Atazanavir

Should be taken with food.

Hypersensitivity. Treatment-experienced patient on haemodialysis. Mild to moderate (w/ ritonavir) and severe (w/ or w/o ritonavir) hepatic impairment. Lactation. Concomitant use w/ statins (e.g. simvastatin, lovastatin), antiarrhythmics (e.g. amiodarone, bepridil, quinidine, systemic lidocaine), antihistamines (e.g. astemizole, terfenadine), antipsychotics (e.g. pimozide, quetiapine), ergot derivatives (e.g. dihydroergotamine, ergometrine, ergotamine, methylergometrine), GI prokinetics (e.g. cisapride), sedative and hypnotics (e.g. triazolam, oral midazolam), α₁-adrenergic antagonists (e.g. alfuzosin), sildenafil (for treatment of pulmonary arterial HTN), irinotecan, and indinavir.

Patient w/ haemophilia A/B, pre-existing cardiac conduction disorder (e.g. 1st-3rd degree AV or complex bundle branch block), DM, bradycardia, long congenital QT, electrolyte imbalance. Hepatic impairment (including chronic hepatitis B or C). Pregnancy. Monitoring Parameters Perform LFTs before and during treatment. Monitor viral load, CD4, blood lipids and glucose, and bilirubin. Monitor ECG esp in patient w/ pre-existing prolonged PR interval.

Jaundice, GI disturbance (e.g. abdominal pain, diarrhoea, nausea, vomiting, dyspepsia), headache, insomnia, peripheral neurological symptoms, ocular icterus, asthenia, fatigue; mild to moderate rash (e.g. maculopapular rash), cholelithiasis, nephrolithiasis; hyperbilirubinaemia, elevated amylase, lipase, and liver enzymes, low neutrophils; lipodystrophy (e.g. central obesity, dorsocervical fat enlargement, peripheral wasting, breast enlargement, cushingoid appearance); insulin resistance, hyperglycaemia, hyperlactataemia; elevated creatine phosphokinase, myalgia, myositis; osteonecrosis, Grave's disease, immune reconstitution syndrome. Rarely, rhabdomyolysis.
Potentially Fatal: Stevens-Johnson syndrome, erythema multiforme, toxic skin eruptions, drug rash w/ eosinophilia and systemic symptoms (DRESS); PR interval prolongation. Rarely, QT prolongation, torsade de pointes.

Decreased concentration w/ PPIs, efavirenz, nevirapine, and rifampicin. May increase serum concentration of inhaled fluticasone and salmeterol.

Antivirals

J05AE08 - atazanavir ; Belongs to the class of protease inhibitors. Used in the systemic treatment of viral infections.