Atazanavir Sulfate, Oral a-ta-za-NA-veer SUL-fate

What are other names for this medicine?

Type of medicine: protease inhibitor (anti-HIV)

Generic and brand names: atazanavir sulfate, oral; Reyataz

What is this medicine used for?

This medicine is taken by mouth to treat HIV-1 infection. It is usually taken with other medicines.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• diabetes
• heart disease or heart rhythm problems
• hemophilia or bleeding problems
• kidney problems
• liver disease
• problems with alcohol abuse

Taking this medicine with certain other medicines may be life-threatening. Tell your provider about ALL of the medicines and natural remedies you take, especially antibiotics, sedatives, St. John's Wort, and medicines to treat cholesterol, prostate problems, migraines, mental disorders, or heart rhythm problems.

Males: If you take sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) while you are taking this medicine, you may be at increased risk of side effects such as low blood pressure, vision changes or priapism (prolonged and painful erections).

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine.

Hormonal birth control may be less effective while you are taking this medicine. Talk to your healthcare provider if you need birth control.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not change your dosage on your own. Do not stop taking this medicine without your healthcare provider's approval. If you are not sure of how much and how often to take this medicine, ask your healthcare provider or pharmacist to explain.

Take this medicine with other medicines your healthcare provider prescribes. Follow your healthcare provider's instructions exactly.

Take this medicine with food. Swallow the capsules whole. Do not open the capsules. If you are taking antacids or didanosine (Videx), take atazanavir at least 2 hours before or 1 hour after doses of these medicines.

What if I miss a dose?

Do not miss any doses. If you do miss a dose and remember within 6 hours, take the missed dose right away. If it is more than 6 hours since the missed dose, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: yellowing of the skin or eyes, irregular heartbeat, stomach pain, nausea, vomiting.

What should I watch out for?

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine is not a cure for HIV infection. You may continue to get illnesses associated with advanced HIV infection, including other infections. There is no evidence that this medicine will reduce the risk of spreading HIV through sexual contact or blood contamination.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Do not give this medicine to other people, even if they have the same symptoms you have.

Your body fat may change as a result of taking this medicine. Your legs and arms may be thin but your chest, belly, back and face may have more fat. Talk with your healthcare provider about this.

You may develop diabetes when you take this medicine. If you already have diabetes, it may get worse. Talk with your healthcare provider about this.

Diabetics: Your dosage of insulin or medicines taken by mouth for diabetes may need to be changed. If you are controlling your diabetes with diet and exercise, you may need to start taking medicine. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider about any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Severe diarrhea; stomach pain; yellowing of the eyes or skin; blistering rash or rash with fever, tiredness, muscle or joint aches, mouth sores, red or inflamed eyes, shortness of breath, or swelling of the face; severe nausea; dizziness; lightheadedness; increased thirst and urination; numbness or tingling of the hands or feet; fast, slow, or irregular heartbeat; blood in your urine; pain when you urinate.

Other: Headache, fatigue, depression, trouble sleeping, gas, nausea, vomiting, muscle pain, mild skin redness or itching.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antacids (take them at least 1 hour before or 2 hours after doses of this medicine)
• antiarrhythmics such as amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide (Tambocor), lidocaine, mexiletine, propafenone (Rythmol), and quinidine
• antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (Ery-Tabs, E.E.S.), rifabutin (Mycobutin), and rifampin (Rifadin, Rimactane)
• antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), trazodone, and venlafaxine (Effexor, Effexor XR)
• antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (VFEND)
• antipsychotic medicines such as aripiprazole (Abilify), haloperidol (Haldol), clozapine (Clozaril), olanzapine (Zyprexa), perphenazine, pimozide (Orap), risperidone (Risperdal), quetiapine (Seroquel), thioridazine, and ziprasidone (Geodon)
• antiseizure medicines such as carbamazepine (Tegretol), clonazepam (Klonopin), ethosuximide (Zarontin), fosphenytoin (Cerebyx), lamotrigine (Lamictal), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin), and valproic acid (Depakote, Depakote ER)
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), and sotalol (Betapace)
• hormonal birth control such as pills, implants, shots, patches, or vaginal rings (talk to your healthcare provider if you need birth control)
• buprenorphine (Buprenex, Subutex) and buprenorphine/naloxone (Suboxone)
• calcium channel blockers such as diltiazem (Cardizem, Tiazac), felodipine, isradipine (DynaCirc CR), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera-HS, Isoptin SR, Verelan)
• calcium supplements such as Os-Cal, Caltrate, Citracal, and Tums (take them at least 1 hour before or 2 hours after doses of this medicine)
• cholesterol-lowering medicines such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor)
• colchicine
• corticosteroids such as dexamethasone, hydrocortisone (Cortef), methylprednisolone (Medrol), and prednisone
• dapsone
• diabetes medicines such as insulin, exenatide (Byetta), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (DiaBeta), metformin (Glucophage), miglitol (Glyset), nateglinide (Starlix), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), and tolbutamide
• digoxin (Digitek, Lanoxicaps, Lanoxin)
• eplerenone (Inspra)
• ergot medicines such as bromocriptine (Parlodel), dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), and methylergonovine (Methergine)
• heartburn medicines such as cimetidine (Tagamet), famotidine (Pepcid, Pepcid AC), nizatidine (Axid), and ranitidine (Zantac)
• imatinib (Gleevec)
• immunosuppressants such as cyclosporine (Sandimmune, Neoral, Gengraf), sirolimus (Rapamune), and tacrolimus (Prograf)
• inhaled or nasal corticosteroids such as fluticasone (Flovent, Flonase) and mometasone (Asmanex, Nasonex)
• inhaled medicines such as salmeterol (Serevent) and salmeterol/fluticasone (Advair)
• maraviroc (Selzentry)
• medicines to treat low sodium such as conivaptan (Vaprisol) and tolvaptan (Samsca)
• medicines to treat cancer such as dasatinib (Sprycel), nilotinib (Tasigna), vincristine, vinblastine, docetaxel (Taxotere), irinotecan (Camptosar), and paclitaxel (Taxol)
• medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
• medicines to treat pulmonary hypertension such as bosentan (Tracleer), sildenafil (Revatio), and tadalafil (Adcirca)
• other medicines to treat HIV such as abacavir (Ziagen), atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), enfuvirtide (Fuzeon), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), raltegravir (Isentress), ritonavir (Norvir), saquinavir (Invirase), tenofovir (Viread), and zidovudine (AZT)
• medicines to treat over-active bladder such as alfuzosin (Uroxatral), darifenacin (Enablex), solifenacin (Vesicare), and tolterodine (Detrol, Detrol LA)
• medicines to block stomach acid such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex)
• natural remedies such as garlic, melatonin, red yeast rice, or St. John's Wort
• pain medicines such as fentanyl (Duragesic), meperidine (Demerol), methadone (Dolophine, Methadone Intensol, Methadose), and tramadol (Ultram, Ultracet)
• quinine sulfate
• ranolazine (Ranexa)
• sedatives such as alprazolam (Xanax), buspirone (BuSpar), clorazepate (Tranxene), chlordiazepoxide (Librium), diazepam (Valium), estazolam (ProSom), eszopiclone (Lunesta), flurazepam, lorazepam (Ativan), midazolam (Versed), triazolam (Halcion), and zolpidem (Ambien)
• silodosin (Rapaflo)
• theophylline
• warfarin (Coumadin)

The effects of this medicine may be increased if you take it with grapefruit juice. Talk with your healthcare provider about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.