Atazanavir and Esomeprazole: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Atazanavir and Esomeprazole unless specifically directed by your doctor.
How Atazanavir interacts with Esomeprazole
Proton pump inhibitors raise gastric pH, reducing the dissolution and absorption of atazanavir which requires an acidic environment, leading to subtherapeutic antiretroviral concentrations and resistance risk.
What you should do
Avoid PPIs in patients on unboosted atazanavir; if essential, use ritonavir-boosted atazanavir 400/100 mg with PPI dose limited to omeprazole 20 mg equivalent, separated by 12 hours.
Key facts
Severity
Major — avoid combination
Mechanism
Proton pump inhibitors raise gastric pH, reducing the dissolution and absorption of atazanavir which requires an acidic ...
Action
Avoid PPIs in patients on unboosted atazanavir; if essential, use ritonavir-boosted atazanavir 400/100 mg with PPI dose ...
Frequently asked questions
Can I take Atazanavir and Esomeprazole together?
No — this combination should generally be avoided. Avoid PPIs in patients on unboosted atazanavir; if essential, use ritonavir-boosted atazanavir 400/100 mg with PPI dose limited to omeprazole 20 mg equivalent, separated by 12 hours.
What is the severity of this interaction?
The interaction between Atazanavir and Esomeprazole is classified as Major — avoid combination. Proton pump inhibitors raise gastric pH, reducing the dissolution and absorption of atazanavir which requires an acidic environment, leading to subtherapeutic antiretroviral concentrations and resistance risk.
What should I do if I'm prescribed both?
Avoid PPIs in patients on unboosted atazanavir; if essential, use ritonavir-boosted atazanavir 400/100 mg with PPI dose limited to omeprazole 20 mg equivalent, separated by 12 hours. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.