atazanavir

• 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.