Uses of Atazanavir

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Atazanavir belongs to the group of anti-bacterial and anti-viral drugs. Used by doctors for HIV patients to reduce the number of HIV virus, facilitate the immune system to develop better... So to find out what is Atazanavir? how does it use? What are the side effects of Atazanavir? Let's learn about the use of Atazanavir through the article below.

1. Effects of Atazanavir

Atazanavir is used with other anti-HIV medicines to treat people 6 years of age and older who are infected with human immunodeficiency virus (HIV). It is a type of anti-HIV medicine called a protease inhibitor.
HIV is the virus that leads to acquired immunodeficiency syndrome (AIDS). HIV infection destroys CD4+ cells (CD4 T cells), which are important for the immune system. The immune system helps fight infections.
After a large number of T cells are destroyed, AIDS develops. This medication helps to block HIV protease, an enzyme necessary for the HIV virus to multiply. This medicine can lower the amount of HIV in your blood, help your body keep a good supply of CD4+ (T) cells, and reduce your risk of death and HIV-related illness.
This medicine does not cure HIV infection or AIDS. There is currently no cure for HIV infection. People taking this medicine may still get opportunistic infections or other conditions that occur with HIV infection. An opportunistic infection is an infection that develops because the body's immune system is weakened.

2. Usage and dosage of Atazanavir

2.1. How to take Atazanavir Take Atazanavir capsules once a day exactly as directed by your healthcare provider. Always take this medication with food (a meal or snack) to help it work better. Swallow the capsule whole. Do not open the capsule. Take this medicine at the same time each day.
If you are taking antacids or didanosine, take them 2 hours before or 1 hour after taking these medicines.
Do not change your dose or stop taking this medicine without first talking to your healthcare provider. It is important to stay under the care of a healthcare provider while taking this medicine.
When your supply of Atavir Capsules begins to run low, get more from your healthcare provider or pharmacy. It is important not to run out of this medicine. The amount of HIV in your blood may increase if the drug is stopped for a short time.
If you miss a dose of this medicine, take it as soon as possible and then take your next scheduled dose at the regular time. However, if it is within 6 hours of your next dose, do not take the missed dose. Wait and take your next dose at the regular time. Do not double your next dose. It is important that you do not miss any doses of this or other anti-HIV medicines.
If you take more than the prescribed dose of this medicine, call your healthcare provider or poison control center right away.
2.2. Dosage of the drug Atazanavir For adults HIV treatment:
Atazanavir in combination with ritonavir: Atazanavir 300 mg x 1 time / day + ritonavir 100 mg x 1 time / day.
If ritonavir is intolerant: Atazanavir 400 mg once daily.
Atazanavir plus cobicistat: 1 tablet atazanavir/cobicistat 300/150 mg or atazanavir 300 mg x 1 time/day + 150 cobicistat x 1 time/day.
Prophylaxis of HIV exposure:
Atazanavir in combination with ritonavir: Atazanavir 300 mg x 1 time / day + ritonavir 100 mg x 1 time / day. Use as soon as possible (preferably within a few hours), if well tolerated, continue for 4 weeks.
For Children The recommended dose of atazanavir + ritonavir * for pediatric patients 6 to under 18 years of age.

The dose of atazanavir + ritonavir is taken with food.
For untreated pediatric patients 13 years of age or older and <40 kg body weight who cannot tolerate ritonavir: The recommended dose is 400 mg atazanavir once daily with food.
For pediatric patients 13 years of age and older and < 40 kg when co-administered with tenofovir, H2-receptor antagonists or proton pump inhibitors, atazanavir should not be taken without ritonavir.
Dosage for pediatric patients ≥ 3 months old weighing ≥ 5 kg (oral powder).

