Reyataz Disease Interactions
There are 8 disease interactions with Reyataz (atazanavir).
- Heart block
- Nephrolithiasis
- Renal impairment
- Liver disease
- PKU
- Hemophilia
- Hyperglycemia
- Hyperlipidemia
Atazanavir (applies to Reyataz) heart block
Major Potential Hazard, Moderate plausibility. Applicable conditions: Abnormal Electrocardiogram
Atazanavir may prolong the PR interval of the electrocardiogram in some patients. In one study, the mean maximum change in PR interval from baseline was 24 msec following a 400 mg oral dose of atazanavir versus 13 msec following placebo dosing. In studies of healthy volunteers and HIV patients, abnormalities in atrioventricular (AV) conduction were asymptomatic and limited to first-degree AV block. Rarely, second-degree AV block and other conduction abnormalities have occurred in overdose. Due to limited clinical experience, therapy with atazanavir should be administered cautiously in patients with preexisting conduction abnormalities (e.g., marked first-degree AV block or second- or third-degree AV block).
References
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
Atazanavir (applies to Reyataz) nephrolithiasis
Major Potential Hazard, Moderate plausibility. Applicable conditions: Dehydration, History - Nephrolithiasis, Renal Dysfunction, Liver Disease
Cases of nephrolithiasis, some of which resulted in acute interstitial nephritis, renal failure, and/or hospitalization, have been reported during postmarketing surveillance in HIV-infected patients receiving atazanavir therapy. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made. The median time between atazanavir initiation and the onset of nephrolithiasis was 1.7 years, with a range of 5 weeks to 6 years. Therapy with atazanavir should be administered cautiously in patients with a current or past history of nephrolithiasis, as well as possible risk factors such as renal and/or hepatic insufficiency. Adequate hydration and/or urine acidification may help reduce the risk. However, urine acidification may be poorly tolerated and possibly harmful, particularly in patients receiving concomitant treatment with sulfonamide antibiotics. Patients who are dehydrated may also be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluids if necessary. Patients should be instructed to seek medical attention if they experience potential signs and symptoms of nephrolithiasis/urolithiasis such as flank pain, hematuria, dysuria, anuria, and urinary urgency. Temporary interruption or discontinuation of therapy may be required.
References
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
- Brewster UC, Perazella MA "Acute interstitial nephritis associated with atazanavir, a new protease inhibitor." Am J Kidney Dis 44 (2004): e81-4
- Pacanowski J, Poirier JM, Petit I, Meynard JL, Girard PM "Atazanavir urinary stones in an HIV-infected patient." AIDS 20 (2006): 2131
- Chang HR, Pella PM "Atazanavir urolithiasis." N Engl J Med 355 (2006): 2158-2159
- Anderson PL, Lichtenstein KA, Gerig NE, Kiser JJ, Bushman LR "Atazanavir-containing renal calculi in an HIV-infected patient." AIDS 21 (2007): 1060-2
- Chan-Tack KM, Truffa MM, Struble KA, Birnkrant DB "Atazanavir-associated nephrolithiasis: cases from the US Food and Drug Administration's Adverse Event Reporting System." AIDS 21 (2007): 1215-8
- Couzigou C, Daudon M, Meynard JL, et al. "Urolithiasis in HIV-positive patients treated with atazanavir." Clin Infect Dis 45 (2007): e105-8
- Izzedine H, M'rad MB, Bardier A, Daudon M, Salmon D "Atazanavir crystal nephropathy." AIDS 21 (2007): 2357-8
Atazanavir (applies to Reyataz) renal impairment
Major Potential Hazard, Moderate plausibility. Applicable conditions: hemodialysis
Atazanavir is not recommended for use in HIV- treatment experienced patients with end stage renal disease managed with hemodialysis.
References
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
Atazanavir (applies to Reyataz) liver disease
Moderate Potential Hazard, Moderate plausibility.
Patients with underlying hepatitis B or C viral infections or marked elevations in transaminases prior to atazanavir treatment may be at increased risk for developing further transaminase elevations or hepatic decompensation during use of atazanavir. In addition, atazanavir is primarily metabolized by the liver and may accumulate in patients with moderate or severe hepatic impairment. Therapy with atazanavir should be administered cautiously in patients with preexisting liver disease, liver enzyme abnormalities, or hepatitis. Atazanavir is not recommended for use in patients with severe hepatic impairment, and the combination of atazanavir/ritonavir is not recommended for patients with any degree of hepatic impairment.
