Atazanavir (Reyataz) is an oral tablet or powder that's used as part of an antiretroviral (ARV) regimen to treat human immunodeficiency virus (HIV) infections. It's often taken in combination with a "booster," like ritonavir (Norvir), to help atazanavir (Reyataz) work better against the virus. Some common side effects of this medication include nausea, vomiting, and headache. Rarely, this medication can also cause jaundice, which is a health condition that causes the skin or whites of the eyes to turn yellow.
Treatment of HIV infection
Atazanavir (Reyataz) is a protease inhibitor, which means it blocks a protein called protease. Normally, protease helps to process viral proteins so that the HIV virus can infect healthy cells. By blocking protease from working, atazanavir (Reyataz) prevents the virus from making copies of itself and spreading.
Source: DailyMed
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:
Incidence not known
blood in the urine
blurred vision
chest pain or discomfort
chills
clay-colored stools
dark urine
decreased appetite
dizziness or lightheadedness
fainting
fast heartbeat
fast, shallow breathing
flushed, dry skin
fruit-like breath odor
gaseous abdominal or stomach pain
general feeling of discomfort
headache
increased hunger
increased thirst
increased urination
indigestion
irregular heartbeat
loss of appetite
loss of consciousness
muscle pain or cramping
pain in the groin or genitals
pain in the stomach, side, or abdomen, possibly radiating to the back
recurrent fever
severe nausea or vomiting
sharp back pain just below the ribs
sleepiness
slow or irregular heartbeat
stomach discomfort or fullness
sweating
swelling
tightness in the chest
trouble with breathing
unexplained weight loss
unpleasant breath odor
unusual tiredness or weakness
vomiting
vomiting of blood
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Back pain
cough, increased
discouragement
extra body fat
feeling sad or empty
irritability
loss of interest or pleasure
trouble concentrating
trouble sleeping
Less common
Burning, numbness, tingling, or painful sensations
difficulty with moving
muscle stiffness
pain in the joints
unsteadiness or awkwardness
weakness in the arms, hands, legs, or feet
Incidence not known
Hair loss or thinning of the hair
rash with flat lesions or small raised lesions on the skin
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.
Powder form can be mixed with soft food or liquid, such as applesauce or milk, so convenient for people with difficulty swallowing pills
Available as a lower-cost generic medication
Can be used in young children 3 months and older who weigh over 5 kg (powder form)
Only taken once a day
Interacts with a lot of medications
Requires regular blood work and lab tests
Not safe for use for people with serious kidney problems
Needs to be taken with food
Atazanavir (Reyataz) should always be taken along with other HIV ARVs and with food. This combination works better against HIV infection for you.
Get your routine blood tests done on time while you’re taking atazanavir (Reyataz). Lab work is important to make sure that atazanavir (Reyataz) works against the virus, and that the medication isn't causing unwanted effects.
Atazanavir (Reyataz) can interact with many medications. Some medications might need to be stopped or the dose changed before you start HIV ARV regimen. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements.
Atazanavir (Reyataz) might raise your blood sugars. This can lead to or worsen diabetes. If you have diabetes, it's important that you check your blood sugar while taking this medication. Talk to your provider to see if you need additional medications to help control your sugar levels during treatment with atazanavir (Reyataz).
Atazanavir (Reyataz) might also raise your cholesterol (fat) levels. This can raise your risk of a heart attack or stroke. If you have a history of high cholesterol, talk to your provider to see if you need additional medications to help control your cholesterol levels during treatment with atazanavir (Reyataz).
Always follow the directions on your medications. This is extra important for HIV ARV medications. Don't stop any HIV medications, including atazanavir (Reyataz), without speaking to your provider. Doing so can cause the virus to become harder to treat.
Don't open atazanavir (Reyataz) capsules since they must be taken whole in order to absorb properly. If you've trouble swallowing or you're giving this medication to a child, consider using atazanavir (Reyataz) oral powder.
