" in black ink on both the cap and body, and filled with white-to-pale-yellow powder, contains atazanavir sulfate equivalent to 150 mg of atazanavir. Nonmedicinal ingredients: crospovidone, lactose monohydrate, magnesium stearate; capsule shell: D&C Red 28, FD&C Blue No. 1, FD&C Red No. 3, gelatin, iron oxide yellow, and titanium dioxide; black imprinting ink: black iron oxide, potassium hydroxide, propylene glycol, shellac, and strong ammonia solution.

200 mg
Each hard-shell gelatin capsule with a blue opaque cap and blue opaque body, axially printed with "MYLAN" over "ARC200" in black ink on both the cap and body, and filled with white-to-pale-yellow powder, contains atazanavir sulfate equivalent to 200 mg of atazanavir. Nonmedicinal ingredients: crospovidone, lactose monohydrate, magnesium stearate; capsule shell: FD&C Blue No. 1, FD&C Red No. 3, gelatin, and titanium dioxide; black imprinting ink: black iron oxide, potassium hydroxide, propylene glycol, shellac, and strong ammonia solution.

300 mg
Each hard-shell gelatin capsule with a red opaque cap and greenish-blue opaque body, axially printed with "MYLAN" over "AR300" in black ink on both the cap and body, and filled with white-to-pale-yellow powder, contains atazanavir sulfate equivalent to 300 mg of atazanavir. Nonmedicinal ingredients: crospovidone, lactose monohydrate, magnesium stearate; capsule shell: FD&C Blue No. 1, FD&C Red No. 3, iron oxide red, iron oxide yellow, gelatin, and titanium dioxide; black imprinting ink: black iron oxide, potassium hydroxide, propylene glycol, shellac, and strong ammonia solution.

Do not take atazanavir if you:

• are allergic to atazanavir or any ingredients of the medication
• are taking any of the following medications:
  • Alfuzosin
  • Apixaban (if also taking ritonavir)
  • ergot-type medications (i.e., Dihydroergotamine, ergonovine, ergotamine, or methylergonovine)
  • Hepatitis C direct acting antivirals (e.g., elbasvir, grazoprevir, glecaprevir, pibrentasvir)
  • indinavir
  • Irinotecan
  • Lovastatin
  • Lomitapide
  • Lurasidone (if also taking ritonavir)
  • nevirapine
  • Pimozide
  • Quetiapine
  • quinidine
  • rifampin
  • Rivaroxaban (if also taking ritonavir)
  • Sildenafil (when used for pulmonary arterial hypertension)
  • Simvastatin
  • St. John's wort
  • Triazolam

There may be an interaction between atazanavir and any of the following:

• Alitretinoin
• alpha-blockers (e.g., alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• Amiodarone
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• anticancer medications (e.g., Cabazitaxel, Docetaxel, Doxorubicin, Etoposide, Ifosfamide, irinotecan, Vincristine)
• antipsychotics (e.g., Clozapine, Haloperidol, lurasidone, Olanzapine, pimozide, quetiapine, Risperidone)
• Apalutamide
• apixaban
• Aprepitant
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, Voriconazole)
• benzodiazepines (e.g., Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam, midazolam, triazolam)
• birth control pills (estrogen and progestin)
• Bosentan
• Bromocriptine
• Buprenorphine
• Buspirone
• calcifediol
• Calcitriol
• calcium channel blockers (e.g., diltiazem, Felodipine, nicardipine, Nifedipine, verapamil)
• cannabis
• Cobicistat
• Colchicine
• conivaptan
• corticosteroids (e.g., Dexamethasone, fluticasone, Hydrocortisone, Prednisone)
• Cyclosporine
• dabigatran
• Dapsone
• Darifenacin
• Deferasirox
• Degarelix
• diabetes medications (e.g., Canagliflozin, Glyburide, insulin, Linagliptin, Metformin, Repaglinide, Rosiglitazone, Sitagliptin)
• Disopyramide
• Domperidone
• Dronedarone
• Dutasteride
• Elagolix
• Eliglustat
• Eluxadoline
• enfuvirtide
• Enzalutamide
• Eplerenone
• ergotamine or ergot-type medications (e.g., dihydroergotamine, ergonovine, or methylergonovine)
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Everolimus
• Flibanserin
• Galantamine
• grapefruit juice
• Guanfacine
• H2 antagonists (e.g., Famotidine, Ranitidine)
• hepatitis C antivirals (e.g., glecaprevir and pibrentasvir, grazoprevir, ledipasvir, sofosbuvir)
• HIV integrase inhibitors (e.g., bictegravir, dolutegravir, elvitegravir, raltegravir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• other HIV protease inhibitors (e.g., indinavir, ritonavir, saquinavir)
• HIV nucleoside reverse transcriptase inhibitors (NRTIs; e.g., abacavir, didanosine, lamivudine, tenofovir, zidovudine)
• Ivabradine
• Ivacaftor
• lidocaine
• lomitapide
• lumacaftor and ivacaftor
• Macitentan
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• maraviroc
• Mefloquine
• Methadone
• mifepristone
• Minocycline
• Minoxidil
• Mirtazapine
• Modafinil
• Naloxegol
• narcotics (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
• Orlistat
• Oxybutynin
• phosphodiesterase (PDE 5) inhibitors (e.g., sildenafil, Tadalafil, Vardenafil)
• Pimecrolimus
• praziquantel
• progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone, Norethindrone)
• Propafenone
• protein kinase inhibitors (e.g., Bosutinib, imatinib, Nilotinib)
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• quinidine
• quinine
• rifabutin
• rifampin
• rilpivirine
• Riociguat
• rivaroxaban
• Romidepsin
• rupatadine
• St. John's wort
• salmeterol
• Sarilumab
• seizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, Phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• siltuximab
• Sirolimus
• Solifenacin
• "statin" anti-cholesterol medications (e.g., Atorvastatin, lovastatin, simvastatin)
• Tacrolimus
• Tamoxifen
• Ticagrelor
• Tocilizumab
• Tolterodine
• Tolvaptan
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Imipramine, Nortriptyline)
• "triptan" migraine medications (e.g., Almotriptan, Eletriptan)
• Ulipristal
• Vilazodone
• Warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with . Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use .

