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Atazanavir

Atazanavir

Spectrum Of Activity

General Information

Treatment for HIV infection.

Monitor viral load (plasma HIV-RNA) prior to initiation or modification of treatment.

Monitor CD4 cell counts prior to initiation or with modification of ARV treatment and every 3 -6 months; thereafter during at least the first 2 years of treatment.

Monitor hepatitis B screening at baseline and with modification of ARV treatment.

Perform hepatitis C antibody testing prior to initiation or modification of ARV treatment.

Monitor ALT, AST, and total bilirubin at baseline and with modification of ARV treatment.

Common

  • Rash
  • Headache
  • Fever
  • Nausea
  • Vomiting
  • Hyperbilirubinemia
  • Jaundice
  • Serum amylase raised
  • Myalgia
  • Scleral icterus

Serious

  • Atrioventricular block
  • Prolonged PR interval
  • Erythema multiforme
  • Stevens-Johnson syndrome
  • Diabetes mellitus
  • Hyperglycemia
  • Grade 3 or 4 neutropenia
  • Cholelithiasis
  • Immune reconstitution syndrome
  • Nephrolithiasis

Multiple drug-drug interactions

  • Increased risk of virologic failure due to decreased atazanavir exposure and increased risk of nevirapine toxicity
  • Increased exposure to atazanavir and/or ketoconazole
  • QT interval prolonging drugs
  • CYP3A4 inhibitors/inducers

Antimicrobial class: Antiretroviral agent, HIV-1 protease inhibitor

Pregnancy category: B

Average serum half life: 6.5-7.9 hours (unboosted), 8.6-18.1hours (boosted with ritonavir)

Urine penetration: Therapeutic

CSF penetration: Therapeutic

Precautions: Use caution in patients with mild to moderate hepatic impairment (Child-Pugh class B); use unboosted atazanavir only; dose adjustments recommended for treatment-naive patients.

Use caution in patients with preexisting conduction system disease; monitoring recommended.

Consider alternative treatment options in high risk renal patients; monitoring recommended and discontinuation may be required.

Use is not recommended in HIV treatment-experienced patients with end-stage renal disease managed by hemodialysis.

Discontinue if severe rash develops.

Initiation or dose adjustment of insulin or oral hypoglycemic agent may be required.