Others Patients with hepatic impairment:
Atazanavir should be used with caution in patients with mild to moderate hepatic impairment.
For patients with moderate hepatic impairment (Child Pugh score group B) who have not experienced previous viral treatment failure, a reduction in the dose of atazanavir to 300 mg once daily should be considered.
Atazanavir should not be used in patients with severe hepatic impairment (Child-Pugh score C).
The atazanavir/ritonavir combination has not been studied in subjects with hepatic impairment and is not recommended.
Patients with renal impairment:
Patients with renal impairment, including those with severe renal impairment but not on dialysis, no dose adjustment of atazanavir is necessary.
Untreated patients with end-stage renal disease receiving hemodialysis will receive 300mg of atazanavir + 100mg of ritonavir.
Atazanavir should not be given to HIV-treated patients with end-stage renal disease who are on hemodialysis.
2.3. Overdose and Management Single doses up to 1,200 mg have been administered to healthy volunteers but no systemic symptoms have been observed.
At high doses, jaundice due to indirect (unconjugated) hyperbilirubinemia (without changes in liver function tests) or prolongation of the PR interval has been observed.
Treatment of overdose
Treatment of overdose with atazanavir should include general supportive measures, including monitoring of vital signs and electrocardiogram (ECG) and observation of the patient's condition.
If indicated, removal of unabsorbed atazanavir should be done by induction of vomiting or gastric lavage. There is no specific antidote for atazanavir overdose.
Dialysis does not provide significant benefit in removing these drugs.
2.4. Missed dose and treatment If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take twice the prescribed dose.

3. Contraindications of Atazanavir

Severe liver failure. The patient has a history of hypersensitivity to any of the ingredients. Co-administration with drugs that are highly dependent on CYP3A or UGTIAI enzymes for clearance. Concomitant use of atazanavir with drugs such as: α-adrenergic receptor antagonists (alfuzosin), antituberculous drugs (antimycobacterials: Rifampin), anticancer drugs (irinotecan), benzodiazepines (triazolam, oral midazolam), derivatives Ergot ergot mushrooms (dihydroergotamine, methylergonovin, ergotamine, ergonovin), gastric motility drugs (cisaprid), medicinal preparations (St. John's wort: Measles), HMG-CoA Reductase enzyme inhibitors (lovastatin) , simvastatin), tranquilizers (pimozide), PDE5 enzyme inhibitors (sildenafil in doses for the treatment of pulmonary arterial hypertension), protease inhibitors (indinavir).

