Atazanavir
Drug Info:
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Atazanavir
Brand names: Reyataz®
Chemical formula:
- Drug Forms:
- Atazanavir Sulfate Oral capsule (below)
- Atazanavir capsules
Atazanavir Sulfate Oral capsule
What is this medicine?
ATAZANAVIR (at a za NA veer) is an antiretroviral medicine. It is used with other medicines to treat HIV. This medicine is not a cure for HIV. It will not stop the spread of HIV to others.
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
•diabetes
•hemophilia
•kidney disease requiring dialysis treatment
•liver disease
•irregular heartbeat
•an unusual or allergic reaction to atazanavir, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
How should I use this medicine?
Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take this medicine with food. Take your medicine at regular intervals. Do not take your medicine more often than directed. For your anti-HIV therapy to work as well as possible, take each dose exactly as prescribed. Do not skip doses or stop your medicine even if you feel better. Skipping doses may make the HIV virus resistant to this medicine and other medicines. Do not stop taking except on your doctor's advice.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What may interact with this medicine?
Do not take this medicine with any of the following medications:
•certain medicines for stomach problems like esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole
•cisapride
•dofetilide
•etravirine
•indinavir
•irinotecan
•lovastatin
•medicines for headaches like dihydroergotamine, ergonovine, ergotamine, methylergonovine
•midazolam
•pimozide
•ranolazine
•red yeast rice
•rifampin
•rifapentine
•simvastatin
•St. John's wort
•triazolam
•zalcitabine
•ziprasidone
This medicine may also interact with the following medications:
•antacids or buffered medications
•birth control pills or patch
•clarithromycin
•cyclosporine
•fluticasone
•medicines for blood pressure, heart disease, irregular heart beat
•medicines for cholesterol like atorvastatin or rosuvastatin
•medicines for depression, anxiety, or psychotic disturbances
•medicines for erectile dysfunction
•medicines for fungal infections like ketoconazole, itraconazole, posaconazole and voriconazole
•medicines for stomach problems like cimetidine, famotidine, nizatidine, ranitidine
•other medicines for HIV
•rifabutin
•sirolimus
•tacrolimus
•warfarin
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What should I watch for while using this medicine?
Visit your doctor or health care professional for regular check ups. Discuss any new symptoms with your doctor. You will need to have important blood work done while on this medicine.
HIV is spread to others through sexual or blood contact. Talk to your doctor about how to stop the spread of HIV.
Birth control pills may not work properly while you are taking this medicine. Talk to your doctor about using an extra method of birth control. Women who can still have children must use a reliable form of barrier contraception, like a condom or diaphragm.
This medicine may affect blood sugar levels. If you have diabetes, check with your doctor or health care professional before you change your diet or the dose of your diabetic medicine.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•blood in the urine
•dizziness
•feeling faint or lightheaded, falls
•increased hunger or thirst
•increased urination
•irregular heart rate
•nausea, vomiting, abdominal pain
•pain in the lower back or side
•pain when urinating
•redness, blistering, peeling or loosening of the skin, including inside the mouth
•unusually weak or tired
•yellowing of the eyes or skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•depressed mood
•diarrhea
•headache
•tingling or burning in your hands, feet or around the mouth
•trouble sleeping
•weight gain around waist, back, or thinning of face, arms, legs
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Where should I keep my medicine?
Keep out of the reach of children.
Store tightly closed at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from moisture. Dispose of unused medicines through community take-back disposal programs when available or place this medicine in an unrecognizable, closed container in the household trash.
Last updated: 5/12/2003 11:02:00 AM
Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.
Oxford A-Z of Medicinal Drugs:
Top
atazanavir
A protease inhibitor (see antiviral drugs) used, in combination with other antiretroviral drugs, in the treatment of HIV infection. It is available as capsules on prescription only.
Side effects:
include diarrhoea, nausea, vomiting, abdominal pain, loss of appetite, blood disorders, fatigue, headache, dizziness, breathlessness, and peripheral neuropathy (causing numbness and tingling of the limbs).
Precautions:
atazanavir should not be taken by people with porphyria or by women who are breastfeeding. It should be used with caution by pregnant women and by people with diabetes, haemophilia, or liver disease and by those taking drugs that may cause arrhythmias.
Interactions with other drugs:
atazanavir inhibits several enzyme systems in the liver that are involved in metabolizing drugs, resulting in increased plasma concentrations of these drugs and possibly an increase in their adverse effects. A doctor should therefore be consulted before atazanavir is taken with any other drug.
