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Drug interactions

Atazanavir + Lansoprazole

Severity: Major

Atazanavir and Lansoprazole: major interaction.

Last updated

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 absorption depends on gastric acidity, and lansoprazole markedly lowers atazanavir concentrations. This risks loss of virologic suppression and development of resistance.

What this interaction means in plain words

Atazanavir and Lansoprazole 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; Lansoprazole belongs to Gastrointestinal Tract.

Evidence level: High

Why it happens

Higher gastric pH decreases atazanavir solubility and hence absorption.

What to do

Avoid PPIs in treatment-experienced patients on atazanavir. In treatment-naive patients, follow labeling for a low PPI dose taken about 12 hours before ritonavir-boosted atazanavir, or use an alternative antiretroviral.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Atazanavir with Lansoprazole?

MediHelp rates the interaction as major. Atazanavir and Lansoprazole 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 absorption depends on gastric acidity, and lansoprazole markedly lowers atazanavir concentrations. This risks loss of virologic suppression and development of resistance.

How serious is the interaction between Atazanavir and Lansoprazole?

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 PPIs in treatment-experienced patients on atazanavir. In treatment-naive patients, follow labeling for a low PPI dose taken about 12 hours before ritonavir-boosted atazanavir, or use an alternative antiretroviral.

What other medicines interact with Lansoprazole?

MediHelp also lists interactions of Lansoprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Lansoprazole page.

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