Drug interactions
Atazanavir + Methylprednisolone
Severity: Major
Atazanavir and Methylprednisolone: major interaction.
Last updated Sources: UK SmPC
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, especially when boosted with ritonavir or cobicistat, inhibits CYP3A4 and can raise methylprednisolone exposure. This may cause excess corticosteroid effects such as Cushing's syndrome, adrenal suppression, hyperglycemia and infection risk with prolonged use.
What this interaction means in plain words
Atazanavir and Methylprednisolone 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; Methylprednisolone belongs to Endocrine.
Why it happens
Inhibition of CYP3A4-mediated metabolism of methylprednisolone by atazanavir.
What to do
For short courses, monitor for steroid adverse effects; for long-term therapy consider reducing the methylprednisolone dose or choosing a corticosteroid less dependent on CYP3A4, such as prednisolone.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Atazanavir and Methylprednisolone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
- Depo-Medrone 40mg/ml Suspension for Injection - SmPC sections 4.3/4.5 (class statement: HIV protease inhibitors; "9. Antivirals - HIV protease inhibitors:") — electronic medicines compendium (UK SmPC)
Other interactions of Methylprednisolone
- Bcg vaccine live + Methylprednisolone Contraindicated
- Measles mumps and rubella vaccine live + Methylprednisolone Contraindicated
- Measles mumps rubella and varicella vaccine live + Methylprednisolone Contraindicated
- Measles vaccine + Methylprednisolone Contraindicated
- Methylprednisolone + Mifepristone Contraindicated
- Methylprednisolone + Rubella 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 Methylprednisolone?
MediHelp rates the interaction as major. Atazanavir and Methylprednisolone 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, especially when boosted with ritonavir or cobicistat, inhibits CYP3A4 and can raise methylprednisolone exposure. This may cause excess corticosteroid effects such as Cushing's syndrome, adrenal suppression, hyperglycemia and infection risk with prolonged use.
How serious is the interaction between Atazanavir and Methylprednisolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: For short courses, monitor for steroid adverse effects; for long-term therapy consider reducing the methylprednisolone dose or choosing a corticosteroid less dependent on CYP3A4, such as prednisolone.
What other medicines interact with Methylprednisolone?
MediHelp also lists interactions of Methylprednisolone with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Methylprednisolone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
