Question

What if PEP includes atazanavir and I also take omeprazole?

10 April 2024. Related: All topics, Drug interactions, PEP/PEPSE.

Hi. I just started PEP two days ago. They gave me a combination of Truvada and Atazor.

The side effects I’m experiencing the most are stomach ache, nausea and diarrhoea. Can I control those with prescriptions? If yes, which ones do you recommend and how much time apart from the PEP medications.

I read online that omeprazole interacts with atazanavir, substantially decreasing its levels in the blood, and Ioperamide interacts with atazanavir and can lead to irregular heart rhythm and cardiac arrest.

I typically use omeprazole for stomach ache and loperamide for diarrhoea, so I’m having a hard time finding a prescription that can help control my symptoms but and the same time don’t interact with atazor.

Answer

Answer: Simon Collins

Hi there

Thanks, please tell the doctor that prescribed PEP that you also take omeprazole.

This is because omeprazole can significantly reduce levels of atazanavir so it would not be working as PEP.

Please see this link:
Summary of drug interaction between atazanaivr and omeprazole.

You could also talk to a pharmacist for alternative antacids that do not have this interaction. As PEP is only for 28 days, using an alternative might be easier that getting different PEP.

Otherwise, separating PEP from omeprazole by 12 hours might be okay, but your doctor needs to know about this.

Information about PEP, including the different drugs is at this link:
https://i-base.info/qa/factsheets/pep-faq