Atazanavir and cobicistat (Oral)
Generic Name: atazanavir/cobicistat (a-ta-ZAN-a-vir, koe-BIK-i-stat)
Medically reviewed by Drugs.com. Last updated on Aug 1, 2020.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antiretroviral Agent
Pharmacologic Class: Protease Inhibitor
Uses for atazanavir and cobicistat
Atazanavir and cobicistat combination is used together with other medicines to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS).
Atazanavir and cobicistat combination will not cure or prevent HIV infection or AIDS. It helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay problems that are usually related to AIDS or HIV disease from occurring. Atazanavir and cobicistat will not keep you from spreading HIV to other people. People who receive atazanavir and cobicistat may continue to have other problems usually related to AIDS or HIV disease.
Atazanavir and cobicistat is available only with your doctor's prescription.
Before using atazanavir and cobicistat
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For atazanavir and cobicistat, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to atazanavir and cobicistat or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of atazanavir and cobicistat combination in children weighing at least 40 kilograms (kg). However, safety and efficacy have not been established in children weighing less than 40 kg. Use is not recommended in children younger than 3 months of age because atazanavir may cause kernicterus.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of atazanavir and cobicistat combination in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution for patients receiving atazanavir and cobicistat.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking atazanavir and cobicistat, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using atazanavir and cobicistat with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Doxorubicin Hydrochloride Liposome
- Ergoloid Mesylates
- Irinotecan Liposome
- Isavuconazonium Sulfate
- St John's Wort
Using atazanavir and cobicistat with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Ado-Trastuzumab Emtansine
- Arsenic Trioxide
- Brentuximab Vedotin
- Dabigatran Etexilate
- Eslicarbazepine Acetate
- Inotuzumab Ozogamicin
- Irinotecan Liposome
- Morphine Sulfate Liposome
- Tenofovir Disoproxil Fumarate
- Vincristine Sulfate Liposome
Using atazanavir and cobicistat with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Estradiol Cypionate
- Estradiol Valerate
- Ethinyl Estradiol
- Ethynodiol Diacetate
- Medroxyprogesterone Acetate
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Other medical problems
The presence of other medical problems may affect the use of atazanavir and cobicistat. Make sure you tell your doctor if you have any other medical problems, especially:
- Diabetes or
- Fanconi syndrome (kidney disease), history of or
- Gallbladder problems or
- Hemophilia (a bleeding problem) or
- Hyperglycemia (high blood sugar) or
- Kidney failure, history of or
- Liver disease (eg, hepatitis B or C)—Use with caution. May make these conditions worse.
- Heart block or
- Heart rhythm problems (eg, prolonged PR interval)—May change the way your heart beats and increase your chance of getting side effects.
- Kidney disease (eg, end-stage kidney disease undergoing dialysis), severe or
- Liver disease—Use is not recommended in these patients.
Proper use of atazanavir and cobicistat
Take atazanavir and cobicistat exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
Atazanavir and cobicistat comes with a patient information leaflet. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. Talk to your doctor if you have any questions.
Take atazanavir and cobicistat with food.
Do not change the dose or stop using atazanavir and cobicistat without checking first with your doctor. When your supply of atazanavir and cobicistat is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of atazanavir and cobicistat.
If you use antacids, take them 2 hours before or 2 hours after you take atazanavir and cobicistat.
Take atazanavir and cobicistat at least 2 hours before or 1 hour after taking didanosine (Videx®).
Atazanavir and cobicistat contains a fixed amount of medicine in each tablet.
The dose of atazanavir and cobicistat will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of atazanavir and cobicistat. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For treatment of HIV infection:
- Adults and children weighing at least 40 kilograms (kg)—One tablet once a day. Each tablet contains 300 milligrams (mg) of atazanavir and 150 mg of cobicistat.
- Children weighing less than 40 kg—Use and dose must be determined by your doctor.
- For treatment of HIV infection:
If you miss a dose of atazanavir and cobicistat, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions while using atazanavir and cobicistat
Your doctor will want to check your progress at regular visits, especially during the first few weeks that you take atazanavir and cobicistat. Blood and urine tests may be needed to check for any unwanted effects.
