Drug Interactions Newsletter

Volume 3, Issue 22, 06/14/2011

Question

Why should the proton pump inhibitor omeprazole (Prilosec) be avoided in treatment-experienced HIV infected patients taking the protease inhibitor, atazanavir (Reyataz)?

Answer

Atazanavir (Reyataz) is a once-daily administered protease inhibitor (PI) that can be used as part of the combination antiretroviral therapy in the management of human immunodeficiency virus (HIV) infection.(1)  Unfortunately, many HIV infected patients have gastrointestinal disorders, such as gastritis and gastroesophageal reflux disease (GERD), for which proton pump inhibitors are commonly used to manage the problem.(2)  As such, it is plausible that an HIV infected patient on combined antiretroviral therapy will either be prescribed or self initiate omeprazole (Prilosec) given its over-the-counter (OTC) status.   

Unfortunately, the current product package insert for atazanavir recommends that HIV infected patients with antiretroviral treatment experience...

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