References
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
- Eholie SP, Lacombe K, Serfaty L, Wendum D, Girard PM "Acute hepatic cytolysis in an HIV-infected patient taking atazanavir." AIDS 18 (2004): 1610-1
Atazanavir (applies to Reyataz) PKU
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Phenylketonuria
Atazanavir oral powder (Reyataz) contains phenylalanine (a component of aspartame) which can be harmful to patients with phenylketonuria (PKE). Each packet contains 35 mg of phenylalanine. Atazanavir in capsules (Reyataz) does not contain phenylalanine.
References
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
PIs (applies to Reyataz) hemophilia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Coagulation Defect
There have been reports of increased bleeding, including spontaneous skin hematomas and hemarthrosis, in patients with hemophilia type A and B treated with protease inhibitors; however, a causal relationship has not been established. In some patients, additional factor VIII was given. In more than half of the reported cases, protease inhibitor therapy was continued or reintroduced. Patients with hemophilia or other coagulation defects should be monitored closely for bleeding during protease inhibitor therapy.
References
- "Product Information. Norvir (ritonavir)." AbbVie US LLC SUPPL-25 (2022):
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb SUPPL-44 (2020):
- "Product Information. Prezista (darunavir)." Janssen Pharmaceuticals SUPPL-68 (2023):
- "Product Information. Lexiva (fosamprenavir)." ViiV Healthcare SUPPL-41 (2019):
- "Product Information. Kaletra (lopinavir-ritonavir)." AbbVie US LLC SUPPL-54 (2020):
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc SUPPL-25 (2021):
- "Product Information. Invirase (saquinavir)." Roche Laboratories SUPPL-25 (2020):
- "Product Information. Aptivus (tipranavir)." Boehringer Ingelheim SUPPL-21 (2020):
PIs (applies to Reyataz) hyperglycemia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Abnormal Glucose Tolerance, Diabetes Mellitus
New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.
References
- "Product Information. Norvir (ritonavir)." AbbVie US LLC SUPPL-25 (2022):
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb SUPPL-44 (2020):
- "Product Information. Prezista (darunavir)." Janssen Pharmaceuticals SUPPL-68 (2023):
- "Product Information. Lexiva (fosamprenavir)." ViiV Healthcare SUPPL-41 (2019):
- "Product Information. Kaletra (lopinavir-ritonavir)." AbbVie US LLC SUPPL-54 (2020):
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc SUPPL-25 (2021):
- "Product Information. Invirase (saquinavir)." Roche Laboratories SUPPL-25 (2020):
- "Product Information. Aptivus (tipranavir)." Boehringer Ingelheim SUPPL-21 (2020):
PIs (applies to Reyataz) hyperlipidemia
Moderate Potential Hazard, Moderate plausibility.
Treatment with ritonavir alone or in combination with other protease inhibitors (e.g., lopinavir, saquinavir, tipranavir, fosamprenavir) has resulted in substantial increases in the concentration of total cholesterol and triglycerides. These effects have also been reported with other protease inhibitors but may be the most dramatic with ritonavir. The clinical significance of these elevations is unclear. Marked elevation in triglyceride levels is a risk factor for development of pancreatitis. Triglyceride and cholesterol testing is recommended before starting ritonavir (with or without other protease inhibitors) and periodically during therapy. Lipid disorders should be managed as clinically appropriate.
References
- "Product Information. Norvir (ritonavir)." AbbVie US LLC SUPPL-25 (2022):
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb SUPPL-44 (2020):
- "Product Information. Lexiva (fosamprenavir)." ViiV Healthcare SUPPL-41 (2019):
- "Product Information. Kaletra (lopinavir-ritonavir)." AbbVie US LLC SUPPL-54 (2020):
- "Product Information. Invirase (saquinavir)." Roche Laboratories SUPPL-25 (2020):
- "Product Information. Aptivus (tipranavir)." Boehringer Ingelheim SUPPL-21 (2020):
Reyataz drug interactions
There are 546 drug interactions with Reyataz (atazanavir).
Reyataz alcohol/food interactions
There are 3 alcohol/food interactions with Reyataz (atazanavir).
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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