section name header

Pronunciation

a-ta-ZAN-a-veer/koe-BIK-i-stat

Classifications

Therapeutic Classification: antiretrovirals

Pharmacologic Classification: protease inhibitors, pharmacoenhancers

Indications

REMS

Action

Therapeutic Effects:

Pharmacokinetics

Atazanavir

Absorption: Rapidly absorbed ( by food).

Distribution: Enters cerebrospinal fluid and semen.

Metabolism/Excretion: Primarily metabolized in the liver via the CYP3A isoenzyme; 80% excreted in feces, 13% excreted unchanged in urine.

Half-life: 7 hr.

Cobicistat

Absorption: Absorption follows oral administration.

Distribution: Unknown.

Protein Binding: 97–98%.

Metabolism/Excretion: Primarily metabolized in this liver via the CYP3A isoenzyme, and to a lesser extent by the CYP2D6 isoenzyme; 86.2% excreted in feces, 8.2% excreted in urine.

Half-life: 3–4 hr.

Time/Action Profile

(plasma concentrations)

ROUTEONSETPEAKDURATION
atazanavir (PO)rapid2.5 hr24 hr
cobicistat (PO)unknown3 hr24 hr

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: cardiac conduction abnormalities.

Derm: DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), ERYTHEMA MULTIFORME, rash, STEVENS-JOHNSON SYNDROME.

EENT: ocular icterus.

Endo: Graves' disease, hyperglycemia.

GI: autoimmune hepatitis, cholelithiasis, hepatotoxicity, hyperbilirubinemia, jaundice, nausea.

GU: nephrolithiasis, new onset/worsening renal impairment.

Metab: accumulation/redistribution of body fat.

MS: polymyositis.

Neuro: Guillain-Barré syndrome.
Misc: immune reconstitution syndrome.

Interactions

Drug-Drug:

Drug-Natural Products:

Route/Dosage

Availability

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Evotaz