Evotaz (Generic Atazanavir and Cobicistat)
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Why is this medication prescribed?
Human immunodeficiency virus (HIV) infection is treated with atazanavir and cobicistat in conjunction with other drugs in adults and children who weigh at least 77 lb (35 kg). Protease inhibitors are a class of drugs that includes atazanavir. It functions by lowering the level of HIV in the blood. Cobicistat belongs to the group of drugs known as pharmacokinetic boosters. It functions by boosting the body’s supply of atazanavir so that it can exert more of an impact. Atazanavir does not treat HIV, but it may lessen your risk of getting AIDS and other diseases connected to HIV, such as cancer or serious infections. The risk of spreading the HIV virus to others may be reduced by taking these medications, engaging in safer sexual behavior, and changing other aspects of one’s lifestyle.
How should this medicine be used?
Cobicistat and atazanavir are available as oral tablets. It is typically taken once daily with food. Take cobicistat and atazanavir at roughly the same time each day. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Take cobicistat and atazanavir exactly as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.
Do not chew, break, or crush the tablets; instead, swallow them whole.
HIV cannot be cured, however atazanavir and cobicistat can control it. HIV infection cannot be treated with atazanavir and cobicistat alone; they must always be administered as a whole regimen. In order for the meds to continue to function to manage the infection, it is crucial that you take all of the prescription drugs your doctor has prescribed to treat your HIV infection at the same time. Even if you feel well, keep taking cobicistat and atazanavir. Without consulting your doctor, do not discontinue taking atazanavir and cobicistat.
For a copy of the manufacturer’s information for the patient, ask your chemist or doctor. If you have any questions, make sure you carefully read this information and ask your doctor or chemist.
Other uses for this medicine
Ask your doctor or chemist for more details if you believe this drug should be used for something else.
What special precautions should I follow?
Before taking atazanavir and cobicistat,
- If you have any allergies, including to atazanavir, cobicistat, other medicines, or any of the substances in atazanavir and cobicistat tablets, inform your doctor right away. Request a list of the ingredients from your chemist.
- If you are using any of the following drugs or natural remedies, let your doctor know: alfuzosin (Uroxatral); several hepatitis C antiviral drugs as elbasvir and grazoprevir (Zepatier) and glecaprevir and pibrentasvir (Mavyret); dronedarone (Multaq); drosperinone (in Beyaz, Gianvi, Loryna, Ocella, Safyral, Syeda, Yasmin, Yaz); cisapride (Propulsid; unavailable in the US); dihydroergotamine (D.H.E. 45, Migranal), ergonovine, ergotamine (Ergomar, in Cafergot, in Migergot), or methylergonovine (Methergine) are examples of ergot alkaloids; certain drugs, including nevirapine (Viramune) and indinavir (Crixivan), are also used to treat HIV infection; irinotecan (Camptosar), various drugs used to treat excessive cholesterol, including lomitapide (Juxtapid), lovastatin (Mevacor), and simvastatin (Zocor); midazolam used orally, pimozide (Orap), ranolazine (Ranexa), lurasidone (Latuda); drugs used to treat seizures, such as rifampin (Rimactane, Rifadin, in Rifater, in Rifamate); carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Tegretol XR); phenobarbital; and phenytoin (Dilantin, Phenytek); St. John’s wort, triazolam (Halcion), and sildenafil (the sole brand of Revatio used for pulmonary illness). If you are currently on one or more of these drugs, your doctor generally won’t recommend that you take atazanavir.