More tips for taking atazanavir (Reyataz) oral powder:
Atazanavir (Reyataz) oral powder can be mixed with soft food (applesauce, pudding) or liquid (water, infant formula, milk). The mixture should be given within 1 hour of mixing. Make sure you receive detailed instructions for mixing when you pick up the medication at the pharmacy. If you mixed atazanavir (Reyataz) oral powder with water, make sure to eat right after to help your body absorb this medication better.
Atazanavir (Reyataz) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of heart problems | Taking medications that affect heart rhythm
Atazanavir (Reyataz) can affect your heart rhythm, which can be serious and life-threatening. Your risk is higher if you've certain conditions, including electrolyte levels that's out of balance, heart rhythm problems, or are taking other medications that cause heart rhythm problems, such as digoxin (Lanoxin), among others. If you feel your chest pounding, have trouble breathing, have chest pain, or feel faint or lightheaded while taking atazanavir (Reyataz), get medical attention right away.
Atazanavir (Reyataz) can sometimes cause rash and other severe skin reactions. Rash is most common in the first 8 weeks of treatment and can often last a little more than a week. If you have a mild or moderate rash, continue to take atazanavir (Reyataz) and let your provider know. If you have a severe rash or your rash gets worse, talk with your provider right away. In rare cases, if you experience a severe rash with fever, general discomfort, muscle or joint pain, mouth sores, blisters, or facial swelling, stop taking atazanavir (Reyataz) right away and get medical attention.
Risk factors: Hepatitis B or C | History of liver problems
Atazanavir (Reyataz) can cause life-threatening liver problems. In particular, this medication can cause a buildup of bilirubin, a yellow toxin that can lead to jaundice. As a result, your provider will order blood tests for you before and during treatment so they can make sure this medication is safe for your liver. Let your provider know immediately if you experience signs and symptoms of liver damage, such as feeling sleepy, nausea, loss of appetite, light-colored stool, upper right stomach pain, yellowing of the skin or eyes, or dark urine.
Risk factors: History of kidney problems | Taking other medications that can cause kidney problems
Atazanavir (Reyataz) can cause kidney damage and is not a good option for people with kidney problems or are at risk for kidney problems. Before and during treatment with this medication, your provider will check your blood works to make sure atazanavir (Reyataz) is safe for you kidneys. Make sure your provider knows all the medications you take, including over-the-counter (OTC) pain or cold medications. Many of these medications can include ingredients, such as ibuprofen (Advil), that can cause kidney problems. Avoid taking atazanavir (Reyataz) if you're on dialysis.
Though rare, few people who took atazanavir (Reyataz) have reported developing kidney stones or gallstones during treatment. Stop taking atazanavir (Reyataz) and let your provider know right away if you experience symptoms such as pain in the lower stomach or back, nausea, and vomiting.
Risk factor: Taking certain HIV ARVs (e.g., protease inhibitors)
Taking atazanavir (Reyataz) and certain HIV ARVs can raise your blood sugar levels or worsen your diabetes. In some cases, your provider will need to adjust your dose of diabetic medications to make sure your blood sugar is under control. If you have a history of diabetes, let your provider know before starting atazanavir (Reyataz). Your provider might ask you to check your blood sugar at home to make sure this medication is safe for you.
Taking combination ARV therapy, such as atazanavir (Reyataz) with other HIV medications, can cause changes to your immune system called immune reconstitution syndrome. This condition happens when your immune system becomes overly active after you start combination therapy. So your immune system begins to fight off different infections that it was too weak to fight off before you started treatment. In rare cases, your immune response might improve too much with treatment that it starts to attack normal cells in your body (autoimmune). You can develop these conditions as early as during the first few weeks of treatment or many months later. Tell your healthcare provider right away if you start having any new symptoms, such as fever, pain, hair loss, bulging eyes, or sweating, after starting atazanavir (Reyataz).
Rarely, people taking HIV medications, such as atazanavir (Reyataz), have experienced changes in body fat. These changes include fat buildup in the back of the neck, breast, and around the middle of the body. Some people also lost fat from the legs, arms, and face. It's not clear whether atazanavir (Reyataz) causes these changes to body fat, why this happens, and whether it will affect your health in the future. Let your provider know if these changes occur while you're taking atazanavir (Reyataz).
