atazanavir and cobicistat

What is the most important information I should know about atazanavir and cobicistat?

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact with atazanavir and cobicistat, and some drugs should not be used together.

What is atazanavir and cobicistat?

Atazanavir and cobicistat is a combination medicine given together with other antiviral medicines to treat human immunodeficiency virus (HIV) in adults. HIV is the virus that can cause acquired immunodeficiency syndrome (AIDS). This medicine is not a cure for HIV or AIDS.

Atazanavir and cobicistat is for use in adults and children who weigh at least 77 pounds (35 kilograms).

Atazanavir and cobicistat may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking atazanavir and cobicistat?

Many drugs can interact and cause dangerous effects. Some drugs should not be used together with atazanavir and cobicistat. Your doctor may change your treatment plan if you also use:

• alfuzosin;
• cisapride;
• colchicine;
• drospirenone and ethinyl estradiol (birth control pills);
• irinotecan;
• oral midazolam, triazolam;
• pimozide;
• rifampin;
• sildenafil (Revatio, for treating pulmonary arterial hypertension);
• St. John's wort;
• antipsychotic medicine --lurasidone, pimozide;
• cholesterol lowering medicine --lomitapide, lovastatin, simvastatin;
• ergot medicine --dihydroergotamine, ergotamine, ergonovine, methylergonovine;
• heart medication --dronedarone, ranolazine;
• hepatitis C antivirals --elbasvir and grazoprevir, glecaprevir and pibrentasvir;
• other HIV medicines --indinavir, nevirapine; or
• seizure medicine --carbamazepine, phenobarbital, phenytoin.

Tell your doctor if you have ever had:

• heart disease;
• liver disease (especially hepatitis B or C);
• a bleeding or blood clotting disorder such as hemophilia;
• diabetes; or
• kidney disease (or if you are on dialysis).

Use your medications properly to control your infection. HIV can be passed to your baby if the virus is not controlled during pregnancy. Your name may be listed on a registry to track any effects of antiviral medicine on the baby.

How should I take atazanavir and cobicistat?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Atazanavir and cobicistat must be given in combination with other antiviral medications and should not be used alone. However, there are certain antiviral medicines you should not take with atazanavir and cobicistat. Follow your doctor's medication and dosing instructions very carefully.

You will need frequent medical tests.

Use all HIV medications as directed and read all medication guides you receive. Do not change your dose or stop using a medicine without your doctor's advice. Every person with HIV should remain under the care of a doctor.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely. Missing doses may increase the risk of your virus becoming resistant to medication.

What happens if I overdose?

What should I avoid while taking atazanavir and cobicistat?

Using this medicine may not prevent your disease from spreading. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

What are the possible side effects of atazanavir and cobicistat?

• severe dizziness, irregular heartbeats;
• high blood sugar --increased thirst, increased urination, dry mouth, fruity breath odor;
• liver or gallbladder problems --upper stomach pain, nausea, vomiting, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• a severe skin reaction --fever, flu-like symptoms, mouth sores, muscle or joint pain, swelling in your face, burning eyes, skin pain, blistering, warmth or redness under your skin; or
• signs of a kidney stone --pain in your side or lower back, painful or difficult urination, blood in your urine.

Atazanavir and cobicistat affects your immune system, which may cause certain side effects (even weeks or months after you've taken this medicine). Tell your doctor if you have:

• signs of a new infection --fever, night sweats, swollen glands, cold sores, cough, wheezing, diarrhea, weight loss;
• trouble speaking or swallowing, problems with balance or eye movement, weakness or prickly feeling; or
• swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence.

Common side effects may include:

• rash;
• jaundice; or
• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect atazanavir and cobicistat?

Some medicines can make atazanavir and cobicistat much less effective when taken at the same time. If you take any of the following medicines, take them separately from your dose of atazanavir and cobicistat:

• Antacids: Take atazanavir and cobicistat at least 2 hours before or 2 hours after you take the antacid.
• Enteric-coated didanosine: Take your atazanavir and cobicistat dose with food 2 hours before or 1 hour after you take didanosine.
• Medicine to reduce stomach acid (such as cimetidine, ranitidine, Tagamet, Pepcid, or Zantac): Either take the medicines at the same time, or take atazanavir and cobicistat least 10 hours after taking the stomach medicine.
• A proton pump inhibitor (such as omeprazole, esomeprazole, Nexium, Prevacid, Prilosec, or Protonix): take your atazanavir and cobicistat dose at least 12 hours after taking the other medicine.

Many other drugs can affect atazanavir and cobicistat, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about atazanavir and cobicistat.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2023 Cerner Multum, Inc. Version: 4.01. Revision date: 1/29/2021.