What is Reyataz (Atazanavir)?
Reyataz (atazanavir) is an azapeptide compound that acts as an HIV protease inhibitor (PI) drug. It is active against both mutant and wild-type HIV-1 virus protease, and is used in the treatment of HIV-1 infection in combination with other antiretroviral drugs, usually including low-dose ritonavir. Reyataz is not active against HIV-2. It works by selectively inhibiting the viral–specific protein processing necessary for the formation of mature virions. It is cytotoxic only at extremely high concentrations, well above therapeutic levels. Its effects are additive to synergistic with a number of other antiretroviral medications. Unlike other PIs, Reyataz does not elevate serum lipids, and can be given as a once-daily dose
Dosage and administration
Reyataz is indicated for the treatment of HIV-1 infection, or off-label as post-exposure prophylaxis for HIV following occupational exposure, as part of a combination drug regimen. It may be used in adults, children, and infants three months and older weighing 5 kg or more. Reyataz has not been studied in children under three months and 5 kg, and may cause hyperbilirubinemia and kernicterus in that group. It is available as oral capsules or an oral powder. Oral capsules must be swallowed whole and should not be opened. Dosing instructions and considerations are given in detail in the product monograph.
A reduced dosage of Reyataz may be needed in patients with hepatic dysfunction, and the drug should not be used in the presence of severe hepatic impairment (Child-Pugh Class C). It can cause transient elevations in serum liver enzymes, and indirect bilirubin. Patients with hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection or pre-existing liver dysfunction may develop further transaminase elevations or liver decompensation, and should be monitored as described in the product monograph. No dosage adjustments are necessary for patients with renal impairment, except for those receiving hemodialysis. Considerations for these patients are given in the product monograph.
Reyataz Side effects
Patients using this medication may experience adverse side effects.
These effects include, but are not limited to:
- nausea, vomiting, diarrhea, stomach pain
- numbness or burning pain in hands or feet
- changes in the distribution of body fat
Patients should contact a medical care professional if they experience any of the following:
- unexplained weight loss
- muscle aches or weakness
- joint pain
- vision changes,
- signs of infection (such as fever, chills, trouble breathing, cough, non-healing skin sores)
- signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter)
- signs of a certain nerve problem known as Guillain-Barre Syndrome (such as difficulty breathing/swallowing/moving your eyes, drooping face, paralysis, slurred speech)
- yellowing eyes or skin
- increased thirst or urination
- signs of a kidney stone (such as pain in side/back/abdomen, painful urination, blood in the urine)
A complete list of side effects is provided in the product monograph and should be consulted by prescribers.
Current HIV treatment guidelines recommend that all HIV-positive patients should be screened for HBV and HCV at the time of diagnosis. Co-infection with HIV and HBV or HCV should be treated with antiretroviral therapy targeting both viruses, and should continue indefinitely to achieve optimal suppression of HIV and prevention of HBV or HCV exacerbation. Regimens and considerations are outlined in treatment guidelines.
Reyataz should be used with caution in the presence of cardiac AV block, as it may prolong the PR interval in some patients.
Pregnancy and lactation
Highly active retroviral combination treatment should be used in all pregnant women, regardless of viral load and CD4 count. The Antiretroviral Pregnancy Registry data from more than 1,250 first-trimester pregnancy exposures to atazanavir show no increase in risk of overall major birth defects compared to baseline. Current guidelines should be consulted when treating women in pregnancy. Reyataz is excreted in the breast milk. The CDC recommends that all HIV-positive women, treated or untreated, avoid breastfeeding to prevent vertical transmission of the virus.
A complete list of drug interactions is provided in the product monograph and should be consulted by prescribers.
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