Home Drug Guide Atazanavir Sulfate

Drug Guide

Generic Name

Atazanavir Sulfate

Brand Names Reyataz

Classification

Therapeutic: Antiretroviral agent, Protease inhibitor

Pharmacological: HIV-1 protease inhibitor

FDA Approved Indications

  • Treatment of HIV-1 infection in combination with appropriate antiretroviral agents

Mechanism of Action

Atazanavir inhibits the HIV-1 protease enzyme, preventing viral maturation and production of infectious virus particles.

Dosage and Administration

Adult: Typically 300 mg once daily with food. Dose adjustments may be necessary based on co-administered drugs.

Pediatric: Safety and efficacy established for patients ≥6 years old weighing ≥25 kg; dosing should be determined by a healthcare provider.

Geriatric: No specific dosage adjustments recommended, but caution in older adults due to potential comorbidities.

Renal Impairment: No dosage adjustment needed for mild to moderate impairment; caution advised in severe impairment.

Hepatic Impairment: Use with caution; dose adjustment may be necessary especially in severe hepatic impairment.

Pharmacokinetics

Absorption: Well-absorbed when taken with food

Distribution: Widely distributed; high protein binding (~86%)

Metabolism: Primarily via CYP3A4, with some contribution from CYP2D6

Excretion: Primarily fecal (via biliary excretion), minimal renal excretion

Half Life: Approximately 6-7 hours

Contraindications

  • Hypersensitivity to atazanavir or any component of the formulation

Precautions

  • Use with caution in patients with underlying cardiac conduction abnormalities, hepatic impairment, or concerning jaundice.

Adverse Reactions - Common

  • Hyperbilirubinemia (often leading to jaundice or scleral icterus) (Frequent)
  • Nausea, rash, headache (Common)

Adverse Reactions - Serious

  • QT prolongation, and PR interval prolongation leading to potential cardiac arrhythmias (Serious but rare)
  • Severe skin reactions, hepatotoxicity, immune reconstitution syndrome (Serious but rare)

Drug-Drug Interactions

  • Atazanavir is a substrate and inhibitor of CYP3A4; hold or adjust doses of concomitant drugs accordingly.
  • Calcium or magnesium-containing antacids, acid reducers (PPI, H2 antagonists) may decrease absorption. Use antacids 2 hours before or after atazanavir.
  • Metformin, statins, and other drugs metabolized by CYP3A4 and UDP-glucuronosyltransferases may have altered levels.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of hepatic dysfunction, skin reactions, cardiovascular abnormalities, and changes in bilirubin levels.

Diagnoses:

  • Risk for hepatotoxicity, skin rash, or cardiac rhythm disturbances.

Implementation: Administer with food; monitor liver function tests, complete blood counts, and cardiac status.

Evaluation: Assess viral load and CD4 counts to evaluate efficacy.

Patient/Family Teaching

  • Take medication as prescribed, with food.
  • Report symptoms of jaundice, severe skin rash, or allergic reactions.
  • Avoid unprescribed medications, especially acid reducers, without consultation.
  • Maintain regular follow-up visits for lab monitoring.

Special Considerations

Black Box Warnings:

  • None currently established for atazanavir.

Genetic Factors: None specific.

Lab Test Interference: May cause benign hyperbilirubinemia, which can be mistaken for liver dysfunction; monitor liver function accordingly.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, or other gastrointestinal symptoms.

Treatment: Supportive care; no specific antidote. Consider gastric lavage or activated charcoal if ingestion is recent.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F). Keep in original container.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.