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Atazanavir and cobicistat (Oral route)

Pronunciation:

a-ta-ZAN-a-vir, koe-BIK-i-stat

Brand Names:

  • Evotaz

Dosage Forms:

  • Tablet

Classifications:

Therapeutic

Antiretroviral Agent

Pharmacologic

Protease Inhibitor

Uses of This Medicine:

Atazanavir and cobicistat combination is used together with other medicines to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS).

Atazanavir and cobicistat combination will not cure or prevent HIV infection or AIDS. It helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay problems that are usually related to AIDS or HIV disease from occurring. This medicine will not keep you from spreading HIV to other people. People who receive this medicine may continue to have other problems usually related to AIDS or HIV disease.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Appropriate studies have not been performed on the relationship of age to the effects of atazanavir and cobicistat combination in the pediatric population. Safety and efficacy have not been established. Use is not recommended in children younger than 3 months of age because atazanavir may cause kernicterus.

Older adults

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of atazanavir and cobicistat combination in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution for patients receiving this medicine.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Alfuzosin
  • Amifampridine
  • Amisulpride
  • Bepridil
  • Carbamazepine
  • Cisapride
  • Colchicine
  • Conivaptan
  • Crizotinib
  • Dihydroergotamine
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Dronedarone
  • Eletriptan
  • Eliglustat
  • Enzalutamide
  • Eplerenone
  • Ergoloid Mesylates
  • Ergonovine
  • Ergotamine
  • Flibanserin
  • Fluconazole
  • Fosphenytoin
  • Grazoprevir
  • Indinavir
  • Irinotecan
  • Irinotecan Liposome
  • Isavuconazonium Sulfate
  • Ivabradine
  • Ketoconazole
  • Lomitapide
  • Lovastatin
  • Lurasidone
  • Maraviroc
  • Mesoridazine
  • Methylergonovine
  • Methysergide
  • Midazolam
  • Mitotane
  • Naloxegol
  • Nelfinavir
  • Nevirapine
  • Pazopanib
  • Phenobarbital
  • Phenytoin
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Primidone
  • Ranolazine
  • Rifampin
  • Riociguat
  • Romidepsin
  • Saquinavir
  • Sildenafil
  • Silodosin
  • Simvastatin
  • Sparfloxacin
  • St John's Wort
  • Terfenadine
  • Thioridazine
  • Tolvaptan
  • Triazolam
  • Venetoclax
  • Vinflunine
  • Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ado-Trastuzumab Emtansine
  • Afatinib
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amlodipine
  • Amprenavir
  • Anagrelide
  • Apixaban
  • Aprepitant
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether
  • Atorvastatin
  • Avanafil
  • Axitinib
  • Bedaquiline
  • Boceprevir
  • Bosentan
  • Bosutinib
  • Brentuximab Vedotin
  • Brexpiprazole
  • Bromocriptine
  • Budesonide
  • Buprenorphine
  • Buserelin
  • Cabazitaxel
  • Cabozantinib
  • Calcifediol
  • Cariprazine
  • Ceritinib
  • Cilostazol
  • Cimetidine
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Cobimetinib
  • Cyclophosphamide
  • Cyclosporine
  • Dabrafenib
  • Daclatasvir
  • Darunavir
  • Dasabuvir
  • Dasatinib
  • Degarelix
  • Delamanid
  • Delavirdine
  • Deslorelin
  • Dexamethasone
  • Dexlansoprazole
  • Diazepam
  • Digoxin
  • Diltiazem
  • Disopyramide
  • Docetaxel
  • Domperidone
  • Donepezil
  • Elbasvir
  • Eletriptan
  • Eluxadoline
  • Eplerenone
  • Erlotinib
  • Erythromycin
  • Escitalopram
  • Esomeprazole
  • Eszopiclone
  • Etravirine
  • Everolimus
  • Famotidine
  • Felodipine
  • Fentanyl
  • Flecainide
  • Fluoxetine
  • Fluticasone
  • Fluvastatin
  • Fosamprenavir
  • Fosaprepitant
  • Garlic
  • Gonadorelin
  • Goserelin
  • Grazoprevir
  • Haloperidol
  • Histrelin
  • Hydrocodone
  • Hydroxychloroquine
  • Ibrutinib
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imatinib
  • Imipramine
  • Irinotecan
  • Irinotecan Liposome
  • Itraconazole
  • Ivacaftor
  • Ixabepilone
  • Ketoconazole
  • Lacosamide
  • Lamotrigine
  • Lansoprazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Levomilnacipran
  • Lidocaine
  • Lofepramine
  • Lopinavir
  • Lumefantrine
  • Macitentan
  • Manidipine
  • Metronidazole
  • Mexiletine
  • Mifepristone
  • Minocycline
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nafarelin
  • Nevirapine
  • Nicardipine
  • Nifedipine
  • Nilotinib
  • Nimodipine
  • Nisoldipine
  • Nizatidine
  • Olaparib
  • Omeprazole
  • Ondansetron
  • Oxcarbazepine
  • Oxycodone
  • Palbociclib
  • Panobinostat
  • Pantoprazole
  • Paritaprevir
  • Pasireotide
  • Pimavanserin
  • Piperaquine
  • Pitolisant
  • Pixantrone
  • Ponatinib
  • Pravastatin
  • Propafenone
  • Quetiapine
  • Quinidine
  • Rabeprazole
  • Ranitidine
  • Reboxetine
  • Regorafenib
  • Repaglinide
  • Retapamulin
  • Rifabutin
  • Rifapentine
  • Ritonavir
  • Rivaroxaban
  • Rosuvastatin
  • Ruxolitinib
  • Salmeterol
  • Saquinavir
  • Saxagliptin
  • Sevoflurane
  • Simeprevir
  • Sirolimus
  • Sonidegib
  • Sulpiride
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tadalafil
  • Tamoxifen
  • Tamsulosin
  • Telithromycin
  • Temsirolimus
  • Tenofovir Disoproxil Fumarate
  • Ticagrelor
  • Tipranavir
  • Topotecan
  • Toremifene
  • Trabectedin
  • Tramadol
  • Trazodone
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venetoclax
  • Venlafaxine
  • Verapamil
  • Vilanterol
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Vorapaxar
  • Voriconazole
  • Warfarin
  • Zolpidem
  • Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Cobicistat
  • Dapsone
  • Darunavir
  • Desogestrel
  • Didanosine
  • Dienogest
  • Drospirenone
  • Efavirenz
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Indinavir
  • Levonorgestrel
  • Lopinavir
  • Medroxyprogesterone Acetate
  • Mestranol
  • Methadone
  • Nelfinavir
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Suvorexant
  • Telaprevir
  • Trazodone

