Atazanavir slows the progress of HIV infection. It is one of a number of medicines that you will need to take regularly.
Take one capsule a day, with a meal.
Atazanavir has been associated with some side-effects. Your doctor will discuss these with you before you start treatment.
|Type of medicine||A protease inhibitor (PI) antiretroviral medicine|
|Used for||Human immunodeficiency virus (HIV) infection, in adults and in children over 6 years of age|
There is also a combination tablet available called Evotaz® (atazanavir with cobicistat)
Atazanavir is an antiretroviral medicine. It is prescribed for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. Atazanavir slows down the progress of HIV infection by reducing the amount of virus in your body. It does this by stopping the production of a protein that the virus needs to copy (replicate) itself.
Atazanavir will be prescribed for you by a doctor who is a specialist. It belongs to a group of antiretroviral medicines known as protease inhibitors (PIs). It is given alongside a number of other antiretroviral medicines, as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine. One brand of atazanavir called Evotaz® also contains a medicine called cobicistat. Cobicistat boosts the effect of atazanavir. Not all of the information in this document may apply to the combination brand - please refer to the manufacturer's printed information leaflet from inside the pack.
It is vital to take your antiretroviral medicines exactly as prescribed to maintain success and to help to prevent the virus from becoming resistant to the medicines. These medicines are usually taken for life.
Before taking atazanavir
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking atazanavir it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have diabetes (diabetes mellitus).
- If you have liver inflammation (called hepatitis), or any other liver problem.
- If you have any problems with the way your kidneys work.
- If you have been told you have a heart rhythm disorder.
- If you have either haemophilia or porphyria, which are both rare inherited blood disorders.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take atazanavir
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about atazanavir, and it will also provide you with a full list of the side-effects which you could experience from taking it.
- Take atazanavir exactly as your doctor tells you to. It is usual to take one dose each day. There are several strengths of atazanavir capsule available - your doctor will tell you which is right for you (or your child). It is important that you take atazanavir with food, as this will help your body to absorb the medicine. Swallow the capsule whole with a drink of water. You will also be asked to take a booster medicine (such as ritonavir or cobicistat) at the same time as you take atazanavir.
- Try to take atazanavir at the same time of day each day, as this will help you to remember to take it regularly.
- If you forget to take a dose, take it (with something to eat) as soon as you remember. If you do not remember until the next day then leave out the forgotten dose and take your dose that it is due on that day. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests to check how well your medicines are working.
- It is important that you continue to take atazanavir and your other antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
- If you develop any infection soon after you start this treatment, let your doctor know. As a result of taking atazanavir, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
- Follow carefully any advice your doctor gives to you about making lifestyle changes to reduce any risk of damage to your heart and blood vessels. These can include stopping smoking, eating healthily and taking regular exercise.
- Some people taking antiretroviral medicines develop changes to the way body fat is distributed in the body. This can result in changes to body image. Your doctor will discuss the possibility of this with you.
- Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
- It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made and treatment has been started. If you have any feelings of depression, or any distressing thoughts about harming yourself then you should speak with your doctor straightaway.
- Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is a bone disease where bone tissue dies because there is a reduced blood supply to it. It leads to joint pains and stiffness, and can cause difficulties in movement. If you notice any of these symptoms, speak with your doctor.
- If you buy any medicines, check with a pharmacist that they are suitable to take with atazanavir and your other medicines. This is because some medicines and herbal remedies interfere with atazanavir and stop it from working properly. In particular, do not take indigestion remedies during the two hours before and the two hours after you take your doses, and do not take St John's wort.
- If you have diabetes you may need to check your blood sugar (glucose) more frequently as this medicine can affect the levels of sugar in your blood. Your doctor will advise you about this.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- Treatment for HIV is usually lifelong. Continue to take atazanavir regularly for as long as your doctor tells you to, even if you feel well. This is to keep your immune system healthy.
Can atazanavir cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with atazanavir. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common atazanavir side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick (nausea) or being sick (vomiting), tummy (abdominal) pain, indigestion||Stick to simple meals - avoid fatty or spicy food. If it continues, speak with your doctor|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Yellow skin or yellowing of the whites of your eyes||Let your doctor know about this straightaway|
|Headache||Drink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Feeling tired or dizzy||Do not drive and do not use tools or machines while affected|
|Skin rash||Let your doctor know about this. Although a skin rash is common during the first few weeks of treatment, a severe rash with blisters may be a sign of a more serious allergic-type reaction|
Some people taking atazanavir have developed kidney stones - let your doctor know as soon as possible if you feel pain in your side or when you pass urine, or if you notice any blood in your urine.
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further information.
How to store atazanavir
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Reyataz® 150 mg, 200 mg and 300 mg Hard Capsules; Bristol-Myers Squibb Pharmaceutical Limited, The electronic Medicines Compendium. Dated February 2019.
British National Formulary, 77th Edition (Mar 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.