Meds and you

27 September 2013

Atazanavir

Atazanavir is an ant-iretroviral. Anti-retrovirals are drugs that suppress the activity or replication of retroviruses such as HIV.

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Atazanavir is the active ingredient of Reyataz Capsules (Nappi Code: 708257-001, 708258-001).

General Information
Atazanavir is an ant-iretroviral. Anti-retrovirals are drugs that suppress the activity or replication of retroviruses such as HIV.

This specific anti-viral is classified as a protease inhibitor, meaning that it blocks an enzyme, which plays an essential role in viral multiplication: it interferes with the ability of the virus to make copies of itself.

In South Africa atazanavir is registered for the treatment of infection with the human immunodeficiency virus (HIV), often in combination with other anti-retroviral drugs.

If not treated, HIV will advance to weaken the body's immune system, gradually chipping away to create breeding grounds for other infections, which the body will find more and more difficult to protect itself against. HIV develops into acquired immune deficiency syndrome (Aids) when your immune system has been severely weakened.

For atazanavir to be effective, it has to be taken regularly. By skipping even a few doses the risk for treatment failure increases substantially. Try to ensure that you take all your doses, and at the correct time.

It should be understood that atazanavir is not a cure for HIV or Aids, but is one of a variety of drugs that only restricts the advance of the virus, keeping the immune system up and running. It is used in combination with other anti-retroviral drugs and should not be prescribed on its own.

Atazanavir does not reduce transmission of HIV; you can still infect another person with the virus, and the use of appropriate precautions to prevent the spread to other persons is highly recommended.

How does atazanavir work?
After a human T-cell is infected with HIV, the virus needs to multiply to spread to other cells. A crucial part of HIV multiplication is the production of an enzyme called protease, which is essential for the assembly of new viral copies. This drug interferes with the working of this enzyme, thereby leaving the new copies of the virus immature and non-infectious.

Fast facts

Drug schedule: schedule 4
Available as: atazanavir is available as capsules.
What does it do? Atazanavir is an anti-viral drug.
Overdose risk: medium
Dependence risk: low
Is atazanavir available as a generic? no
Is atazanavir available on prescription only? yes

User information

Dietary advice: atazanavir should be taken with or after a meal.
Stopping this medicine: do not stop taking this drug without consulting your doctor.
Prolonged use: side effects may develop with long-term use; frequent blood tests may be required with prolonged therapy to prevent serious blood disorders, and to determine liver function.

Special precautions
Consult your doctor before using this drug if:

  • you have known liver or kidney problems
  • you have been diagnosed with a condition that increases your risk of bleeding
  • you have a heart condition
  • you have diabetes
  • you have porphyria
  • you are taking other medication.

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. Not only can the HIV-infection be passed to your baby through breast milk, but atazanavir is also present and transmitted in breast milk.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
The elderly: caution is advised in the elderly, as side effects may be more severe.
Infants and children: this medication is not intended for use in children.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness or light-headedness. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

 

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
diarrhoea
X
 
X
 
dry mouth
X
 
X
 
nausea/vomiting
X
 
X
 
loss of appetite
X
 
X
 
abdominal pain
X
 
X
 
indigestion
 
X
X
 
taste disturbance
 
X
X
 
dizziness
 
X
X
 
mouth ulcers
 
X
X
 
headache
 
X
X
 
anxiety/changes in mood
 
X
 
X
palpitations
 
X
 
X
chest pain
 
X
 
X
dizziness
 
X
X
 
mouth ulcers
 
X
X
 
headache
 
X
X
 
anxiety/changes in mood
 
X
 
X
palpitations
 
X
 
X
chest pain
 
X
 
X
abnormal body fat distribution
 
X
 
X
skin rash
 
X
 
X
sore throat
 
X
 
X
yellowing of skin/eyes
 
X
 
X
muscle weakness
 
X
 
X
muscle/joint pain
 
X
 
X

Interactions

Drug interactions

 

carbamazepine, phenytoin, phenobarbitone reduced effect of atazanavir
benzodiazepines increased risk of toxicity
ketoconazole increased risk of atazanavir toxicity
St Johns wort reduced effect of atazanavir
dexamethasone reduced effect of atazanavir
didanosine take the 2 drugs at least 2 hours apart
ergotamine increased risk of toxicity
ciclosporin increased risk of toxicity
clarithromycin increased risk of toxicity
sildenafil increased risk of toxicity
omeprazole, lansoprazole, ranitidine, other related products reduced absorption of atazanavir
amiodarone, diltiazem, verapamil, chloroquine increased risk of cardiac toxicity
simvastatin and other similar cholesterol-lowering drugs increased risk of muscle wasting
haloperidol increased risk of toxicity of these agents

Many other drugs may interact with Atazanavir. It is important to consult your doctor or pharmacist before combining any drug with Atazanavir.

Disease interactions
Contact your doctor in case of liver/kidney disease, if you have diabetes or porphyria, or if you have been diagnosed with a condition that increases your risk of bleeding.

Overdose action A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage
Adults, oral: 400mg once daily with food.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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