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diabetes or
  • Fanconi syndrome (kidney disease), history of or
  • Gallbladder problems or
  • Hemophilia (a bleeding problem) or
  • Hyperglycemia (high blood sugar) or
  • Kidney failure, history of or
  • Liver disease (eg, hepatitis B or C) Use with caution. May make these conditions worse.
  • Heart block or
  • Heart conduction problems (eg, prolonged PR interval) May change the way your heart beats and increase your chance of getting side effects.
  • Kidney disease, severe Use is not recommended in these patients.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a patient information leaflet. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. You should talk to your doctor if you have any questions.

Do not change the dose or stop using this medicine without checking first with your doctor. When your supply of this medicine is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of this medicine.

If you are also using antacids or didanosine (Videx®), take atazanavir 2 hours before or 1 hour after taking these medicines.

Atazanavir and cobicistat contains a fixed amount of medicine in each tablet.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of HIV infection:
      • Adults One tablet once a day with food. Each tablet contains 300 milligrams (mg) of atazanavir and 150 mg of cobicistat.
      • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Do not take this medicine if it has been more than 12 hours since you missed your last dose.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

Your doctor will want to check your progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for any unwanted effects.

This medicine should not be used together with alfuzosin (Uroxatral®), carbamazepine (Tegretol®), cisapride (Propulsid®), colchicine (Colcrys®), dronedarone (Multaq®), indinavir (Crixivan®), irinotecan (Camptosar®), lovastatin (Mevacor®), lurasidone (Latuda®), midazolam (Versed®), nevirapine (Viramune®), phenobarbital (Luminal®), phenytoin (Dilantin®), pimozide (Orap®), ranolazine (Ranexa®), rifampin (Rifadin®, Rimactane®), sildenafil (Revatio®), simvastatin (Zocor®), St John's wort, triazolam (Halcion®), or ergot medicines (such as dihydroergotamine, ergotamine, methylergonovine, Cafergot®, Ergomar®, Wigraine®).

This medicine may cause heart rhythm problems (eg, PR prolongation). Tell your doctor right away if you get dizzy or lightheaded.

Serious allergic and skin reactions can occur with this medicine. Check with your doctor right away if you have any of the following symptoms while using this medicine: severe rash, blistering, peeling, or loose skin, chills, cough, diarrhea, itching, joint or muscle pain, red skin lesions, often with a purple center, skin rash, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.

This medicine may increase your risk of having kidney stones or gallstones. Check with your doctor right away if you have blood in your urine, nausea and vomiting, pain in the groin or genitals, or sharp back pain just below the ribs, stomach fullness or pain, recurrent fever, or yellow eyes or skin.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) may also occur.

This medicine may increase blood sugar levels. Check with your doctor if you notice a change in the results of your blood or urine sugar tests.

This medicine does not decrease the risk of transmitting the HIV infection to others through sexual contact or by contaminated blood. Make sure you understand and practice safe sex, even if your partner also has HIV. Avoid sharing needles with anyone.

This medicine may cause you to have excess body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from the legs, arms, and face.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or non-prescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Abdominal or stomach pain
chills
clay-colored stools
dark urine
dizziness
fever
headache
itching or rash
loss of appetite
nausea
unpleasant breath odor
unusual tiredness or weakness
vomiting of blood
yellow eyes or skin
Incidence not known
Abdominal or stomach fullness or tenderness
black, tarry stools
blistering, peeling, or loosening of the skin
blood in the urine
chest pain
clay colored stools
decreased appetite
diarrhea
gaseous abdominal or stomach pain
joint or muscle pain
pain in the groin or genitals
painful or difficult urination
recurrent fever
red skin lesions, often with a purple center
red, irritated eyes
sharp back pain just below the ribs
sore throat
sores, ulcers, or white spots in the mouth or on the lips
swelling of the feet or lower legs
swollen glands
unusual bleeding or bruising

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 9/15/2016
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