- Inform your physician and chemist about any additional prescription and over-the-counter drugs, vitamins, herbal remedies, and dietary supplements you are now taking or intend to take. Any of the following should be mentioned: some medications, including erythromycin and clarithromycin (often known as “blood thinners”); apixaban (Eliquis), betrixaban (Bevyxxa), dabigatran (Pradaxa), edoxaban (Savaysa), rivaroxaban (Xarelto), and warfarin (Coumadin, Jantoven); antidepressants (often known as “mood elevators”) such amitriptyline, desipramine (Norpramin), doxepin (Silenor, Zonalon), fluoxetine (Prozac), imipramine (Tofranil, Surmontil), paroxetine (Paxil), and trazodone; anticancer medications like dasatinib (Sprycel), nilotinib (Tasigna), some antifungals, including voriconazole (Vfend), itraconazole (Onmel, Sporanox), and ketoconazole (Extina, Nizoral, Xolegel); some drugs used to treat arrhythmias, including amiodarone (Cordarone); lidocaine, mexiletine (Mexitil), propafenone (Rythmol, Rythmol SR), flecainide (Tambocor), disopyramide (Norpace, Norpace CR), and quinidine; beta blockers such nadolol (Corgard, in Corzide), propranolol (Hemangeol, Inderal, Innopran XL, in Inderide), and labetalol (Trandate); bosentan (Tracleer); calcium channel blockers like nifedipine (Adalat, Afeditab, Procardia), diltiazem (Cardizem, Cartia, Tiazac, and others), felodipine (Plendil), nicardipine (Cardene), and verapamil (Calan, Verelan, in Tarka, and others); such as atorvastatin (Lipitor, in Caduet), fluvastatin (Lescol, Lescol XL), pravastatin (Pravachol), and rosuvastatin (Crestor); corticosteroids such as methylprednisolone, mometasone (Asmanex HFA, Asmanex Twisthaler, Nasacort, in Dulera), dexamethasone, fluticasone (Flovent, Flonase, in Advair, Breo Ellipta, Trelegy Ellipta), ciclesonide (Alevsco), and budesonide (Entocort EC); digoxin (Lanoxin), immune system-suppressing drugs such cyclosporine (Gengraf, Neoral, Sandimmune), everolimus (Afinitor, Zortress), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf); various HIV-treatment drugs, such as efavirenz (Sustiva, in Atripla), etravirine (Intelence), maraviroc (Selzentry), ritonavir (Norvir, in Kaletra, in Viekira Pak), saquinavir (Invirase), and tenofovir (Viread, in Atripla, in Stribild, in Truvada, among others); a number of analgesics, including buprenorphine (Belbuca, Butrans, in Suboxone, Subutex), fentanyl (Actiq, Duragesic, Lazanda, Subsys), methadone (Dolophine, Methadone), and tramadol (Conzip, Qdolo, Rybix ODT, Ryzolt, Ultram, Ultram ER, in Ultracet); avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn), among other phosphodiesterase inhibitors (PDE-5 inhibitors) used to treat erectile dysfunction; seroquel; rifabutin (Mycobutin); risperidone (Risperdal); salmeterol (Serevent, in Advair); some sedatives, including flurazepam (Dalmane), zolpidem (Ambien), diazepam (Valium), and buspirone (Buspar); such as eslicarbazepine (Aptiom), clonazepam (Klonopin), lamotrigine (Lamictal), and oxcarbazepine (Oxtellar XR, Trileptal); and sofosbuvir, velpatasvir, and voxilaprevir (Sovaldi, Epclusa, Vosevi). Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects. Atazanavir may also interact with many other drugs, so be sure to let your doctor know about all the drugs you’re taking, even if they don’t appear on this list.
- 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 the drug. Take atazanavir and cobicistat either two hours prior to or one hour following the administration of didanosine delayed-release capsules (Videx EC). If you’re uncertain whether any of the medications you’re taking are buffered, consult your doctor or chemist.
- Inform your physician if you take any antacids, such as cimetidine, esomeprazole (Nexium, in Vimovo), famotidine (Pepcid, in Duexis), or omeprazole (Nexium), for heartburn, ulcers, or indigestion, nizatidine (Axid), omeprazole (Prilosec, in Zegerid), pantoprazole (Protonix), rabeprazole (AcipHex), or ranitidine (Zantac) are some examples of antacids. Lansoprazole (Prevacid, in Prevpac) is one such example. It’s possible that your doctor will advise you to skip the prescription or take a smaller amount. Your physician will advise you on how long to wait before taking atazanavir and cobicistat if you are to continue taking the drug.
