Atazanavir and Emtricitabine and tenofovir interaction

Atazanavir and Emtricitabine and tenofovir: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Emtricitabine and tenofovir (DESCOVY) label · effective 2026-07-07

Major

Drug Interactions Concomitant Drug Class: Drug Name Effect on Concentration ↓=Decrease Clinical Comment ↑= Increase Antiretroviral Agents: Protease Inhibitors (PI) tipranavir/ritonavir ↓ TAF Coadministration with DESCOVY is not recommended. atazanavir/cobicistat ↑ TAF Coadministration with DESCOVY in pediatric patients weighing 14 to < 35 kg is not recommended…

Drug interactionsby drug classView label on DailyMed
Minor

Lactic Acidosis/Severe Hepatomegaly with Steatosis Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including emtricitabine, a component of DESCOVY, and tenofovir DF, another prodrug of tenofovir, alone or in combination with other antiretrovirals.

Warnings and precautionsby drug classView label on DailyMed
Minor

TAF is a weak inhibitor of CYP3A in vitro .

Drug interactionsby drug classView label on DailyMed
No interaction

…the components of DESCOVY, no clinically significant drug interactions have been either observed or are expected when DESCOVY is combined with the following antiretroviral agents: atazanavir with ritonavir, atazanavir with cobicistat (in those weighing ≥35 kg), darunavir with ritonavir or cobicistat, dolutegravir, efavirenz, ledipasvir, lopinavir/ritonavir, maraviroc,…

Drug interactionsnames AtazanavirView label on DailyMed

From the Atazanavir (REYATAZ) label · effective 2024-12-05

Major

In a clinical study, saquinavir 1200 mg coadministered with REYATAZ 400 mg and tenofovir DF 300 mg (all given once daily), and nucleoside analogue reverse transcriptase inhibitors did not provide adequate efficacy [see Clinical Studies (14.2) ] . indinavir Coadministration of REYATAZ with indinavir is contraindicated.

Drug interactionsnames Emtricitabine and tenofovirView label on DailyMed
Major

REYATAZ is not recommended for pregnant patients during the second and third trimester taking REYATAZ with both tenofovir DF and an H2RA.

Drug interactionsnames Emtricitabine and tenofovirView label on DailyMed
Moderate

Nucleotide Reverse Transcriptase Inhibitors: tenofovir disoproxil fumarate (DF) ↓ atazanavir ↑ tenofovir When coadministered with tenofovir DF in adults, it is recommended that REYATAZ 300 mg be given with ritonavir 100 mg and tenofovir DF 300 mg (all as a single daily dose with food).

Drug interactionsnames Emtricitabine and tenofovirView label on DailyMed
Moderate

Higher tenofovir concentrations could potentiate tenofovir-associated adverse reactions, including renal disorders.

Drug interactionsnames Emtricitabine and tenofovirView label on DailyMed
Moderate

Patients receiving REYATAZ and tenofovir DF should be monitored for tenofovir-associated adverse reactions.

Drug interactionsnames Emtricitabine and tenofovirView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.