Yes — the active ingredient is metabolized by a gene known to vary between individuals.
Relevant genes: UGT1A1
others is affected by pharmacogenetics through the UGT1A1 gene. Your genotype for this gene can change how your body processes others, which can affect both how well it works and how well you tolerate it. The strongest evidence level on this page is Strong, based on CPIC or FDA guidelines.
Published guidance from CPIC on how atazanavir should be dosed or substituted based on your UGT1A1 phenotype.
| Phenotype | What it means | Recommendation | Evidence |
|---|---|---|---|
|
Normal Metabolizer
UGT1A1
|
Your body processes atazanavir normally. You have a very low chance of developing yellowing of the skin or eyes (jaundice) as a side effect of this medication. |
CPIC
There is no need to avoid prescribing of atazanavir based on UGT1A1 genetic test result.
|
Strong |
|
Intermediate Metabolizer
UGT1A1
|
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 Metabolizer
UGT1A1
|
Your body processes atazanavir much more slowly than normal, which gives you a higher chance of developing jaundice (yellowing of skin or eyes). Your doctor may recommend an alternative HIV medication. |
CPIC
Consider an alternative agent particularly where jaundice would be of concern to the patient.
|
Strong |
|
Indeterminate
UGT1A1
|
The impact of your genotype on response to this drug is unknown |
CPIC
Initiate therapy with recommended starting dose.
|
— |
|
Not available
UGT1A1
|
The impact of your genotype on response to this drug is unknown |
CPIC
Initiate therapy with recommended starting dose.
|
— |
Source: CPIC
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.
This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.
Get your report Look up another medicationInformational 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.