atazanavir sulfate at a glance
Medicine class
HIV protease inhibitor
Main role
Combination treatment of HIV-1 in adults and eligible children
Food
Take with a meal or substantial snack to support absorption
Capsule administration
Swallow the capsule whole
What is atazanavir sulfate used for?
The selected capsule is licensed as part of combination antiretroviral treatment.
Treatment of HIV-1 infection in adults.
Treatment of HIV-1 infection in children aged 6 years and older who can use capsules.
Licensed use specifies combination with ritonavir and other antiretrovirals. Treatment history and resistance testing are important in treatment-experienced people.
How does atazanavir sulfate work?
Atazanavir blocks HIV-1 protease, an enzyme needed to make mature infectious virus particles. Ritonavir increases atazanavir exposure by slowing its CYP3A4-mediated metabolism.
atazanavir sulfate preparations and strengths
Capsule
Route: Oral
Strengths: 150 mg, 200 mg, 300 mg
How to take atazanavir sulfate
Follow the specialist HIV team’s instructions and use atazanavir with the other prescribed antiretrovirals.
Take with food because fasting reduces absorption and makes it less predictable.
Swallow the selected hard capsule whole.
Do not stop atazanavir or ritonavir without speaking to the HIV team, because viral control may be lost and resistance may develop.
Check before starting prescription, over-the-counter or herbal products, particularly indigestion treatments.
atazanavir sulfate side effects
Common or expected effects
- Nausea, vomiting or diarrhoea
- Headache
- Abdominal discomfort or indigestion
- Tiredness
- Yellowing of the eyes or skin from increased bilirubin
Get urgent medical advice
- Severe rash, blistering, mouth ulcers, fever or facial swelling
- Fainting, marked dizziness or an abnormal heartbeat
- Jaundice with dark urine, pale stools, itching or abdominal pain
- Severe side, back or lower abdominal pain, blood in urine or painful urination
- Right upper abdominal pain with fever, nausea or vomiting
atazanavir sulfate in pregnancy
Available pregnancy data have not identified a malformation signal, but atazanavir exposure can change during later pregnancy and after birth. Treatment should be planned and monitored by specialist HIV and maternity teams; additional maternal drug-level or neonatal bilirubin monitoring may be considered.
atazanavir sulfate while breastfeeding
Atazanavir enters human milk, and the product information recommends not breastfeeding. In current UK practice, formula feeding is the safest way to eliminate postnatal HIV transmission. Someone with sustained viral suppression who wishes to breastfeed should discuss this early with the specialist team because close maternal and infant monitoring is required.
atazanavir sulfate interactions
Atazanavir and ritonavir have many clinically important interactions. A pharmacist or HIV specialist should review all medicines and supplements.
Rifampicin, carbamazepine, phenytoin, phenobarbital, apalutamide and St John’s wort
Strong CYP3A4 induction can greatly reduce atazanavir exposure, causing treatment failure and resistance; these combinations are contraindicated.
Proton-pump inhibitors, H2-receptor antagonists and antacids
Increasing stomach pH can reduce atazanavir absorption; suitability and administration timing require specialist review.
Simvastatin and lovastatin
Atazanavir can markedly increase exposure and the risk of severe muscle toxicity; use is contraindicated.
Common questions about atazanavir sulfate
Answers are fully visible for fast scanning and source review.
Is atazanavir sulfate the same as atazanavir?
Atazanavir sulfate is the salt form used in the capsule; the active antiviral component is atazanavir.
Does atazanavir cure HIV?
No. It suppresses HIV replication as part of combination treatment but does not remove HIV from the body.
Why must atazanavir be taken with food?
Food improves absorption and makes atazanavir exposure more consistent.
Why is atazanavir used with ritonavir?
Ritonavir slows atazanavir metabolism, increasing and sustaining its concentration.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.