Class Name(s):

• 8:18.08.08 HIV Protease Inhibitors

Pronunciation:

• (at a za na' veer) (koe bik' i stat)

Brand Name(s):

• Evotaz^®

WHY is this medicine prescribed?

The combination of atazanavir and cobicistat is used to treat human immunodeficiency virus (HIV) infection. Atazanavir is in a class of medications called protease inhibitors. It works by decreasing the amount of HIV in the blood. Cobicistat is in a class of medications called pharmacokinetic boosters. It works by increasing the amount of atazanavir in the body so that it can have a greater effect.

Although atazanavir does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses. Taking these medications along with practicing safer sex and making other life-style changes may decrease the risk of giving the HIV virus to other people.

HOW should this medicine be used?

Atazanavir and cobicistat comes as a tablet to take by mouth. Take with food one time a day. Take atazanavir and cobicistat at around the same time every day.

Take atazanavir and cobicistat exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

You will take other medications for HIV while you are taking atazanavir and cobicistat. Your doctor will tell you whether these medications should be taken at the same time as atazanavir, or several hours before or after you take atazanavir and cobicistat. Follow this schedule carefully, and ask your doctor or pharmacist if you have questions about the times you should take your medications.

Atazanavir and cobicistat controls HIV but does not cure it. Continue to take atazanavir and cobicistat even if you feel well. Do not stop taking atazanavir and cobicistat without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Read this information carefully and ask your doctor or pharmacist if you have any questions.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking atazanavir and cobicistat,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• Some medications should not be taken with atazanavir and cobicistat. Other medications may cause dosing changes or extra monitoring when taken with atazanavir and cobicistat. Make sure you have discussed any medications you are currently taking or plan to take before starting atazanavir and cobicistat with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking atazanavir and cobicistat, please get the advice of your doctor or pharmacist.
• The following nonprescription or herbal products may interact with atazanavir: medications for indigestion, heartburn or ulcers (esomeprazole [Nexium^®], famotidine [Pepcid^®], omeprazole [Prilosec^®, Zegerid^®], ranitidine [Zantac^®]) or St. John's wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking atazanavir and cobicistat. Do not start any of these medications while taking atazanavir and cobicistat without discussing with your healthcare provider.
• if you are taking antacids or any other buffered medication such as buffered aspirin (Bufferin^®), take atazanavir and cobicistat 2 hours before or 2 hours after you take the medication. If you are taking didanosine, take atazanavir and cobicistat 2 hours before or 1 hour after you take the medication. Ask your doctor or pharmacist if you are not sure if any of the medications you are taking are buffered.
• tell your doctor if you have or have ever had an irregular heartbeat, diabetes or high blood sugar, hemophilia (a condition in which the blood does not clot normally) or any other bleeding disorder, hepatitis (a viral infection of the liver) or any other liver disease, kidney or heart disease.
• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking atazanavir and cobicistat, call your doctor.
• tell your doctor if you are breastfeeding or plan to breastfeed. Some of the medication and HIV may be passed to your baby in your breast milk. Talk to your doctor about the risks of breastfeeding your baby if you are taking atazanavir and cobicistat.
• you should know that atazanavir and cobicistat may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, implants, and injections). Talk to your doctor about methods of birth control that will work for you while you are taking atazanavir and cobicistat.
• you should know that you may experience hyperglycemia (increases in your blood sugar) while you are taking this medication, even if you do not already have diabetes. Tell your doctor immediately if you have any of the following symptoms while you are taking atazanavir and cobicistat: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include: dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness.
• you should know that while you are taking medications to treat HIV infection, your immune system may get stronger and begin to fight other infections that were already in your body. This may cause you to develop symptoms of those infections. If you have new or worsening symptoms at any time during your treatment with atazanavir and cobicistat, be sure to tell your doctor.
• you should know that your body fat may increase or move to different areas of your body such as your breasts, upper back, neck, chest, and stomach area. Loss of fat from the legs, arms, and face can also happen.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Atazanavir and cobicistat may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• rash
• nausea
• diarrhea
• headache

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

• irregular heartbeat, dizziness, feeling faint or lightheadedness
• pain in your back or low stomach area, pain with urination, blood in urine,
• nausea, vomiting, loss of appetite, dark-colored urine, light-colored bowel movements, yellowing of skin or eyes
• decreased urination

If you develop a severe rash with any of the following symptoms, stop taking atazanavir and cobicistat and call your doctor immediately or get emergency medical treatment:

• general ill feeling or 'flu-like' symptoms; fever; muscle or joint aches; red or swollen eyes; blisters or peeling skin; mouth sores; swelling of your face or neck; painful, warm, or red lump under your skin; painful, warm, or red lump under your skin

Atazanavir and cobicistat may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• yellowing of skin or eyes
• changes in heart rhythm or irregular heartbeat

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will/may order certain lab tests to check your body's response to atazanavir and cobicistat.

Keep a supply of atazanavir and cobicistat on hand. Do not wait until you run out of medication to refill your prescription.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: August 15, 2025.