atazanavir, Reyataz (cont.)

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Atazanavir is best absorbed under acidic conditions. Therefore, medications that decrease stomach acidity could reduce the absorption of atazanavir. Drugs that decrease stomach acidity include antacids, proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex) esomeprazole (Nexium); H2-receptor antagonists such as cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), nizatidine (Axid); and buffered drugs such as didanosine (Videx). Individuals who are taking antacids or didanosine should take their atazanavir two hours before or one hour after the didanosine or antacid. Proton pump inhibitors should not be combined with atazanavir in previously treated patients. For treatment naive patients the dose of proton pump inhibitor should not exceed the equivalent of omeprazole 20 mg and must be given 12 hours before administration of atazanavir. The dose of H2-antagonists should not exceed the equivalent of 40 mg famotidine twice daily and atazanavir should be administered 2 hours before or 10 hours after administration of the H2-antagonists.

Atazanavir increases the effect of warfarin (Coumadin). Therefore the effect of warfarin should be monitored more frequently and doses should be modified accordingly.

Combining amiodarone (Cordarone), lidocaine, quinidine, or bepridil (Vascor) with atazanavir may cause dangerous abnormal heart rhythms.

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