Diabetes: Some people taking protease inhibitor medications such as atazanavir have developed diabetes during treatment, and some people who already had diabetes noticed that their diabetes became worse during treatment. If you have diabetes, discuss with your doctor how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Gallstones: Atazanavir can cause gallstones, concentrations of the bile that is produced by the liver. If you experience symptoms of gallstones, such as persistent severe pain on the right side of your abdomen, nausea and vomiting, or pain between the shoulder blades or under the right shoulder, contact your doctor as soon as possible.

Heart effects: Atazanavir can affect heart rhythm (heartbeat) for some people. If you have problems with the electrical conduction system of your heart (e.g., first-, second-, and third-degree AV block) or are taking medications that affect the electrical conduction system of the heart (e.g., Diltiazem, Verapamil), discuss with your doctor how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Hemophilia: People with hemophilia A or B may be at an increased risk of bleeding while taking atazanavir. If you have a bleeding condition, discuss with your doctor how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Immune reconstitution inflammatory syndrome: When you start taking HIV medications such as atazanavir, your immune system may get stronger and start to fight other infections that have been hidden in your body (e.g., pneumonia, herpes, or Tuberculosis). Contact your doctor if you develop any new symptoms after starting HIV medications such as atazanavir.

Kidney function: Chronic Kidney Disease has been reported with the use of atazanavir. If you have a history of kidney disease, discuss with your doctor how may affect your medical condition, how your medical condition may affect the dosing and effectiveness of , and whether any special monitoring is needed.

Kidney stones: Some people taking atazanavir have developed kidney stones. If you develop signs or symptoms of kidney stones (e.g., pain in your side, blood in your urine, or pain when you urinate), contact your doctor immediately.

Lactic acidosis: People taking atazanavir in combination with some other HIV medications (e.g., abacavir, didanosine, lamivudine, and zidovudine) may be at risk of a serious condition called lactic acidosis. Lactic acidosis is a buildup of lactic acid in the blood. If you notice any of the symptoms of lactic acidosis, such as difficulty breathing, abdominal pain, muscle weakness, nausea, and vomiting, stop taking and contact your doctor immediately.

Lactose: contains lactose. If you have hereditary problems of galactose intolerance, lactase deficiency, or glucose-galactose malabsorption, talk to your doctor about whether is appropriate for you.

Liver function: Liver disease or reduced liver function may cause to build up in the body, causing side effects. can also cause liver failure and reduced liver function. People with hepatitis B or C, or liver disease, may experience worsening of their liver disease symptoms while taking . Your doctor will monitor your liver function while you are taking atazanavir. Report any signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools) to your doctor immediately. People with severe liver disease should not take .

Other medications: Atazanavir may interact with a number of medications, which may mean a change in how you take (see "What medications can interact with ?"). Tell your doctor about all the medications that you are taking. Certain medications should not be taken with atazanavir at all (see "Who should NOT take ?").

Atazanavir should never be used alone; it should always be used in combination with other HIV medications.

Pregnancy: should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking , contact your doctor immediately.

Breast-feeding: passes into breast milk. If you are breast-feeding and are taking atazanavir, it may affect your baby. Breast-feeding is not recommended for HIV-positive women since the virus can be transmitted through breast milk.

Children and adolescents: The safety and effectiveness of using have not been established for children between 3 months and 6 years of age. Do not give to children younger than 3 months as it can cause a form of brain damage known as kernicterus.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. The capsule of this medication should not be opened, crushed or chewed. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication is more effective if taken with food. Always take it with a meal or a snack. To ensure effectiveness, avoid taking an antacid within 2 hours (before or after) of this medication.