Question

Is food important with atazanavir? what about the yellowing?

17 December 2008. Related: Adherence, All topics, Side effects.

Is a snack (e.g. a biscuit or crisps) enough food for Reyataz to be effective? Also, which meds is lipoatrophy associated with? Finally, will the yellow tinge disappear or will this side effect remain?

Thanks

Answer

Answer: Simon Collins

Here is some info from the company’s site: “A meal or snack can be a glass of orange juice and some toast. It doesn’t have to be a full meal, but it should be more than just something to drink. Even if you’re not hungry, eat something small before you take REYATAZ. It’ll help REYATAZ work better.”

This needs to be more than a biscuit, but it is important to make the effort, as this increases drug levels by 30-40%. It is very frustrating when ‘food’ is talked about so generally without an indication of how many calories they used in the studies. This isn;t even included in the more detailed information included in the Summary of Product Characteristics (SPC) for atazanavir on the EMEA website.
The recommendation to take with food is important even if you are also taking atazanavir with ritonavir boosting.

Lipoatrophy is associated with d4T (stavudine), AZT (zidovudine, aslo in Combivir and Trizivir) and possibly with efavirenz. There is a detailed report on lipoatrophy here.

Yellowing of the skin or eyes is related to the levels of atazanavir. If this is something that is causing problems ask for drug levels to be checked (with TDM). This may help your doctor know whether any dose modification is possible. For more details on yellowing of the skin and eyes see here.