4. Notes when using Atazanavir

4.1. General Note Antiretroviral therapy has not been shown to eliminate the risk of HIV transmission to others through sexual contact or blood-borne transmission. Patients should continue to take appropriate precautions.
Atazanavir prolongs the PR interval on the electrocardiogram, asymptomatic atrioventricular (AV) conduction abnormalities, and is usually limited to grade I of atrioventricular block in some patients.
In controlled clinical trials, rash (of all grades) occurred in approximately 20% of patients treated with atazanavir. The maculopapular skin rash is usually mild to moderate. Stevens-Johnson syndrome, erythema multiforme, and multiple toxic necrosis syndrome, including drug rash, eosinophilia, and systemic symptoms (DRESS - Drug rash with eosinophilia and systemic symptoms), has been reported in patients receiving atazanavir.
Most of the patients who had received atazanavir were associated with asymptomatic elevation of free plasma bilirubin due to inhibition of the UDP glucuronosyltransferase (UGT) enzyme. This hyperbilirubinemia is reversible upon discontinuation of atazanavir.
Hepatotoxicity: Caution should be exercised when atazanavir is administered to patients with hepatic impairment because concentrations of atazanavir may be increased. Patients with latent hepatitis B or hepatitis C virus infection or with significantly elevated transaminase levels prior to treatment may be at increased risk of developing additional transaminase elevations or compensatory hepatitis. In these patients, liver tests should be performed prior to initiating and during treatment with atazanavir.
Cases of renal and/or gallstones reported in post-marketing experience have occurred in HIV-infected patients receiving atazanavir.
New-onset diabetes, hyperglycemia, or aggravation of diabetes has occurred in HIV-infected patients treated with protease inhibitors.
Immune reconstitution syndrome has been reported in patients receiving antiretroviral therapy, including atazanavir.
Distribution/accumulation of body fat including obesity, increased fat on the nape of the neck (buffalo hump), peripheral atrophy, facial atrophy, breast enlargement and the appearance of a “round face due to obesity” ” (cushingoid) has also been observed in patients receiving antiretroviral therapy.
Hemophilia: An increase in bleeding, including spontaneous skin hematomas and joint hematomas, has been reported in patients with hemophilia types A and B treated with hemophilia. protease inhibitors.
Different degrees of cross-resistance among protease inhibitors have been observed. Resistance to atazanavir may not preclude further use of other protease inhibitors.
4.2. Precautions for pregnant women Atazanavir should not be taken without ritonavir.
Atazanavir should only be given to pregnant women infected with atazanavir susceptible strains of HIV-1.
For pregnant patients, dosage adjustment of atazanavir is not required in the following exceptions:
For pregnant women in the second or third trimester of pregnancy who have been treated, when atazanavir co-administered with either an H2 antagonist or tenofovir, a dose of atazanavir 400 mg + ritonavir at 100 mg once daily is recommended. There are insufficient data to recommend the co-administration of atazanavir with both H2-receptor antagonists and tenofovir in treated pregnant women. 4.3. Note to lactating women Contraindicated for those who are breast-feeding.
4.4. Precautions while driving and using machines No studies on the effects on the ability to drive and use machines have been performed. However, the patient's condition and adverse reactions to atazanavir should be taken into account when considering the patient's ability to drive or use machines.

5. Side effects of Atazanavir

Call 911 right away if you experience any of the following signs of an allergic reaction: hives; shortness of breath; swelling of the face, lips, tongue, or throat.
Stop taking the medicine and call your doctor at once if you have a dangerous side effect such as:
Severe dizziness, fast heartbeat , feeling like you are going to faint; Severe pain in the side and lower back, painful urination, blood in the urine; easy bruising or bleeding, new signs of infection such as fever or chills, cough, or flu symptoms; Jaundice (yellowing of the skin or eyes); Increased sweating, tremors, anxiety, irritability, trouble sleeping (insomnia); Diarrhea, unexplained weight loss, menstrual changes, impotence, loss of interest in sex; Swelling in the neck or throat (enlarged thyroid gland); muscle weakness, tired feeling, trouble speaking or swallowing, joint or muscle pain, feeling short of breath, shortness of breath; Weakness or sharp pain such as prickles in your fingers or toes, loss of bladder or bowel control; Have problems walking, speaking, swallowing and eye movement; high blood sugar (excessive thirst, increased urination, hunger, dry mouth, fruity breath, drowsiness, dry skin, blurred vision); Serious skin reactions--fever, sore throat, swelling of the face or tongue, burning eyes, skin pain, followed by a red or purple rash (especially on the face or upper body) and blistering blistering and peeling. Less serious side effects include: Nausea, vomiting, stomach upset; Numbness or burning pain in the hands or feet; Headache, dizziness, low mood; Changes in the shape or location of body fat (especially in the arms, legs, face, neck, chest, and waist). Not everyone experiences these side effects. There may be other side effects not mentioned. If you have any questions about side effects, consult your doctor or pharmacist.

6. How to store Atazanavir

Store at room temperature, away from moisture and light. Do not store in the bathroom. Do not store in the freezer. Each drug may have different storage methods. Read the storage instructions on the package carefully, or ask your pharmacist. Keep medicine out of reach of children and pets.
Do not throw medicine into the toilet or plumbing unless asked to do so. Dispose of medication properly when it is past its expiration date or cannot be used. Consult your pharmacist or local waste disposal company about safe disposal of medications.

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