Atazanavir And Cobicistat (Oral Route) Proper Use

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

Evotaz

Descriptions

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. This medicine will not keep you from spreading HIV to other people. People who receive this medicine may continue to have other problems usually related to AIDS or HIV disease.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

Tablet

Before Using

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 this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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.

Pediatric

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.

Geriatric

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 this medicine.

Breastfeeding

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.

Drug Interactions

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 this medicine, 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 this medicine 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.

Alfuzosin
Alprazolam
Amiodarone
Bepridil
Bromocriptine
Carbamazepine
Cisapride
Colchicine
Conivaptan
Crizotinib
Dihydroergotamine
Doxorubicin
Doxorubicin Hydrochloride Liposome
Dronedarone
Drospirenone
Elbasvir
Eletriptan
Eliglustat
Enzalutamide
Eplerenone
Ergoloid Mesylates
Ergonovine
Ergotamine
Finerenone
Flibanserin
Fluconazole
Fosphenytoin
Gepirone
Glecaprevir
Grazoprevir
Indinavir
Irinotecan
Irinotecan Liposome
Isavuconazonium Sulfate
Itraconazole
Ivabradine
Ketoconazole
Levoketoconazole
Lisuride
Lomitapide
Lovastatin
Lurasidone
Maraviroc
Mavacamten
Mesoridazine
Metergoline
Methylergonovine
Methysergide
Midazolam
Mitotane
Naloxegol
Nelfinavir
Nevirapine
Nicergoline
Pacritinib
Pazopanib
Phenobarbital
Phenytoin
Pibrentasvir
Pimozide
Piperaquine
Primidone
Quinidine
Ranolazine
Rifampin
Riociguat
Romidepsin
Saquinavir
Sildenafil
Silodosin
Simvastatin
Sparfloxacin
St John's Wort
Terfenadine
Thioridazine
Tolvaptan
Triazolam
Ubrogepant
Venetoclax
Voclosporin
Voriconazole
Ziprasidone

Using this medicine 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.

