Atazanavir with Dexlansoprazole Interaction Details
Brand Names Associated with Atazanavir
- Atazanavir
- ATZ
- Reyataz®
Brand Names Associated with Dexlansoprazole
- Dexilant® (formerly available as Kapidex®)
- Dexlansoprazole
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 29, 2024
Interaction Effect
Reduced atazanavir exposure and an increased risk of reduced efficacy and development of resistance
Interaction Summary
Concomitant use of atazanavir and a PPI may result in substantially decreased atazanavir exposure, leading to a loss of atazanavir efficacy and development of HIV resistance. When multiple doses of atazanavir 400 mg once daily was given with omeprazole at 40 mg once daily (2 hours before atazanavir), atazanavir AUC decreased by 94%, Cmax by 96%, and Cmin by 95%[1][2]. Therefore, coadministration is not recommended, especially in treatment-experienced patients. If use in treatment-naive patients is required, do not exceed a PPI dose equivalent to omeprazole 20 mg and administer the PPI 12 hours prior to atazanavir [2].
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of atazanavir and a proton pump inhibitor (PPI) may result in substantially decreased atazanavir exposure, leading to a loss of atazanavir efficacy and development of HIV resistance. Therefore, coadministration is not recommended[3][4][5][6][7][8][9][1], especially in treatment-experienced patients. If use in treatment-naive patients is required, do not exceed a PPI dose equivalent to omeprazole 20 mg and administer the PPI 12 hours prior to atazanavir [2].
Mechanism Of Interaction
Reduced absorption due to decreased intragastric acidity
Literature Reports
A) Concomitant administration of multiple doses of atazanavir 400 mg once daily with omeprazole 40 mg once daily (2 hours before atazanavir) in 16 subjects resulted in decreases in atazanavir AUC by 94%, Cmax by 96%, and Cmin by 95% [2][1].
References
1 ) Product Information: KONVOMEP(TM) powder for oral suspension, omeprazole sodium bicarbonate powder for oral suspension. Azurity Pharmaceuticals Inc (per manufacturer), Woburn, MA, 2022.
2 ) Product Information: REYATAZ(R) oral capsules, powder, atazanavir oral capsules, powder. Bristol-Myers Squibb (per FDA), Princeton, NJ, 2014.
3 ) Product Information: DEXILANT(TM) oral delayed-release capsules, dexlansoprazole oral delayed-release capsules. Takeda Pharmaceuticals America, Inc. (per FDA), Deerfield, IL, 2014.
4 ) Product Information: NEXIUM(R) oral delayed-release capsules, suspension, esomeprazole magnesium oral delayed-release capsules, suspension. AstraZeneca LP (per FDA), Wilmington, DE, 2014.
5 ) Product Information: esomeprazole strontium oral delayed-release capsules, esomeprazole strontium oral delayed-release capsules. Amneal Pharmaceuticals (per FDA), Glasgow, KY, 2014.
6 ) Product Information: PREVACID oral delayed-release capsules, lansoprazole oral delayed-release capsules. Takeda Pharmaceuticals America (per FDA), Deerfield, IL, 2014.
7 ) Product Information: PRILOSEC oral delayed-release suspension, omeprazole magnesium oral delayed-release suspension. AstraZeneca LP (per FDA), Wilmington, DE, 2014.
8 ) Product Information: PROTONIX(R) I.V. intravenous injection, pantoprazole sodium intravenous injection. Wyeth Pharmaceuticals (per FDA), Philadelphia, PA, 2014.
9 ) Product Information: ACIPHEX(R) Sprinkle(TM) oral delayed release capsules, rabeprazole sodium oral delayed release capsules. FSC Laboratories, Inc. (per FDA), Charlotte, NC, 2014.
Atazanavir Overview
-
Atazanavir is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children who are at least 3 months of age and weigh at least 22 lb (10 kg). Atazanavir is in a class of medications called protease inhibitors. It works by decreasing the amount of HIV in the blood. Although atazanavir does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Atazanavir must be given with other medications that treat HIV infection to completely treat the infection. Taking these medications along with practicing safer sex and making other lifestyle changes may decrease the risk of transmitting the HIV virus to other people.
Dexlansoprazole Overview
-
Dexlansoprazole is used to treat the symptoms of gastroesophageal reflux disease (GERD; a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus [tube between the throat and stomach]) in adults and children 12 years of age and older. It is also used to treat esophagitis (swelling that may damage tissues of the esophagus) in adults and children 12 years of age and older. Dexlansoprazole is used for the maintenance treatment of esophagitis and healing in adults and children 12 years of age and older. Dexlansoprazole is in a class of medications called proton pump inhibitors. It works by decreasing the amount of acid made in the stomach.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.