Complete adverse effect profile including incidence rates and management
Important Safety Information
This is not a complete list of all possible side effects. Contact your healthcare provider if you experience any unexpected symptoms. For serious or life-threatening side effects, seek emergency medical attention immediately.
6 ADVERSE REACTIONS The following adverse reactions are discussed in greater detail in other sections of the labeling: • cardiac conduction abnormalities [see Warnings and Precautions (5.1) ] • rash [see Warnings and Precautions (5.2) ] • effects on serum creatinine [see Warnings and Precautions (5.3) ] • new onset or worsening renal impairment when used with tenofovir DF [see Warnings and Precautions (5.4) ] • chronic kidney disease [see Warnings and Precautions (5.5) ] • nephrolithiasis and cholelithiasis [see Warnings and Precautions (5.6) ] • hepatotoxicity [see Warnings and Precautions (5.7) ] • hyperbilirubinemia [see Warnings and Precautions (5.10) ] For additional safety information about atazanavir and cobicistat, consult the full prescribing information for these individual products.
Most common adverse reactions seen with atazanavir coadministered with cobicistat (greater than 5%, Grades 2-4) are jaundice and rash.
(6.1) To report SUSPECTED ADVERSE REACTIONS, contact Bristol-Myers Squibb at 1-800-721-5072 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1 Clinical Trial Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Adverse Reactions from Clinical Trial Experience in Adult Participants The safety of atazanavir and cobicistat coadministered as single agents is based on Week 144 data from a Phase 3 trial, Study GS-US-216-0114, in which 692 antiretroviral treatment-naive participants with HIV-1 received: • atazanavir coadministered with cobicistat and emtricitabine/tenofovir DF (N=344) or • atazanavir coadministered with ritonavir and emtricitabine/tenofovir DF (N=348).
The most common adverse reactions (Grades 2-4) and reported in ≥5% of participants in the atazanavir coadministered with cobicistat group were jaundice (6%) and rash (5%).
The proportion of participants who discontinued study treatment due to adverse events regardless of severity, was 11% in both the atazanavir coadministered with cobicistat and atazanavir coadministered with ritonavir groups.
Table 2 lists the frequency of adverse reactions (Grades 2-4) occurring in at least 2% of participants in the atazanavir coadministered with cobicistat group in Study GS-US-216-
Table 2: Selected Adverse Reactions a (Grades 2-4) Reported in ≥2% of Treatment-Naive Adults with HIV-1 in the Atazanavir Coadministered with Cobicistat Group in Study GS-US-216-0114 (Week 144 analysis) Atazanavir coadministered with cobicistat and emtricitabine/tenofovir DF (n=344) Atazanavir coadministered with ritonavir and emtricitabine/tenofovir DF (n=348) Jaundice 6% 3% Rash b 5% 4% Ocular icterus 4% 2% Nausea 2% 2% Diarrhea 2% 1% Headache 2% 1% a Frequencies of adverse reactions are based on Grades 2-4 adverse events attributed to study drugs.
b Rash events include dermatitis allergic, drug hypersensitivity, pruritus generalized, eosinophilic pustular folliculitis, rash, rash generalized, rash macular, rash maculopapular, rash morbilliform, rash papular, and urticaria.
5 WARNINGS AND PRECAUTIONS • Cardiac conduction abnormalities: PR interval prolongation may occur in some patients.
Consider ECG monitoring in patients with preexisting conduction system disease or when administered with other drugs that may prolong the PR interval.
( 5.1 , 6 , 7.3 , 12.2 , 17 ) • Severe skin reactions: Discontinue if severe rash develops.
( 5.2 , 6.1 , 17 ) • Assess creatinine clearance (CLcr) before initiating treatment.
Consider alternative medications that do not require dosage adjustments in patients with renal impairment.
Like all medications, Evotaz can cause side effects. However, not everyone who takes this medication will experience them. Many side effects are dose-dependent and may improve as your body adjusts to the medication. Others may require dose adjustment or medical attention.
Contact your healthcare provider promptly if you experience:
Seek immediate emergency medical care if you experience signs of: