Atazanavir - Oral

Atazanavir is used together with other medicines to treat human immunodeficiency virus (HIV) infection, which can lead to acquired immune deficiency syndrome (AIDS).

This medicine is not a cure for HIV infection. It only helps to keep the virus in check and can help improve the quality of life. It does not prevent the spread of HIV to other people.

Take Atazanavir exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

This medicine should be taken with food or immediately after a meal. Try to take it at the same time each day.

Atazanavir is available as a capsule or oral powder.

If you are taking the capsule, swallow it whole with a glass of water.

If you are taking the oral powder, mix it with soft foods such as applesauce or yoghurt. You may also dissolve this medicine in a beverage such as water, milk or baby formula. Consume the mixture within 1 hour of preparation.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on your condition or previous treatment experience.

Take Atazanavir at regular intervals. Do not skip any doses. You must complete the entire course of medicine. If you don't, the infection will not be properly controlled.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Do not take Atazanavir if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or to any of its ingredients.

Alert your doctor if you have moderate to severe liver disease as this medicine may not be suitable for you.

Do not take Atazanavir with medicines used to treat TB (lung infection known as tuberculosis), sleep disorder, heart disease, high cholesterol levels, migraine (severe throbbing pain or pulsating sensation usually affecting one side of the head that is often accompanied by nausea, vomiting, and sensitivity to light and sound), stomach problems, enlarged prostate gland, allergy and mood disorders. Please see the section "Can I take this with other medicines?" below for more information.

Inform your doctor if you have the following conditions:

• heart disease e.g. heart block, slow heartbeat, congenital long QT syndrome (an inherited disease causing abnormally fast and erratic heartbeats)
• imbalance of essential minerals in the body
• hepatitis B (contagious liver infection caused by a virus that is spread through contact with infected blood or other body fluids)
• hepatitis C (contagious liver infection caused by a virus that is spread through exposure to infected blood [blood-to-blood contact])
• severe kidney disease and undergoing dialysis (a procedure that helps individuals with kidney failure to filter toxic substances from the blood)
• mild liver disease

Be sure to check with your doctor or pharmacist before giving Atazanavir to a child. Children may be more sensitive to the side effects.

Let your doctor know if you are pregnant.

Inform your doctor if you are breastfeeding. It is best that you do not breastfeed as HIV passes into the breast milk. Avoid breastfeeding in order to reduce the risk of passing HIV to your baby. It is recommended to give your baby commercial infant formula, provided that you have access to clean water and facilities.

Individuals who are poor metabolisers of UGT1A1 may experience an enhanced side effect of this medicine such as jaundice (yellowing of the skin and whites of the eyes with stomach pain, persistent tiredness, nausea or vomiting). Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor. Monitor for signs and symptoms of jaundice and let your doctor know immediately.

Atazanavir is not a cure for HIV. It only helps to slow down the development of HIV infection.

This medicine does not reduce your risk of passing HIV infection to others through sexual contact or contamination with infected blood. Ensure that you use proper precautions to avoid spreading HIV infection to others.

Both this medicine and HIV may weaken your immune system, leaving you more vulnerable to infections. Avoid crowded places or those who are sick to minimise the risk of catching an infection. While undergoing treatment, you may develop other infections or experience other health problems. Always keep your doctor updated on your condition and go for your appointed check-ups.

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly. You may need to have routine blood tests (e.g. liver and kidney function tests, blood sugar levels, amount of HIV in a blood sample) while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.

Atazanavir may cause any of the following side effects: nausea, vomiting, diarrhoea, stomach pain, indigestion, dry mouth, stomach wind, dizziness, drowsiness, headache, weight gain or loss, joint or muscle pain, hair loss, abnormal dreams, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes or mouth
• signs and symptoms of liver problems e.g. yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine
• signs and symptoms of gallbladder stones e.g. pain in the upper right side of the stomach, yellowing of the skin or eyes, fever with chills
• irregular heartbeat

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Atazanavir with the following medicines:

• medicines for sleep disorder e.g. oral midazolam, triazolam
• medicines for irregular heartbeat e.g. amiodarone, quinidine
• cholesterol-lowering medicines e.g. lovastatin, simvastatin, lomitapide
• medicines for migraine e.g. ergotamine, dihydroergotamine
• medicines for cold or allergy e.g. terfenadine, astemizole
• medicines for mood disorders e.g. pimozide, quetiapine, lurasidone
• medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
• medicines for cancer e.g. ivosidenib, irinotecan, apalutamide, encorafenib
• medicines for hepatitis C infection e.g. grazoprevir, glecaprevir/pibrentasvir
• bepridil (medicine for chest pain)
• rifampicin (medicine to treat TB)
• cisapride (medicine for stomach problems)
• alfuzosin (medicine to treat enlarged prostate gland)
• sildenafil (medicine used to treat pulmonary arterial hypertension [high blood pressure in the blood vessels leading to the lungs])
• St. John's wort (herbal medicine)

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for HIV infection e.g. indinavir, efavirenz
• medicines that reduce stomach acid production e.g. omeprazole, famotidine
• blood-thinning medicines e.g. apixaban, dabigatran, warfarin
• certain medicines for high blood pressure e.g. diltiazem, verapamil, nifedipine, ticagrelor, clopidogrel
• anti-inflammatory medicines e.g. fluticasone, dexamethasone

This list does not include all medicines that may interact with Atazanavir.

Atazanavir should not be taken with antacids or other medicines that neutralise stomach acids as they could reduce the effectiveness of this medicine. If you must take these medicines, take Atazanavir at least 2 hours before or 1 hour after the antacid or other medicines that neutralise stomach acids.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.