- Inform your doctor if you now or previously had any of the following conditions: irregular heartbeat, diabetes, high blood sugar, haemophilia (a condition in which blood does not clot normally), renal disease, heart disease, hepatitis (a viral infection of the liver), or any other liver illness.
- Inform your doctor if you are expecting a child or if you intend to do so. Call your doctor if you become pregnant while taking atazanavir and cobicistat. If you are HIV-positive and using cobicistat with atazanavir, you shouldn’t breastfeed.
- Atazanavir and cobicistat may lessen the efficacy of hormonal contraceptives (birth control tablets, patches, rings, implants, and injections). Consult your doctor for advice on effective birth control options for you to use while taking atazanavir and cobicistat.
- Inform your doctor or dentist that you are taking cobicistat and atazanavir if you need surgery, including dental surgery.
- You should be aware that even if you do not already have diabetes, using this drug could cause hyperglycemia (increases in blood sugar). While using atazanavir with cobicistat, report any of the following symptoms to your doctor right away: severe thirst, frequent urination, intense hunger, blurred vision, or weakness. Because untreated high blood sugar can result in the deadly disease known as ketoacidosis, it is crucial that you contact your doctor as soon as you experience any of these symptoms. If ketoacidosis is not treated at an early stage, it could turn fatal. Ketoacidosis symptoms include dry mouth, nausea, vomiting, shortness of breath, a fruity odour to the breath, and a loss of consciousness.
- You should be aware that when you take HIV medicine, your immune system could become stronger and start to fight other infections that were already present in your body. You might begin to exhibit signs of those infections as a result of this. Tell your doctor right away if you experience any new or worsening symptoms while taking atazanavir and cobicistat.
- You should be aware that your body fat can change or accumulate in several places, including your breasts, upper back, neck, chest, and abdomen. It is also possible to lose fat from the face, arms, and legs.
What special dietary instructions should I follow?
If you plan to consume grapefruits or grapefruit juice while taking this medication, consult your doctor.
What should I do if I forget a dose?
If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.
What side effects can this medication cause?
Cobicistat with atazanavir may have negative side effects. If any of these symptoms are severe or do not go away, let your doctor know right once:
- Eyes or skin that have a yellow tint
Some adverse effects can be very harmful. Get emergency medical care if you encounter any of the following symptoms, or call your doctor right away:
- Unsteady heartbeat
- Experiencing dizziness or faintness
- Vision alterations
- Skin or eye yellowing, particularly in newborn newborns
- Aches in the low back or abdomen
- Difficulty urinating
- Urinary blood
- Reduced appetite
- Less urinations
- Urine with a dark colour
- Coloured-light bowel motions
Stop taking atazanavir and cobicistat and seek emergency medical attention if you have any of the following symptoms in addition to a severe rash:
- A general malaise or flu-like symptoms
- An aching muscle or joint
- Eye swelling or redness
- Flaking or blistering skin
- Oral sores
- Your face or neck swelling
- A sore, warm, or colourful bump on your body
Cobicistat with atazanavir may also have other adverse effects. If you experience any strange issues while taking this medicine, contact your doctor right away.
You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you suffer a serious side event.
What should I know about storage and disposal of this medication?
Keep this medication tightly closed in the original container and out of the reach of children. Keep it at room temperature and out of the bathroom and other places with excessive heat and moisture.
As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.http://www.upandaway.org
Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the ideal approach to get rid of your medicines. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling department in your city. If you do not have access to a take-back program, see the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.
In case of emergency/overdose
Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.
Overdose symptoms could include:
- Yellowing of the eyes or skin
- Irregular heartbeat or variations in heart rhythm
What other information should I know?
Keep all of your appointments with your physician and the lab. To determine how well atazanavir and cobicistat are working in your body, your doctor may or may not prescribe certain lab tests.
Atazanavir and cobicistat should be kept on hand. Do not put off getting a refill on your prescription until you are out of medicine.
No one else should take your medication. Any queries you may have regarding prescription refills should be directed to your chemist.
You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.