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Overview: Atazanavir is used to treat HIV. It works by helping stop the spread of HIV in your body. Common side effects may include nausea and vomiting, diarrhea, stomach pain, trouble sleeping, dizziness, and muscle aches. Atazanavir interacts with many other medicines. Tell your health care providers about all medicines and supplements you take. Atazanavir is taken by mouth, either as a capsule or a powder that is mixed into food or liquid and swallowed.

Uses

What is atazanavir used for?

Atazanavir is commonly used for the treatment of HIV.

Atazanavir may also be used for other conditions as determined by your health care provider.

How does atazanavir work (mechanism of action)?

Atazanavir works to help stop the spread of HIV in your body. A lower amount of HIV in your body helps protect and preserve the immune system.

How is atazanavir supplied (dosage forms)?

Brands and other names

  • Reyataz

Dosage forms and strengths

  • 100 mg, 150 mg, 200 mg, 300 mg oral capsules
  • 50 mg oral powder

How should I store atazanavir?

Oral Capsule. Atazanavir oral capsules should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). They can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting them. Store in a cool, dry place. Keep the container tightly closed.

Oral Powder. Atazanavir oral powder should be stored at a temperature between 68 F and 86 F (20 C and 30 C). Do not open the powder packet until you are ready to use it. After mixing the powder with food or liquid, it should be taken within one hour.

Side Effects

What are the most common side effects of atazanavir?

The most common side effects of atazanavir are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea or vomiting
  • Skin or the whites of your eyes turning yellowish in color (jaundice)
  • Rash (see below)
  • Headache
  • Stomach pain
  • Trouble sleeping 
  • Burning, tingling, or numbness in your arms, hands, legs, or feet (peripheral neuropathy)
  • Dizziness
  • Muscle aches 
  • Diarrhea
  • Depressed mood
  • Fever

There may be other side effects of atazanavir that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of atazanavir?

While less common, the most serious side effects of atazanavir are described below, along with what to do if they happen.

Heart Rhythm Changes. Atazanavir may cause heart rhythm problems that can lead to an irregular heartbeat and fainting. Some people have a higher risk of this, including people who already have heart disease or who take other medicines that affect the heart. Get emergency help if you have any of the following signs of heart rhythm changes.

  • Chest pain
  • Shortness of breath
  • Feeling dizzy, lightheaded, or fainting
  • Changes in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat

Rash or Severe Skin Reactions. Atazanavir can commonly cause a rash. Sometimes, it can cause a severe rash or skin reaction, such as Stevens-Johnson syndrome (SJS), which can lead to death if not treated. If you get a rash, call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, and muscle aches

Kidney Damage. Kidney damage can happen when taking atazanavir. Atazanavir may also affect how well your kidneys work and could lead to chronic kidney disease. Keep all appointments for blood and urine (pee) testing to check the health of your kidneys. Drink plenty of fluids while taking this medicine. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Kidney Stones. Atazanavir may cause kidney stones. Drinking plenty of water can help prevent kidney stones. Tell your health care provider right away if you have severe pain in your side or back, blood in your urine (pee), or pain while peeing. Your pee may look pink, red, or brown.

Gallbladder Problems. Taking atazanavir may cause gallbladder problems, such as cholelithiasis (also known as gallstones). Call your health care provider right away if you have any of the following symptoms.

  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
  • Fever
  • Pain in your upper stomach area
  • Stool (poop) that is clay-colored
  • Nausea and vomiting

High Blood Sugar. Atazanavir may increase your blood sugar levels and possibly lead to or worsen diabetes. Talk to your health care provider about how to maintain healthy blood sugar levels. Keep all appointments with your health care provider to check your blood work. Call your health care provider if you have any of the following symptoms of high blood sugar (hyperglycemia).

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Fruity-smelling breath

Immune System Changes. When you start atazanavir, your immune system might get stronger and start fighting infections that have been hiding inside your body for a long time. The type of symptoms you may have will depend on the infection. Tell your health care provider right away if you notice any of the following new symptoms of the infection.

  • Fever, sweats, chills, or muscle aches
  • Swollen lymph nodes
  • Vision problems
  • Confusion, problems talking, or headaches
  • Skin problems, such as a painful rash or warts
  • Cough or coughing up blood
  • Weakness or coordination problems

Fat Redistribution. Some people taking atazanavir have changes in how their body stores fat. You may get more fat around the belly, breasts, or upper back (buffalo hump). You may lose fat in your arms, legs, face, or butt. Tell your health care provider right away if you have any of these symptoms.

Severe Allergic Reactions. Atazanavir may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown, depending on your skin tone
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Shortness of breath, trouble swallowing, or throat tightness
  • Swelling in your feet, ankles, or legs
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Warnings & Precautions

Who should not use atazanavir?

