Drug interactions
Atazanavir + Everolimus
Severity: Major
Atazanavir and Everolimus: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir is a strong CYP3A4 inhibitor (typically boosted with ritonavir or cobicistat) and may markedly raise everolimus concentrations. This increases the risk of stomatitis, infections, pneumonitis, myelosuppression and metabolic toxicity.
What this interaction means in plain words
Atazanavir and Everolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Everolimus belongs to Oncology.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces everolimus clearance.
What to do
Avoid concomitant use and choose an alternative antiretroviral with less CYP3A4 inhibition. If it cannot be avoided, reduce the everolimus dose and monitor trough levels and toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Everolimus?
MediHelp rates the interaction as major. Atazanavir and Everolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir is a strong CYP3A4 inhibitor (typically boosted with ritonavir or cobicistat) and may markedly raise everolimus concentrations. This increases the risk of stomatitis, infections, pneumonitis, myelosuppression and metabolic toxicity.
How serious is the interaction between Atazanavir and Everolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concomitant use and choose an alternative antiretroviral with less CYP3A4 inhibition. If it cannot be avoided, reduce the everolimus dose and monitor trough levels and toxicity.
What other medicines interact with Everolimus?
MediHelp also lists interactions of Everolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Levoketoconazole. The full list is on the Everolimus page.
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