- Atazanavir (tradename Reyataz in Europe) is a protease inhibitor that is usually taken with a separate boosting dose of either ritonavir or cobicistat.
- Standard adult dose:
1 x 300 mg or 2 x 150 mg capsules, once-daily, usually plus booster. The booster is either 1 x 100 mg ritonavir or 1 x 150 mg cobicistat. When a booster is not used the standard adult dose increases to 2 x 200 mg capsules, once-daily.
- Atazanavir needs to be taken with food. This is to increase absorption for better drug levels. Food can be a light meal (calorie count is not specified) and does not need to contain fat.
- Side effects: yellowing eyes or skin in 10% of patients. This is a cosmetic change rather than causing a health problem. It total bilirubin levels increase to 60-70 mmol/L atazanavir is either changes or the dose is modified. Cholesterol can increase due to the use of ritonavir. Atazanavir can cause kidney stones and gallstones. Other side effects include nausea, diarrhoea and lipodystrophy.
- Other notes: if ritonavir/cobicistat or yellow causes problems, atazanavir can be used on its own at a higher dose of 400 mg once-daily with food (but not when combined with tenofovir or Truvada because of a drug interaction). Therapeutic drug monitoring (a blood tests to look at drug levels) can be used to check the dose is safe.
- Atazanavir plus cobicistat is available combined in a single pill called Evotaz.
Information on increased bilirubin from the i-Base side effects guide.
Information on lipodystrophy from the i-Base side effects guide.
The European patient information and detailed Product Information for atazanavir are available from this link on the European Medicines Agency (EMA) website.
The Patient Information is a simplified summary: what the drug is, why it is used, results from studies and cautions including side effects.
The Product Information is a detailed technical summary that you can access as a PDF file by clicking the ‘Product Information’ tab. It describes more precisely how the drug works and how it is processed by your body. This includes, for example, reported food interaction studies in terms of calories or fat content. It includes more details of the study results and a full list of side effects and drug interactions.