If you or someone you care for is starting atazanavir, here's a straightforward rundown you can use at the clinic or at home. Atazanavir is an HIV protease inhibitor used as part of combination antiretroviral therapy. It helps stop HIV from making new virus particles and works best when taken with other HIV drugs.
Atazanavir is usually given as 300 mg once daily with a booster: either ritonavir 100 mg or cobicistat 150 mg. Taking it with food raises absorption, so swallow it with a meal. Avoid missing doses—consistency matters for keeping the virus suppressed. For people with severe liver problems, doctors adjust the dose or choose a different drug, so tell your provider about any liver disease.
The most noticeable side effect is an increase in bilirubin. That can make your skin or eyes look yellow (jaundice) without meaning your liver is failing. It looks alarming but often isn't dangerous; still, tell your doctor if it appears. Other side effects include nausea, headache, and stomach upset. Atazanavir can also affect heart rhythm in people with certain conditions—if you have a history of heart block or take other drugs that slow conduction, your doctor may want an ECG.
Less common but important issues: some people develop kidney stones or changes in kidney lab tests, and long-term metabolic effects like changes in cholesterol can occur. Regular blood tests help track these problems.
Drug interactions matter a lot with atazanavir. It needs an acidic stomach to be absorbed, so antacids, H2 blockers, and proton pump inhibitors can lower its levels—PPIs are generally discouraged. St. John's wort and rifampin reduce atazanavir effectiveness and should be avoided. Many statins and other common drugs interact too, so always check with a pharmacist before starting new medicines or supplements.
If you're planning pregnancy or breastfeeding, tell your healthcare team. Atazanavir has been used in pregnancy, but choices depend on individual situations and current guidelines.
Monitoring while on atazanavir usually includes routine bloodwork: liver tests, bilirubin, kidney function, and lipid panels. Your clinic will set the schedule, but expect checks early on and at regular follow-ups.
Practical tips: take atazanavir with food, space antacids at least two hours before or one hour after dosing (only if your doctor allows), keep a current list of all medicines with you, and contact your care team if you notice yellowing of skin or eyes, dark urine, severe stomach pain, or fainting.
Buying medication online? Be careful. Use only licensed pharmacies and avoid sellers who skip prescriptions or offer unreal prices. When in doubt, ask your clinic or local pharmacist for help—safer options beat a risky bargain every time.
Have questions about how atazanavir fits into your treatment plan? Talk with your HIV care provider—they can explain alternatives, boosters, and monitoring tailored to your needs.
