atazanavir (Reyataz, ATV/r)
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Introduction
Tradename: Reyataz (FDA approved 2003)
Indications
- treatment of HIV1
- may be boosted with saquinavir or darunavir
- acceptable for use during pregnancy[4]
Contraindications
- consider alternative regimen if 2 decreased function UGT1A1 alleles[5]
- concurrent use of proton pump inhibitors[6]
Dosage
* take with food, absorption requires food & gastric acidity[6]
Tabs: 150, 200, 300 mg
Pharmacokinetics
- inhibits several cyt P450's
- metabolized by cyt P450's
Adverse effects
- does NOT increase serum cholesterol or serum triglycerides
- lipodystrophy ?
- hyperbilirubinemia (unconjugated bilirubin), jaundice (reversible)
- does NOT seem to cause hepatotoxicity
- serum ALT, serum AST, serum alkaline phosphatase normal
- nephrolithiasis
- nausea
- rash
- drug adverse effects of antiretroviral protease inhibitors
- drug adverse effects of antiretroviral agents
Drug interactions
- many
- proton pump inhibitors prevent absorption
- drug interaction(s) of fluticasone with HIV1 protease inhibitors
- drug interaction(s) of antiretroviral protease inhibitor in combination with ritonavir
- drug interaction(s) of boceprevir in combination with ritonavir & atazanavir
- drug interaction(s) of statins with antiviral protease inhibitors
- drug interaction(s) of antibiotics with warfarin
Laboratory
- UGT1A1 genotyping[5]
- atazanavir in amniotic fluid
- atazanavir in CSF
- atazanavir in cord blood
- atazanavir in serum/plasma
Mechanism of action
More general terms
Component of
References
- ↑ Prescriber's Letter 10(8):45 2003
- ↑ Department of Veterans Affairs, VA National Formulary
- ↑ Chan-Tack KM et al Atazanavir-associated nephrolithiasis: Cases from the Food and Drug Administration's Adverse Event Reporting System. AIDS 2007, 21:1215 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17502736
- ↑ 4.0 4.1 Zuger A Use of Antiretroviral Drugs in Pregnancy. Physician's First Watch, April 22, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. 2014. AIDSinfo. Clinical Guidelines Portal. March 28, 2014. http://aidsinfo.nih.gov/Guidelines/HTML/3/perinatal-guidelines/0 (corresponding NGC guideline withdrawn March 2016) - ↑ 5.0 5.1 5.2 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline information for atazanavir and UGT1A1 https://www.pharmgkb.org/guideline/PA166128738Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline information for atazanavir and UGT1A1 https://www.pharmgkb.org/guideline/PA166128738
- ↑ 6.0 6.1 6.2 Medical Knowledge Self Assessment Program (MKSAP) 17, 18 American College of Physicians, Philadelphia 2015, 2018