Allergies to Ingredients. People who are allergic to any of the following should not take atazanavir.

  • Atazanavir
  • Reyataz
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific atazanavir products they stock.

Drug Interactions. Atazanavir should not be taken while you are using certain other medicines. Before taking atazanavir, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about atazanavir before using it?

Do not take atazanavir unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share atazanavir with other people, even if they have the same condition as you. It may harm them.

Keep atazanavir out of the reach of children.

Take each dose of atazanavir with food. Follow your health care provider’s advice about how to take it with other HIV medicines.

If you are taking atazanavir capsules, swallow them whole and do not open them.

If you are taking atazanavir powder, read and follow the instructions that come with the medicine and make sure you understand how to take it properly. The powder can be mixed with food or a liquid (such as applesauce, yogurt, milk, or water), and then it should be taken within one hour. If you have any questions, talk to your health care provider.

Taking certain acid reducers, such as antacids, H2 blockers, or proton pump inhibitors (PPIs), with atazanavir can make it not work as well. Talk with your health care provider about the best way to take acid reducers while taking atazanavir.

It is important to keep all appointments with your health care provider, including for lab tests, before starting this medicine and while you are taking it. This helps your health care provider make sure it is safe for you to take this medicine.

While atazanavir can help keep the HIV infection under control, it does not cure it. Atazanavir does not help protect against or prevent the spread of sexually transmitted infections (STIs), such as chlamydia, gonorrhea, or syphilis.

What should I tell my health care provider before using atazanavir?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if atazanavir is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems, including an irregular heart rate or rhythm
  • Liver problems, including hepatitis B or hepatitis C
  • Kidney problems, including kidney stones or dialysis
  • Gallstones
  • Diabetes
  • Hemophilia

Phenylketonuria (PKU). Some forms of atazanavir may contain phenylalanine, which can be dangerous for people with phenylketonuria (PKU). Tell your pharmacist and other health care providers if you have PKU. They can explain which form of atazanavir is safe for you to take.

Pregnancy. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take atazanavir while you are pregnant or trying to get pregnant. If you become pregnant while taking atazanavir, you can register for the Antiretroviral Pregnancy Registry by calling 800-258-4263 or at www.apregistry.com. This registry collects safety information about the use of HIV medicines during pregnancy.

Breastfeeding. Atazanavir passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take atazanavir while breastfeeding. There may be risks with breastfeeding while taking atazanavir and having HIV.

Interactions

Does atazanavir interact with foods or drinks?

There are no known interactions between atazanavir and foods or drinks. Atazanavir should be taken with food.

It is unknown if drinking alcohol will affect atazanavir. The risk of certain side effects, such as dizziness, may be increased if you drink alcohol while taking atazanavir.

Does atazanavir interact with other medicines (drug interactions)?

Many medicines interact with atazanavir. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking atazanavir.

  • Any other medicine for HIV 
  • A medicine for hepatitis C
  • Alfuzosin, which is a medicine used for trouble peeing due to an enlarged prostate
  • Any medicine for seizures, such as carbamazepine, phenobarbital, or phenytoin
  • Amiodarone (Pacerone and others), which is a medicine used for an irregular heart rhythm  
  • Quinidine, which is a medicine used to treat malaria or control your heart rate or rhythm 
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Rifabutin (Mycobutin), which is a medicine used to prevent Mycobacterium avium complex infection
  • A medicine used to treat cancer
  • An antipsychotic, which is a medicine for certain mental health conditions 
  • A benzodiazepine, such as midazolam or triazolam, which is a medicine used for anxiety or seizures
  • An ergot, such as dihydroergotamine (Migranal or Trudhesa) or ergotamine (Ergomar), which is a medicine used to treat migraine
  • St. John’s wort, which is a supplement that may be used for depression
  • A statin, such as atorvastatin (Lipitor and others), lovastatin, rosuvastatin (Crestor), or simvastatin (Zocor), which is a medicine to lower cholesterol
  • Lomitapide (Juxtapid), which is a medicine to lower cholesterol
  • A phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), sildenafil (Revatio, Viagra, and others), tadalafil (Cialis and others), or vardenafil (Levitra, Staxyn), which is a medicine used for erectile dysfunction or pulmonary arterial hypertension (PAH)
  • An antacid
  • An H2 blocker, such as cimetidine (Tagamet), famotidine (Pepcid, Zantac), or nizatidine (Axid) 
  • A proton pump inhibitor (PPI), such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex)
  • A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD) that contains hormones

Many other medicines may alter the blood levels of atazanavir, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with atazanavir. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much atazanavir?

If you or someone else has used too much atazanavir, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of atazanavir?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

Missing doses of atazanavir can cause it to not work as well over time. So it is important not to miss or skip doses.