Atazanavir and cobicistat should not be used together with alfuzosin (Uroxatral®), carbamazepine (Tegretol®), cisapride (Propulsid®), dronedarone (Multaq®), drospirenone/ethinyl estradiol (Yasmin®, Yaz®), elbasvir/grazoprevir (Zepatier®), glecaprevir/pibrentasvir (Mavyret®), indinavir (Crixivan®), irinotecan (Camptosar®), lomitapide (Juxtapid®), lovastatin (Mevacor®), lurasidone (Latuda®), midazolam (Versed®), nevirapine (Viramune®), phenobarbital (Luminal®), phenytoin (Dilantin®), pimozide (Orap®), ranolazine (Ranexa®), rifampin (Rifadin®, Rimactane®), sildenafil (Revatio®), simvastatin (Zocor®), St. John's wort, triazolam (Halcion®), or ergot medicines (eg, dihydroergotamine, ergotamine, methylergonovine, Cafergot®, Ergomar®, Wigraine®). Do not use atazanavir and cobicistat together with colchicine (Colcrys®) if you have kidney or liver disease.
Using atazanavir and cobicistat while you are pregnant can harm your unborn baby. It may also cause a rare but serious reaction called lactic acidosis (too much acid in the blood) in pregnant women. Birth control pills may not work as well to prevent pregnancy when used with atazanavir and cobicistat. Use another form of birth control (eg, condoms, spermicide) along with your pills. If you think you have become pregnant while using atazanavir and cobicistat, tell your doctor right away.
Atazanavir and cobicistat may cause heart rhythm problems (eg, PR prolongation). Tell your doctor right away if you get dizzy or lightheaded.
Serious allergic and skin reactions (eg, Stevens-Johnson syndrome, erythema multiforme, or toxic skin eruptions) can occur with atazanavir and cobicistat. Check with your doctor right away if you have any of the following symptoms while using atazanavir and cobicistat: severe rash, blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red skin lesions, often with a purple center, skin rash, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.
Atazanavir and cobicistat may increase your risk for kidney problems, including acute kidney failure, chronic kidney disease, or Fanconi syndrome (when used together with tenofovir DF). Check with your doctor right away if you have changes in how much you urinate, decreased mental sharpness, nausea, vomiting, loss of appetite, or muscle twitches or cramps.
Atazanavir and cobicistat may increase your risk of having kidney stones or gallstones. Check with your doctor right away if you have blood in your urine, nausea and vomiting, pain in the groin or genitals, or sharp back pain just below the ribs, stomach fullness or pain, recurrent fever, or yellow eyes or skin.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders (eg, Graves' disease, polymyositis, Guillain-Barré syndrome, and autoimmune hepatitis) may also occur.
Atazanavir and cobicistat may increase blood sugar levels. Check with your doctor if you notice a change in the results of your blood or urine sugar tests.
Atazanavir and cobicistat does not decrease the risk of transmitting the HIV infection to others through sexual contact or by contaminated blood. Make sure you understand and practice safe sex, even if your partner also has HIV. Avoid sharing needles with anyone.
Atazanavir and cobicistat may cause you to have excess body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from the legs, arms, and face.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or non-prescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Atazanavir and cobicistat side effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
- clay-colored stools
- dark urine
- itching, skin rash
- loss of appetite
- stomach pain
- unpleasant breath odor
- unusual tiredness or weakness
- vomiting of blood
- yellow eyes or skin
Incidence not known
- Black, tarry stools
- blistering, peeling, or loosening of the skin
- blood in the urine
- chest pain
- decreased appetite
- gaseous stomach pain
- joint or muscle pain
- pain in the groin or genitals
- painful or difficult urination
- recurrent fever
- red skin lesions, often with a purple center
- red, irritated eyes
- sharp back pain just below the ribs
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- stomach fullness or tenderness
- swelling of the feet or lower legs
- swollen glands
- unusual bleeding or bruising
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
More about atazanavir / cobicistat
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- En Español
- Drug class: antiviral combinations
- Other brands
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