Abametapir
Acalabrutinib
Acecainide
Adagrasib
Adenosine
Ado-Trastuzumab Emtansine
Afatinib
Ajmaline
Alfentanil
Alprazolam
Aluminum Carbonate, Basic
Aluminum Hydroxide
Aluminum Phosphate
Amineptine
Amiodarone
Amisulpride
Amitriptyline
Amitriptylinoxide
Amlodipine
Amoxapine
Amphetamine
Amprenavir
Anagrelide
Apalutamide
Apixaban
Apomorphine
Aprepitant
Aprindine
Aripiprazole
Arsenic Trioxide
Artemether
Asciminib
Asenapine
Astemizole
Atogepant
Atorvastatin
Avacopan
Avanafil
Avapritinib
Axitinib
Azithromycin
Bedaquiline
Benzhydrocodone
Benzphetamine
Betamethasone
Betrixaban
Boceprevir
Bosentan
Bosutinib
Brentuximab Vedotin
Bretylium
Brexpiprazole
Brigatinib
Budesonide
Buprenorphine
Buserelin
Buspirone
Cabazitaxel
Cabotegravir
Cabozantinib
Calcifediol
Calcium Carbonate
Calcium Silicate
Capivasertib
Cariprazine
Carvedilol
Cenobamate
Ceritinib
Chloroquine
Chlorpromazine
Ciclesonide
Cilostazol
Cimetidine
Ciprofloxacin
Cisapride
Citalopram
Clarithromycin
Clofazimine
Clomipramine
Clopidogrel
Clothiapine
Clozapine
Cobimetinib
Codeine
Copanlisib
Cyclobenzaprine
Cyclophosphamide
Cyclosporine
Dabigatran Etexilate
Dabrafenib
Daclatasvir
Daridorexant
Darunavir
Dasabuvir
Dasatinib
Deflazacort
Degarelix
Delamanid
Delavirdine
Desipramine
Deslorelin
Deutetrabenazine
Dexamethasone
Dexlansoprazole
Dexmedetomidine
Dextroamphetamine
Diazepam
Dibenzepin
Didanosine
Digoxin
Dihydrocodeine
Dihydroxyaluminum Aminoacetate
Dihydroxyaluminum Sodium Carbonate
Diltiazem
Disopyramide
Docetaxel
Dofetilide
Dolasetron
Domperidone
Donepezil
Doxepin
Droperidol
Duvelisib
Ebastine
Ebrotidine
Edoxaban
Efavirenz
Elacestrant
Elagolix
Elbasvir
Elexacaftor
Eluxadoline
Elvitegravir
Encainide
Encorafenib
Entrectinib
Eplerenone
Erdafitinib
Eribulin
Erlotinib
Erythromycin
Escitalopram
Eslicarbazepine Acetate
Esomeprazole
Estazolam
Eszopiclone
Ethinyl Estradiol
Etrasimod
Etravirine
Everolimus
Famotidine
Fedratinib
Felbamate
Felodipine
Fentanyl
Fesoterodine
Fexinidazole
Finerenone
Fingolimod
Flecainide
Fluconazole
Fluoxetine
Fluticasone
Fluvastatin
Fluvoxamine
Formoterol
Fosamprenavir
Fosaprepitant
Foscarnet
Fosnetupitant
Fostemsavir
Futibatinib
Galantamine
Garlic
Gatifloxacin
Gemifloxacin
Gepirone
Gilteritinib
Glasdegib
Gonadorelin
Goserelin
Granisetron
Grazoprevir
Halofantrine
Haloperidol
Histrelin
Hydrocodone
Hydrocortisone
Hydroquinidine
Hydroxyamphetamine
Hydroxychloroquine
Hydroxyzine
Ibrexafungerp
Ibrutinib
Ibutilide
Idelalisib
Ifosfamide
Iloperidone
Imipramine
Indecainide
Infigratinib
Inotuzumab Ozogamicin
Irinotecan
Irinotecan Liposome
Isavuconazole
Istradefylline
Itraconazole
Ivabradine
Ivacaftor
Ivosidenib
Ixabepilone
Ketoconazole
Lacosamide
Lamotrigine
Lansoprazole
Lapatinib
Larotrectinib
Lefamulin
Lemborexant
Lenacapavir
Leniolisib
Lenvatinib
Lercanidipine
Leuprolide
Levofloxacin
Levoketoconazole
Levomilnacipran
Lidocaine
Lisdexamfetamine
Lofepramine
Lofexidine
Lopinavir
Lorlatinib
Lovotibeglogene Autotemcel
Lumateperone
Lumefantrine
Lurbinectedin
Macimorelin
Macitentan
Magaldrate
Magnesium Carbonate
Magnesium Hydroxide
Magnesium Oxide
Magnesium Peroxide
Magnesium Trisilicate
Manidipine
Mavacamten
Mefloquine
Melitracen
Meperidine
Methadone
Methamphetamine
Methotrimeprazine
Methylprednisolone
Metoprolol
Metronidazole
Mexiletine
Midostaurin
Mifepristone
Minocycline
Mirtazapine
Mirvetuximab Soravtansine-gynx
Mitapivat
Mizolastine
Mobocertinib
Mometasone
Moricizine
Morphine
Morphine Sulfate Liposome
Moxifloxacin
Nafarelin
Nebivolol
Neratinib
Netupitant
Nevirapine
Nicardipine
Nifedipine
Nilotinib
Nimodipine
Nirogacestat
Nisoldipine
Nizatidine
Norfloxacin
Nortriptyline
Octreotide
Ofloxacin
Olanzapine
Olaparib
Oliceridine
Omaveloxolone
Omeprazole
Ondansetron
Opipramol
Orlistat
Osilodrostat
Osimertinib
Oxaliplatin
Oxcarbazepine
Oxycodone
Ozanimod
Paclitaxel
Pacritinib
Palbociclib
Paliperidone
Palovarotene
Panobinostat
Pantoprazole
Papaverine
Paritaprevir
Paroxetine
Pasireotide
Pemigatinib
Pentamidine
Pentazocine
Perphenazine
Pexidartinib
Pimavanserin
Pipamperone
Piperaquine
Pirtobrutinib
Pitavastatin
Pitolisant
Pixantrone
Ponatinib
Ponesimod
Posaconazole
Prajmaline
Pralsetinib
Pravastatin
Probucol
Procainamide
Prochlorperazine
Promethazine
Propafenone
Protriptyline
Quetiapine
Quinidine
Quinine
Quizartinib
Rabeprazole
Ranitidine
Ranitidine Bismuth Citrate
Reboxetine
Regorafenib
Relugolix
Repaglinide
Repotrectinib
Retapamulin
Ribociclib
Rifabutin
Rifapentine
Rimegepant
Risperidone
Ritlecitinib
Ritonavir
Rivaroxaban
Roflumilast
Rosuvastatin
Roxatidine
Ruxolitinib
Salmeterol
Saquinavir
Selpercatinib
Selumetinib
Sertindole
Sertraline
Sevoflurane
Simeprevir
Siponimod
Sirolimus
Sirolimus Protein-Bound
Sodium Bicarbonate
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Sofosbuvir
Solifenacin
Sonidegib
Sorafenib
Sotalol
Sparfloxacin
Sparsentan
Sparteine
Sufentanil
Sulpiride
Sultopride
Sunitinib
Suvorexant
Tacrolimus
Tadalafil
Tamoxifen
Tamsulosin
Tazemetostat
Tedisamil
Telaprevir
Telavancin
Telithromycin
Temsirolimus
Tenofovir Alafenamide
Tenofovir Disoproxil Fumarate
Tetrabenazine
Tezacaftor
Thioridazine
Thiotepa
Tianeptine
Ticagrelor
Timolol
Tipranavir
Tocainide
Tolterodine
Tolvaptan
Topotecan
Toremifene
Trabectedin
Tramadol
Trazodone
Triamcinolone
Triclabendazole
Trimipramine
Triptorelin
Ubrogepant
Upadacitinib
Valbenazine
Vamorolone
Vandetanib
Vardenafil
Velpatasvir
Vemurafenib
Venetoclax
Venlafaxine
Verapamil
Vernakalant
Vilanterol
Vilazodone
Vinblastine
Vincristine
Vincristine Sulfate Liposome
Vinflunine
Voclosporin
Vonoprazan
Vorapaxar
Voriconazole
Vorinostat
Vortioxetine
Voxilaprevir
Warfarin
Zaleplon
Zanubrutinib
Ziprasidone
Zolpidem
Zotepine
Zuclopenthixol
Zuranolone

