Before taking atazanavir,
tell your doctor and pharmacist if you are allergic to atazanavir, any other medications, or any of the ingredients in atazanavir capsules or powder. Your doctor may tell you not to take atazanavir. Ask your pharmacist for a list of the ingredients.
tell your doctor if you are taking any of following medications or herbal products: alfuzosin (Uroxatral); cisapride (Propulsid; not available in the US); ergot alkaloids such as dihydroergotamine (D.H.E. 45, Migranal), ergonovine, ergotamine (Ergomar, in Cafergot, in Migergot), or methylergonovine (Methergine); indinavir (Crixivan); irinotecan (Camptosar); lovastatin (Altoprev); lurasidone (Latuda); midazolam by mouth; nevirapine (Viramune), pimozide (Orap); rifampin (Rimactane, Rifadin, in Rifater, in Rifamate); sildenafil (only Revatio brand used for lung disease); simvastatin (Zocor, in Vytorin); St. John's wort; and triazolam (Halcion). Your doctor will probably tell you not to take atazanavir if you are taking one or more of these medications.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, herbal products, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); antidepressants ('mood elevators') such as amitriptyline, desipramine (Norpramin), doxepin (Silenor, Zonalon), imipramine (Tofranil, Surmontil), protriptyline (Vivactil), trazodone, and trimipramine (Surmontil); certain antifungals such as itraconazole (Onmel, Sporanox), ketoconazole (Extina, Nizoral, Xolegel), and voriconazole (Vfend); bepridil (Vascor) (not available in the US); beta blockers such as labetalol (Trandate), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran XL, in Inderide); boceprevir (no longer available in the U.S.; Victrelis); bosentan (Tracleer); buprenorphine (Buprenex, Butrans, in Bunavail, in Suboxone, in Zubsolv); calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac, others), felodipine, nicardipine (Cardene), nifedipine (Adalat, Afeditab, Procardia), and verapamil (Calan, Verelan, in Tarka, others); certain cholesterol-lowering medications (statins) such as atorvastatin (Lipitor, in Caduet), and rosuvastatin (Crestor); clarithromycin (Biaxin, in Prevpac); colchicine (Colcrys, Mitigare); digoxin (Lanoxin); fluticasone (Flonase, Flovent, in Advair); medications for irregular heartbeat such as amiodarone (Cordarone, Nexterone, Pacerone), lidocaine (Octocaine, Xylocaine), and quinidine (in Nuedexta); medications that suppress the immune system such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf); other medications for HIV or AIDS including efavirenz (Sustiva, in Atripla), ritonavir (Norvir, in Kaletra, in Viekira Pak), saquinavir (Invirase), and tenofovir (Viread, in Atripla, in Stribild, in Truvada, others); midazolam by injection; paclitaxel (Abraxane, Taxol); certain phosphodiesterase inhibitors (PDE-5 inhibitors) used for erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn); repaglinide (Prandin, in Prandimet); quetiapine (Seroquel); rifabutin (Mycobutin); salmeterol (Serevent, in Advair); and tadalafil (Adcirca, Cialis). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with atazanavir, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
if you are taking antacids, didanosine delayed-release capsules (Videx EC), or any other buffered medication such as buffered aspirin (Bufferin), take atazanavir 2 hours before or 1 hour after you take the medication. Ask your doctor or pharmacist if you are not sure if any of the medications you are taking are buffered.
tell your doctor if you are taking a medication for indigestion, heartburn, or ulcers such as cimetidine, esomeprazole (Nexium, in Vimovo), famotidine (Pepcid, in Duexis), lansoprazole (Prevacid, in Prevpac), nizatidine (Axid), omeprazole (Prilosec, in Zegerid), pantoprazole (Protonix), rabeprazole (AcipHex), or ranitidine (Zantac). Your doctor may tell you not to take the medication or to take a lower dose of the medication. If you are to continue taking the medication, your doctor will tell you how much time you should allow between taking the medication and taking atazanavir.
tell your doctor if you have or have ever had an irregular heartbeat, diabetes or high blood sugar, hemophilia (a condition in which the blood does not clot normally) or any other bleeding disorder, hepatitis (a viral infection of the liver) or any other liver disease, kidney or heart disease.
tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking atazanavir, call your doctor. You should not breast-feed if you are infected with HIV and are taking atazanavir.
you should know that atazanavir may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, implants, and injections). Talk to your doctor about methods of birth control that will work for you while you are taking atazanavir.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking atazanavir.
you should know that you may experience hyperglycemia (increases in your blood sugar) while you are taking this medication, even if you do not already have diabetes. Tell your doctor immediately if you have any of the following symptoms while you are taking atazanavir: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include: dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness.
you should know that while you are taking atazanavir your body fat may increase or move to different areas of your body such as the back of your neck and upper shoulders ('buffalo hump'), stomach, and breasts. You may lose fat from your arms, legs, face, and buttocks. Talk to your doctor if you notice any of these changes in your body fat.
if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that atazanavir oral powder is sweetened with aspartame that forms phenylalanine.
you should know that while you are taking medications to treat HIV infection, your immune system may get stronger and begin to fight other infections that were already in your body. This may cause you to develop symptoms of those infections. If you have new or worsening symptoms at anytime during your treatment with atazanavir, be sure to tell your doctor.