Taking it

In the European Union, boosted atazanavir (Reyataz) is taken once daily as one 300mg capsule with a 100mg dose of ritonavir. It can also be dosed with two 150mg capsules plus one 100mg ritonavir (Norvir) capsule once a day. Atazanavir is approved for use by treatment-naive and treatment-experienced people in the United States and the European Union.

Atazanavir can also be taken once daily as a single fixed-dose combination pill with the boosting agent cobicistat. This product is approved in the European Union as Evotaz. See Evotaz for further details.

In the United States, the approved dosing for treatment-naive people is 300mg atazanavir/100mg ritonavir once daily with food or atazanavir 400mg once daily with food. If taken in combination with efavirenz or tenofovir, both of those drugs are dosed normally, but the recommendation is to use boosted atazanavir (300mg/r 100mg once daily).

If using unboosted atazanavir, treatment-naive people should avoid the combination of enteric-coated didanosine with tenofovir.1

Treatment-experienced people should take 300mg atazanavir/100mg ritonavir daily with food. Unboosted atazanavir is not recommended.

Experimental doses of 300 or 400mg atazanavir plus 200mg ritonavir have been shown to improve atazanavir exposure in people with suboptimal levels on the standard boosted dose.2

A dosing study in HIV-negative volunteers found that taking 400mg atazanavir with food increased drug concentrations by 35 to 70%, so taking the drug without food could result in failing to meet the necessary pharmacokinetic targets for efficacy. Atazanavir should also not be taken with proton pump inhibitors or antacids as the AUC of atazanavir is decreased with co-administration.

Atazanavir should not be used in people with severe liver damage. A dose reduction to 300mg once daily should be made for someone with moderate liver damage (Child-Pugh Class B). In cases of mild liver damage, it should be used with caution.

Treatment-naive people with end-stage renal disease managed with haemodialysis should receive 300mg of atazanavir with 100mg of ritonavir. Atazanavir should not be given to treatment-experienced people with end-stage renal disease managed with haemodialysis.3

References

  1. National Institute of Allergy and Infectious Disease Monitoring Board recommends stopping experimental treatment regimen in international study of patients new to HIV treatment. NIAID Bulletin, available online at www3.niaid.nih.gov/news/newsreleases/2008/ACTG_5175 [accessed 28 October 2008], 2008
  2. Harris M et al. Effect on atazanavir (ATZ) and ritonavir (rtv) plasma levels of increasing ATZ / rtv daily dosing from 300 / 100 mg to 300 / 200 mg and 400 / 200 mg. Third International AIDS Society Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, abstract WePe3.2C07, 2005
  3. Bristol-Myers Squibb Company Reyataz (atazanavir sulfate) capsules [prescribing information]. www.fda.gov/cder/foi/label/2007/021567s0141bl.pdf, 2007
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.