Using this medicine 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.

Amlodipine
Aripiprazole Lauroxil
Atazanavir
Cobicistat
Dapsone
Darunavir
Desogestrel
Dienogest
Estradiol
Ethinyl Estradiol
Ethynodiol
Etonogestrel
Gestodene
Indinavir
Levonorgestrel
Mestranol
Methadone
Nelfinavir
Norethindrone
Norgestimate
Norgestrel
Telaprevir

Other Interactions

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.

Proper Use

Take this medicine 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.

This medicine 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 this medicine with food.

Do not change the dose or stop using this medicine without checking first with your doctor. When your supply of this medicine is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of this medicine.

If you use antacids, take them 2 hours before or 2 hours after you take this medicine.

Take this medicine at least 2 hours before or 1 hour after taking didanosine (Videx®).

Atazanavir and cobicistat contains a fixed amount of medicine in each tablet.

Dosing

The dose of this medicine 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 this medicine. 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.

Missed Dose

If you miss a dose of this medicine, 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.

Storage

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

Your doctor will want to check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for any unwanted effects.

This medicine 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 this medicine together with colchicine (Colcrys®) if you have kidney or liver disease.

Using this medicine 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 this medicine. Use another form of birth control (eg, condoms, spermicide) along with your pills. If you think you have become pregnant while using this medicine, tell your doctor right away.

This medicine 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 this medicine. Check with your doctor right away if you have any of the following symptoms while using this medicine: 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.

This medicine 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.

This medicine 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.

This medicine may increase blood sugar levels. Check with your doctor if you notice a change in the results of your blood or urine sugar tests.

This medicine 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.

This medicine 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.

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:

More common

Chills
clay-colored stools
dark urine
dizziness
fever
headache
itching, skin rash
loss of appetite
nausea
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
diarrhea
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.

Portions of this document last updated: April 01, 2024

Original article: https://www.mayoclinic.org/zh-hans/drugs-supplements/atazanavir-and-cobicistat-oral-route/proper-use/drg-20137729

Atazanavir And Cobicistat (Oral Route)