Risk factor: History of bleeding problems
Some people with a bleeding condition called hemophilia have had more bleeding after starting protease inhibitors, such as atazanavir (Reyataz). About half the time, you can continue taking this medication after the bleeding stops. Let your provider know if you notice sudden bleeding or have bleeding that's difficult to stop.
Some medications can interfere with how well your body gets rid of atazanavir (Reyataz) from your system. This can affect the amount of atazanavir (Reyataz) in your body, how well it works, and the risk of side effects.
Taking certain supplements (e.g., St. John's Wort) or tuberculosis medication (e.g., rifampin (Rifadin)) can lower the amount of atazanavir (Reyataz) in your body. This can make atazanavir (Reyataz) not work as well to treat your HIV. So this combination must be avoided.
Atazanavir (Reyataz) also interferes with how your body gets rid of other medications. For example, taking atazanavir (Reyataz) with medications like alfuzosin (Uroxatral) can raise the amount of alfuzosin in your body. This can lead to dangerously low blood pressure. In addition, taking atazanavir (Reyataz) with some statins (e.g., lovastatin (Altoprev), simvastatin (Zocor)) can cause your body to absorb more of these statins and raise your risk for serious muscle problems.
Because of the potential for serious interactions with atazanavir (Reyataz) and various medications, tell your provider and pharmacist about all the medications you take or plan to take. They can make sure your medications are safe to take together.
Atazanavir (Reyataz) oral tablets
Adults: The typical dose ranges from 300 mg to 400 mg by mouth once daily. Your provider will determine your dose based on different factors, such as whether you're taking ritonavir (Norvir), and whether or not you've taken another protease inhibitor before.
Children 6 years and older: The dose will depend on your child's weight.
15 kg (33 lbs) to less than 35 kg (77 lbs): The typical dose is 200 mg by mouth once a day taken together with 100 mg ritonavir (Norvir) and food.
35 kg (77 lbs) and more: The typical dose is 300 mg by mouth once a day taken together with 100 mg ritonavir (Norvir) and food.
Atazanavir (Reyataz) oral powder
Children 3 months and older: The dose will depend on your child's weight.
5 kg (11 lbs) to less than 15 kg (33 lbs): The typical dose is 200 mg by mouth once a day taken together with 80 mg ritonavir (Norvir) and food.
15 kg (33 lbs) to less than 25 kg (55 lbs): The typical dose is 250 mg by mouth once a day taken together with 80 mg ritonavir (Norvir) and food.
Your dose might be different if you've kidney or liver problems. Your dose might also be different if you're pregnant.
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.
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.
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.
Taken with certain medications that are cleared by a specific liver protein (CYP3A4 or UGT1A1), including alfuzosin (Uroxatral), rifampin (Rifadin), lovastatin, and simvastatin (Zocor)
Treatment of HIV infection in people aged 3 years and older
By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
Bristol-Myers Squibb Company. (2020). Instructions for use: Reyataz (RAY-ah-taz) (atazanavir) oral powder.
Centers for Disease Control and Prevention. (2023). What is hemophilia?
Clinical Info HIV.gov. (n.d.). Boosting.
Clinical Info HIV.gov. (n.d.). Immune reconstitution inflammatory syndrome (IRIS).
Clinical Info HIV.gov. (n.d.). Nucleoside reverse transcriptase inhibitor (NRTI).
Clinical Info HIV.gov. (2023). Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States.
E.R. Squibb & Sons, L.L.C. (2023). REYATAZ- atazanavir capsule, gelatin coated REYATAZ- atazanavir powder [package insert]. DailyMed.
HIVinfo.NIH.gov. (2021). Drug resistance.
MedlinePlus. (2022.). Bilirubin blood test.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Symptoms & causes of gallstones.
Thapa, S., et al. (2023). Immune reconstitution inflammatory syndrome. StatPearls.
U.S. Food and Drug Administration. (2023). Drug development and drug interactions | Table of substrates, inhibitors and inducers.
Zydus Pharmaceuticals USA Inc. (2022). Atazanavir- atazanavir capsule [package insert]. DailyMed.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.