Evotaz

• Risk factors: History of heartbeat problems | Taking medications that can affect heart rhythm

Evotaz (atazanavir / cobicistat) can affect your heart rhythm, which can sometimes be serious. Your risk might be higher if you have heart rhythm problems (e.g., heart block) or if you take other medications that cause changes in heart rhythm. Make sure your HIV provider and cardiologist know about the medical conditions you have and the medications you're taking. Your cardiologist might choose to monitor your heartbeat more often if you're at risk for changes in heart rhythm. Get medical attention right away if you feel your chest pounding, have trouble breathing, have chest pain, or feel faint or lightheaded while you're taking Evotaz (atazanavir / cobicistat).

Tell your provider about any new rashes that you have after you start Evotaz (atazanavir / cobicistat). Some people who took this medication had rash and other severe skin reactions. In studies, mild-to-moderate rashes happened within the first 7 weeks of treatment and often went away after a week or so. But stop the medication and get medical attention right away if you get a severe rash, high fever, muscle or joint pain, mouth sores, blisters, or peeling skin. These can be signs of a severe skin reaction.

• Risk factors: History of kidney damage | Also taking tenofovir disoproxil fumarate | Taking other medications that can cause kidney problems

Evotaz (atazanavir / cobicistat) can cause changes to your blood test results that tell your provider about your kidney health. In some cases, these changes can suggest kidney damage. In addition, some people who took Evotaz (atazanavir / cobicistat) reported developing kidney problems.

The risk for kidney damage might be higher for people with a history of kidney problems and for people taking other medications that can harm the kidneys, including tenofovir disoproxil fumarate (Viread) and NSAIDs like ibuprofen (Advil). Tell your provider about your medical conditions and the medications you take (including over-the-counter pain or cold medications). Also, get routine blood work done so your provider can check your kidney function.

Some people taking Evotaz (atazanavir / cobicistat) have kidney stones or gallstones. Talk to your provider if you notice any signs of kidney stones or gallstones, such as unusual pain in your stomach or sides with nausea or vomiting, difficulty urinating, fever, or blood in your urine.

• Risk factors: History of liver problems | Hepatitis B or C infection

Some people have had elevated liver enzyme levels after they start Evotaz (atazanavir / cobicistat). These changes might suggest liver damage. Some people with liver conditions, like hepatitis B or hepatitis C infection, are at risk for worsening liver problems. Make sure your healthcare providers know about the medical conditions you have. Your provider might order blood tests to check your liver before you start Evotaz (atazanavir / cobicistat) and periodically during treatment.

Evotaz (atazanavir / cobicistat) can raise your blood levels of bilirubin, which can lead to jaundice (yellowing of the skin or the white part of your eyes). Let your provider know if you develop jaundice. Discuss with your provider whether you can switch to a different HIV medication if you're concerned about your skin or eye color. This yellowing will go away once Evotaz (atazanavir / cobicistat) is stopped, but don't stop the medication until your provider tells you to so your HIV treatment isn't interrupted.

Evotaz (atazanavir / cobicistat) interacts with a lot of medications. Many times, Evotaz (atazanavir / cobicistat) causes the levels of other medications to build up in your body, which can lead to serious or deadly side effects. Other times, medications can lower Evotaz (atazanavir / cobicistat) levels in the body and interfere with how the HIV medication works.

It isn't recommended to use Evotaz (atazanavir / cobicistat) with other HIV medications that need boosting, like other protease inhibitors or medications containing elvitegravir (e.g., Genvoya, Stribild). Doing so might make the medications work less well and raise the risk for drug resistance. It also isn't recommended to use Evotaz (atazanavir / cobicistat) with other medications containing ritonavir (Norvir) because cobicistat and ritonavir work similarly.

Because of the risk for drug interactions, it's important to talk to your healthcare providers and pharmacists before you start or stop any medications. Your providers can check that your medications are safe for you.

Taking combination ARV therapy 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. 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 so much with treatment that it starts to attack normal cells in your body. You can develop these autoimmune conditions at any time (during the first few weeks of treatment or many months later). Tell your provider right away if you have any new symptoms, such as fever, pain, trouble breathing, hair loss, bulging eyes, sweating, or other sudden changes to your health, after you start Evotaz (atazanavir / cobicistat).

Some people taking protease inhibitors like Evotaz (atazanavir / cobicistat) had high blood sugar levels. Sometimes, this led to diabetes or worsened diabetes. If this happens, your provider might need to adjust your diabetes medications to make sure your blood sugar is under control. Tell your provider before you start Evotaz (atazanavir / cobicistat) if you have a history of diabetes. Your provider might recommend that you check your blood sugar at home to make sure this medication is safe for you.

Some people taking HIV medications, such as Evotaz (atazanavir / cobicistat), have noticed changes in body fat. These changes might look like fat buildup in the upper back, breast, or stomach area. Other people have also lost fat from the legs, arm, and face. It's not clear whether Evotaz (atazanavir / cobicistat) causes these changes to body fat, why this happens, and whether it will affect your health in the future. Tell your provider if you notice these changes while you're taking Evotaz (atazanavir / cobicistat).

Some people who have a genetic bleeding condition called hemophilia have had more bleeding after starting protease inhibitors like Evotaz (atazanavir / cobicistat). Some people might need treatment with blood products like factor VIII. In most cases, treatment with Evotaz (atazanavir / cobicistat) continued or was restarted after the bleeding stopped. It's not clear whether the medication is related to more bleeding. Tell your provider if you have hemophilia before you start Evotaz (atazanavir / cobicistat).