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The following safety and warning information is crucial for understanding the potential risks and necessary precautions when using Atazanavir (Reyataz). Please read carefully and discuss any concerns with your healthcare provider.

• Heart Rhythm Issues: Atazanavir can lead to serious and potentially life-threatening heart rhythm disturbances, particularly in individuals with existing heart conditions or imbalanced electrolytes. If you experience symptoms such as chest pain, palpitations, shortness of breath, or dizziness, seek immediate medical attention. Those with a history of heart problems or who are taking medications like digoxin that affect heart rhythm are at increased risk.

• Severe Skin and Allergic Reactions: Skin rashes and severe allergic reactions may occur, especially within the first eight weeks of treatment. Mild rashes should be reported to your healthcare provider, but severe rashes, especially those accompanied by fever, discomfort, joint pain, or facial swelling, require immediate discontinuation of the medication and urgent medical care.

• Liver Issues: Atazanavir can cause severe liver damage, including a dangerous increase in bilirubin levels, potentially leading to jaundice. Regular blood tests are important to monitor liver function. Notify your provider immediately if you experience symptoms such as fatigue, nausea, jaundice, or dark urine. Individuals with hepatitis B or C or a history of liver problems are at higher risk.

• Kidney Concerns: This medication can harm the kidneys, making it unsuitable for individuals with pre-existing kidney issues or those at risk. Regular monitoring through blood tests is recommended, and it's important to inform your provider of all medications you are taking. Avoid Atazanavir if you are on dialysis.

• Kidney Stones or Gallstones: Though rare, some individuals may develop kidney or gallstones. Symptoms like abdominal or back pain, nausea, or vomiting should prompt immediate cessation of the medication and consultation with a healthcare provider.

• High Blood Sugar: Atazanavir, especially when used with certain HIV antiretrovirals, can elevate blood sugar levels, potentially worsening diabetes. Inform your provider of any history of diabetes, as they may need to adjust your diabetic medications and monitor your blood sugar.

• Overactive Immune System: This medication may trigger immune reconstitution syndrome, leading to an overly active immune system that can attack both infections and normal cells. Report any new symptoms such as fever, pain, or sweating to your provider.

• Body Fat Changes: Rarely, changes in body fat distribution may occur, such as fat buildup in certain areas or fat loss in others. Report any noticeable changes to your provider.

• Bleeding Risks: Individuals with hemophilia or a history of bleeding issues may experience increased bleeding. If bleeding occurs, notify your provider, though you may continue the medication once the bleeding stops.

• Drug Interactions: Certain medications can affect how Atazanavir is metabolized, altering its effectiveness and side effects. Discuss all current medications with your healthcare provider.

Contraindications highlight situations where Atazanavir should not be used, as it may pose serious health risks. Avoid this medication if you are taking drugs metabolized by liver proteins such as CYP3A4 or UGT1A1, including alfuzosin, rifampin, lovastatin, and simvastatin. Always consult your healthcare provider if you fall into these categories before starting Atazanavir.

When taking this medication, some common side effects you might experience include nausea, headaches, elevated liver enzymes, increased cholesterol levels, and in some cases, a mild rash. These effects are often not severe, but if they persist or worsen, it's advisable to consult your healthcare provider. Additionally, you might notice yellowing of the skin or eyes, vomiting, abdominal pain, nerve pain, and diarrhea. While these symptoms can be concerning, they are typically manageable with medical advice.

Other side effects that have been reported include trouble sleeping, dizziness, fever, and feelings of depression. While these are less common, they should be monitored, and any persistence should be discussed with a healthcare professional.

It is crucial to be aware of rare but serious side effects, such as severe allergic reactions, which may present as facial swelling, hives, blistering or peeling skin, and difficulty breathing. Serious liver issues may also occur, indicated by persistent nausea, vomiting, lack of appetite, right-sided stomach pain, jaundice, dark urine, and light-colored stools. Abnormal heart rhythms, indicated by chest pain, breathing difficulties, or feeling faint, require immediate medical attention. Always seek urgent care if you experience these severe symptoms.

Atazanavir, also known as Reyataz, can interact with several medications, potentially altering their effectiveness or how they are processed in the body. Notably, it may impact certain drugs used for chronic hepatitis C, such as elbasvir/grazoprevir and glecaprevir/pibrentasvir, and some HIV treatments, like the combination of elvitegravir/cobicistat/emtricitabine/tenofovir, as well as nevirapine and orlistat.

Some medications can change how atazanavir is removed from your body, affecting its effectiveness. These include drugs like apalutamide, bosentan, certain antiepileptics (e.g., carbamazepine, phenobarbital, phenytoin, primidone), and herbal supplements like St. John's wort.

Conversely, atazanavir may slow the clearance of other drugs, potentially affecting their function. This includes certain alpha blockers like alfuzosin and silodosin, benzodiazepines such as midazolam and triazolam, ergot alkaloids, and statin medications like lovastatin and simvastatin, among others.

Additionally, medications that reduce stomach acid, such as H2 blockers and proton pump inhibitors, can decrease the absorption of atazanavir, possibly reducing its effectiveness. Furthermore, atazanavir may decrease the effectiveness of hormonal birth control methods. It is advisable to discuss alternative or additional contraceptive methods with your healthcare provider.

Always inform your doctor or pharmacist about all the medications and supplements you are taking to appropriately manage potential interactions with atazanavir.