EVOTAZ

Atazanavir Sulfate 300mg, Cobicistat 150mg, Oral tablet

Marijuana

· Severity: Moderate

· Notes for Consumers: The effects of marijuana may be increased and side effects may get worse if it is combined with this medicine. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: The pharmacokinetic parameters of anti-retroviral medications (anti-retroviral non-nucleoside reverse transcriptase inhibitors (NNRTIs), anti-retroviral nucleoside reverse transcriptase inhibitors (NRTIs), anti-retroviral nucleotide reverse transcriptase inhibitors, and anti-retroviral protease inhibitors) metabolized through the CYP isoenzyme system are slightly altered by smoked and oral marijuana. Despite this interaction, marijuana is not expected to adversely affect anti-retroviral efficacy. However, the incidence of marijuana associated adverse effects may change following coadministration with anti-retroviral drugs. Many anti-retrovirals are inhibitors of CYP3A4, an isoenzyme partially responsible for the metabolism of marijuana's most psychoactive compound, delta-9-tetrahydrocannabinol (Delta-9-THC). When given concurrently with anti-retrovirals, the amount of Delta-9-THC converted to the active metabolite 11-hydroxy-delta-9-tetrahydrocannabinol (11-OH-THC) may be reduced. These changes in Delta-9-THC and 11-OH-THC plasma concentrations may result in an altered marijuana adverse event profile.

Atazanavir Sulfate 300mg, Cobicistat 150mg, Oral tablet

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: Although an interaction between Atazanavir and grapefruit or grapefruit juice is possible, they can be used together. Side effects from Atazanavir such as nausea, diarrhea, or headache, may get worse if you also take grapefruit juice or grapefruit. If you eat grapefruit or drink grapefruit juice, keep your consumption regular (do not drastically change your intake) and tell your health care provider that grapefruit is part of your diet. Contact your health care professional if you develop jaundice, abdominal pain, yellowing of the skin, or rash.

· Notes for Professionals: Grapefruit or grapefruit juice ingestion may theoretically increase atazanavir serum concentrations. The possible increase in atazanavir bioavailability would be most likely due to inhibition of the CYP3A4 isoenzyme in the gut. Individuals should not drastically alter their intake of grapefruit or grapefruit juice or should avoid concurrent use unless advised differently by their health care professional.

Atazanavir Sulfate 300mg, Cobicistat 150mg, Oral tablet

Food

· Severity: Major

· Notes for Consumers: Do not take Atazanavir with Food high in calories or fat. It is best to take atazanavir with a light meal or snack. If you eat grapefruit or drink grapefruit juice, keep your consumption regular (do not drastically change your intake) and tell your health care provider that grapefruit is part of your diet.

· Notes for Professionals: Atazanavir needs to be taken with a light snack or meal, such as dry toast with jelly, apple juice, and coffee with skim milk in order to enhance oral absorption. However, administration with food high in calories and fat can result in a decrease in the AUC of atazanavir.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>