Is Atazanavir and Cobicistat (Evotaz) affected by genetics?
Partially. 1 of 2 ingredients has pharmacogenetic evidence.
Atazanavir and cobicistat contains 2 active ingredients, and 1 of them has published pharmacogenetic guidelines. The relevant gene is UGT1A1. Your genotype can change how that ingredient behaves in your body, while the other ingredients aren't affected by genetics in any clinically established way. The strongest evidence level on this page is Strong, from the published guidelines shown below.
Also sold as Evotaz.
Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Atazanavir and cobicistat, it's worth talking over with your prescriber or pharmacist. How we handle combination products.
What's in Atazanavir and cobicistat
Atazanavir Affected by UGT1A1
Affected by UGT1A1. Guidance from CPIC, strong evidence.
Read the full atazanavir genetics guideCobicistat No known pharmacogenetics
No strong published pharmacogenetic guideline currently applies to cobicistat.
Atazanavir phenotype recommendations
Published guidance from CPIC on how atazanavir should be dosed or substituted based on your UGT1A1 phenotype.
| Phenotype | What it means | Recommendation | Evidence |
|---|---|---|---|
| Normal MetabolizerUGT1A1 | Your chance of getting yellow skin or eyes (jaundice) from this drug is very low. | CPIC There is no need to avoid prescribing of atazanavir based on UGT1A1 genetic test result. |
Strong |
| Intermediate MetabolizerUGT1A1 | Your body processes atazanavir a bit more slowly than normal, but you still have a low chance of developing jaundice (yellowing of skin or eyes). The standard dose is expected to be appropriate. | CPIC There is no need to avoid prescribing of atazanavir based on UGT1A1 genetic test result. Inform the patient that some patients stop atazanavir because of jaundice (yellow eyes and skin), but that this patient’s genotype makes this unlikely |
Strong |
| Poor MetabolizerUGT1A1 | With your genes, this drug is likely to cause yellow skin or eyes (jaundice). A different HIV drug may be suggested. | CPIC Consider an alternative agent particularly where jaundice would be of concern to the patient. |
Strong |
| IndeterminateUGT1A1 | The impact of your genotype on response to this drug is unknown | CPIC Initiate therapy with recommended starting dose. |
Not rated |
| Not availableUGT1A1 | The impact of your genotype on response to this drug is unknown | CPIC Initiate therapy with recommended starting dose. |
Not rated |
Source: CPIC
The gene behind the guidance
UGT1A1 UDP Glucuronosyltransferase Family 1 Member A1
UGT1A1 clears bilirubin (the molecule that builds up in jaundice) and several drugs including irinotecan and nilotinib. A variant called *28, common in people of all ancestries, reduces UGT1A1 activity. It's the cause of Gilbert's syndrome, a benign condition, but it also makes cancer patients much more susceptible to severe side effects from irinotecan-based chemotherapy.
Oncology dosing of irinotecan is often adjusted down for patients carrying two copies of the UGT1A1*28 variant.
See all drugs affected by UGT1A1Related medications
Find out how your genetics affect Atazanavir and cobicistat
Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.