REYATAZ (atazanavir) is an HIV PI (Protease Inhibitor) drug that is active against both wild-type and mutant HIV-1. It is used to treat HIV-1 infection in combination with other antiretroviral drugs, usually including low-dose ritonavir. REYATAZ is not active against HIV-2. REYATAZ potently blocks the formation of mature virions by inhibiting the HIV protease function.
Dosing & Administration
REYATAZ is used to treat HIV-1 infection, or as part of a combination drug regimen for HIV following occupational exposure. This drug is used in adults, children, and infants aged three months and older, weighing 5 kg or more. REYATAZ is available as oral capsules or an oral powder. More details about dosing instructions and considerations are available in the package insert.
REYATAZ should not be used in severe hepatic impairment and requires dose reduction in patients with hepatic dysfunction. Patients with HBV or HCV co-infection or pre-existing liver dysfunction should be monitored. Patients with renal impairment do not need dose adjustments, unless they are receiving hemodialysis.
REYATAZ is contraindicated in patients with severe liver dysfunction (Child-Pugh Class C) and in patients with hypersensitivity to the drug. It is also contraindicated when combined with ritonavir in patients with moderate liver impairment. Other medications that are contraindicated with REYATAZ are detailed in the package insert.
REYATAZ can cause serious liver and heart rhythm side effects. Other potential side effects include renal calculi, a rash, fat redistribution, jaundice, and hyperglycemia. A complete list of potential adverse effects is provided in the package insert
A cardiac AV block should be used with caution as it may prolong the PR interval in some patients using REYATAZ. REYATAZ should also be used with caution in hemophiliacs because of an increased risk for bleeding.
Patients who test positive for HIV infection should be screened for comorbid HBV and HCV infection. Regardless of CD4 counts or viral loads, co-infected patients should be started on an antiretroviral regimen targeting co-infected viruses. Drug regimens and prescribing considerations are outlined in current HIV treatment guidelines.
There are a number of drug-to-drug and herbal interactions and contraindications associated with REYATAZ use. Prescribers should familiarize themselves with the list provided in the package insert.
Pregnancy & Lactation
Regardless of viral load and CD4 count, highly active retroviral combination treatment should be used in all pregnant women. Current data does not associate atazanavir with any increased risk of overall major birth defects. Breastfeeding for women with HIV is discouraged because of the risk of vertical transmission of the virus.
As there is no treatment for REYATAZ overdose, patients should be closely monitored and provided with supportive care. Hemodialysis probably does not remove REYATAZ.
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