Proprietary preparation:
Reyataz.
| astringents, asthma, aspirin | |
| atenolol, atherosclerosis, atomoxetine |
Wikipedia on Answers.com:
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Atazanavir
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|---|---|
| Systematic (IUPAC) name | |
| methyl N-[(1S)-1-{[(2S,3S)-3-hydroxy-4-[(2S)-2-[(methoxycarbonyl)amino]-3,3-dimethyl-N'-{[4-(pyridin-2-yl)phenyl]methyl}butanehydrazido]-1-phenylbutan-2-yl]carbamoyl}-2,2-dimethylpropyl]carbamate | |
| Clinical data | |
| AHFS/Drugs.com | monograph |
| MedlinePlus | a603019 |
| Pregnancy cat. | B2 (AU) B (US) |
| Legal status | POM (UK) ℞-only (US) |
| Routes | Oral |
| Pharmacokinetic data | |
| Bioavailability | 60-68% |
| Protein binding | 86% |
| Metabolism | Hepatic (CYP3A4-mediated) |
| Half-life | 6.5 hours |
| Excretion | Fecal and renal |
| Identifiers | |
| CAS number | 198904-31-3  |
| ATC code | J05AE08 |
| PubChem | CID 148192 |
| DrugBank | DB01072 |
| ChemSpider | 130642 |
| UNII | QZU4H47A3S |
| KEGG | D01276  |
| ChEBI | CHEBI:37924 |
| ChEMBL | CHEMBL1163 |
| NIAID ChemDB | 057755 |
| Chemical data | |
| Formula | C38H52N6O7 |
| Mol. mass | 704.856 g/mol |
| SMILES | eMolecules & PubChem |
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Atazanavir, marketed under the trade name Reyataz by Bristol Myers, (formerly known as BMS-232632) is an antiretroviral drug of the protease inhibitor (PI) class. Like other antiretrovirals, it is used to treat infection of human immunodeficiency virus (HIV).
Atazanavir is distinguished from other PIs in that it can be given once-daily (rather than requiring multiple doses per day) and has lesser effects on the patient's lipid profile (the amounts of cholesterol and other fatty substances in the blood). Like other protease inhibitors, it is used only in combination with other HIV medications.
The U.S. Food and Drug Administration (FDA) approved atazanavir on June 20, 2003. Atazanavir is the first PI approved for once-daily dosing, and also appears to be less likely to cause lipodystrophy and elevated cholesterol as side effects. It may also not be cross-resistant with other PIs. When boosted with ritonavir it is of equivalent potency to lopinavir for use in salvage therapy in patients with a degree of drug resistance; although boosting with ritonavir reduces the metabolic advantages of atazanavir.
On October 20, 2006, the FDA approved a new formulation of atazanavir (300 mg capsules) to be taken as part of combination drug therapy.[1] This formulation should reduce pill burden, as one 300 mg capsule may replace two 150 mg capsules.
Newer research has been investigating the potential anticancer effects of atazanavir. For example, laboratory studies have found that this drug can inhibit the growth of brain tumor cells in culture.[2]
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Contents
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Therapeutic efficacy
The efficacy of atazanavir has been assessed in a number of well designed trials in ART-naive and ART-experienced adults.[3]
Adverse effects
Bilirubin levels in the blood are normally asymptomatically raised with atazanavir. A single case of torsades de pointes attributable to atazanavir therapy has been described.[4]
CONTRAINDICATIONS: In April 2009, the FDA issued a warning: Atazanavir should not be used with proton pump inhibitors, such as omeprazole (Prilosec), esomeprazole (Nexium), or rabeprazole (Aciphex). According to the FDA, "A 76% reduction in atazanavir area under the concentration-time curve (AUC) and a 78% reduction in atazanavir trough plasma concentration (Cmin) were observed when REYATAZ/ritonavir [a protease inhibitor, the same class as Azatanavir] 300/100 mg was coadministered with omeprazole 40 mg." In other words, proton pump inhibitors reduce the effects of atazanavir.
For more information, visit: http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/HIVandAIDSActivities/ucm124940.htm
Chemistry
Bold, Guido; Fässler, Alexander; Capraro, Hans-Georg; Cozens, Robert; Klimkait, Thomas; Lazdins, Janis; Mestan, JüRgen; Poncioni, Bernard et al (1998). "New Aza-Dipeptide Analogues as Potent and Orally Absorbed HIV-1 Protease Inhibitors: Candidates for Clinical Development". Journal of Medicinal Chemistry 41 (18): 3387. doi:10.1021/jm970873c. PMID 9719591.
References
- ^ "Bristol wins U.S. approval for single anti-HIV pill". Reuters. 2006-10-20. http://today.reuters.co.uk/news/articlenews.aspx?type=healthNews&storyID=2006-10-20T184537Z_01_WEN7494_RTRIDST_0_HEALTH-BRISTOLMYERS-DC.XML&WTmodLoc=SciHealth-C4-Health-5. Retrieved 2006-10-25.
- ^ Pyrko, P.; Kardosh, A; Wang, W; Xiong, W; Schönthal, AH; Chen, TC (2007). "HIV-1 protease inhibitors nelfinavir and atazanavir induce malignant glioma death by triggering endoplasmic reticulum stress". Cancer Research 67 (22): 10920–8. doi:10.1158/0008-5472.CAN-07-0796. PMID 18006837.
- ^ Ly T, Ruiz M (March 2007). "Prolonged QT interval and torsades de pointes associated with atazanavir therapy Question: Have patients developed Liver stones as a side-effect of this medication?". Clin Infect Dis 44 (6): e67–8. doi:10.1086/511875. PMID 17304444.
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Oxford A-Z of Medicinal Drugs
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