Atazanavir can cause transient and usually asymptomatic elevations in serum aminotransferase levels, mild elevations in indirect bilirubin concentration and, rarely, clinically apparent, acute liver injury. In HBV or HCV coinfected patients, highly active antiretroviral therapy with atazanavir may result of an exacerbation of the underlying chronic hepatitis B or C.
Atazanavir (a" ta zan' a vir) is proteinomimetic, azapeptide that binds to the active, catalytic site of the HIV-1 protease preventing cleavage and processing of viral polyprotein precursors into mature, functional proteins that are necessary for viral replication. Atazanavir, in combination with other antiretroviral agents, has been shown to be effective in lowering HIV RNA levels and improving CD4+ lymphocyte counts in patients with HIV infection and AIDS.
Atazanavir was approved for use in the United States in 2003 for the treatment of HIV infection and is typically given in combination with low “booster” doses of ritonavir or with the pharmacologic enhancer cobicistat, which improve its pharmacokinetics by inhibiting its metabolism by CYP 3A4.
Atazanavir is available under the brand name Reyataz in capsules of 150, 200 and 300 mg. The recommended adult dosage is 400 mg once daily or 300 mg if given with ritonavir (100 mg) once daily. A fixed combination of atazanavir with the cobicistat (300 mg/150 mg) is also available under the brand name Evotaz. The recommended dose of the combination formulation is one tablet daily.
The most common side effects of atazanavir are nausea, diarrhea, gastrointestinal upset, headache, fatigue, rash, hypersensitivity reactions, hyperbilirubinemia and, with long term use, hyperlipidemia and lipodystrophy.
Drugs for HIV Infection, in the Subclass Antiretroviral Agents
- Nonnucleoside Reverse Transcriptase Inhibitors (HIV)
- Nucleoside Analogues (HIV)
- Protease Inhibitors (HIV)
HCV NS5A Inhibitors
HCV NS5B (Polymerase) Inhibitors
- Asunaprevir, Boceprevir, Glecaprevir, Grazoprevir, Paritaprevir, Simeprevir, Telaprevir, Voxilaprevir
Drugs for Herpes Virus Infections (HSV, CMV, others)
Drugs for Influenza