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PCE Dispertab and Reyataz (Atazanavir Powder for Oral Suspension)

Determining the interaction of PCE Dispertab and Reyataz (Atazanavir Powder for Oral Suspension) and the possibility of their joint administration.

Check result:

PCE Dispertab <> Reyataz (Atazanavir Powder for Oral Suspension)

Relevance: 03.12.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using atazanavir together with erythromycin may increase the blood levels and effects of both medications. Increased blood levels of erythromycin can cause an irregular heart rhythm that may be serious. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration of a macrolide antibiotic, such as clarithromycin or erythromycin, with atazanavir and/or cobicistat may increase the plasma concentrations of all the drugs involved. The mechanism may involve both competitive and noncompetitive inhibition of CYP450 3A4, since these drugs are all substrates as well as inhibitors of the isoenzyme. Clinically elevated plasma levels of clarithromycin or erythromycin may increase the risk of QT interval prolongation and torsade de pointes. In a population-based retrospective study of 1476 cases of confirmed sudden death from cardiac causes, concurrent use of erythromycin and a CYP450 3A4 inhibitor was associated with a marked increase in the risk of sudden death from cardiac causes.

MANAGEMENT: Alternative antibiotics should be considered. If clarithromycin or erythromycin is used in combination with atazanavir and/or cobicistat, caution and close clinical monitoring are recommended. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitations, irregular heartbeat, shortness of breath, or syncope. For clarithromycin, a dosage reduction by 50% is recommended in patients with CrCl between 50 and 60 mL/min. No dosage adjustment is needed in patients with CrCl at or above 60 mL/min. Some authorities recommend avoiding the use of the fixed combination atazanavir-cobicistat with a macrolide antibiotic.

References

"Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb, Princeton, NJ.
"Product Information. Evotaz (atazanavir-cobicistat)." Bristol-Myers Squibb, Princeton, NJ.
"Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences, Foster City, CA.
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Cerner Multum, Inc. "Australian Product Information." O 0
Iannini PB "Cardiotoxicity of macrolides, ketolides and fluoroquinolones that prolong the QTc interval." Expert Opin Drug Saf 1 (2002): 121-8
Ray WA, Murray KT, Meredith S, Narasimhulu SS, Hall K, Stein CM "Oral erythromycin and the risk of sudden death from cardiac causes." N Engl J Med 351 (2004): 1089-96

PCE Dispertab

Generic Name: erythromycin

Brand name: EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, E. E. S, EryPed, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: PCE Dispertab (Oral), PCE, PCE (Oral)

What is PCE Dispertab?

Reyataz (Atazanavir Powder for Oral Suspension)

Generic Name: atazanavir

Brand name: Reyataz

Synonyms: Reyataz

What is Reyataz (Atazanavir Powder for Oral Suspension)?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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