Evotaz: Uses, Dosage & Safety Information

Evotaz is a prescription HIV-1 tablet fusing the protease inhibitor atazanavir with the booster cobicistat, which has no antiviral activity of its own. It is taken with other antiretrovirals, not as a complete regimen, and is licensed for adults and children weighing at least 35 kilograms.

Atazanavir has always needed a booster. On its own it does not reach useful concentrations, so for two decades it has been prescribed alongside ritonavir as a separate tablet — the arrangement described on our Reyataz page. Evotaz replaces that separate booster with cobicistat and puts both in one tablet.

The trade is worth stating plainly. One tablet instead of two is a real gain in a lifelong regimen. What it costs is flexibility: the booster cannot be dose-adjusted, cannot be switched for ritonavir when an interaction demands it, and cannot be stopped while the protease inhibitor continues. Whatever cobicistat does to another medicine, this tablet does.

The eligibility threshold moves with the format. Atazanavir alone is licensed from three months and 5 kg because an oral powder can deliver an infant dose; a fixed tablet of 300 mg and 150 mg begins at 35 kg.

The bilirubin effect belongs to the molecule and is unchanged here: most patients develop asymptomatic increases in indirect bilirubin, reversible on discontinuation.

Approved on 29 January 2015 under Bristol Myers Squibb.²

One tablet once daily with food.¹ Atazanavir absorption depends on an acidic stomach, and food supports it.

Before starting and during treatment: renal laboratory testing in all patients, and hepatic testing in anyone with underlying liver disease.

Every new medicine is checked before it is started, including anything bought without a prescription. Cobicistat is a CYP3A inhibitor and some combinations are contraindicated because raised levels of the other drug can be life-threatening; others lose their effect entirely.

Acid-reducing medicines matter as much here as with atazanavir alone. Proton pump inhibitors, H2 blockers and antacids raise gastric pH and can reduce absorption enough to risk treatment failure; timing rules and dose limits come from the prescriber.

The tablet is not split, and the booster is not supplemented or replaced. If cobicistat has to change, the whole product changes.

The effects divide cleanly by component, and knowing which one is responsible determines what happens next.

Source: ¹

Rows one and three are the reason this page separates them: one makes a patient look jaundiced without liver disease, the other makes their kidney numbers look worse without kidney disease. Neither is a reason to stop, and both are reasons to have been told in advance.

Evotaz is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection, in adults and in children weighing at least 35 kg.¹

It is not a complete regimen. Unlike a single-tablet product such as Genvoya, this tablet supplies the protease inhibitor and its booster and expects a nucleoside backbone to be prescribed alongside it.

Where it fits is a question of what else the person takes. A boosted protease inhibitor is a strong option, but cobicistat carries a substantial interaction load, and a regimen built on it must be checked against every other medicine in use. Where an interaction rules out cobicistat, the separate combination of atazanavir with ritonavir remains available and can be adjusted independently.

The molecule and everything that follows from it — the bilirubin effect, the need for stomach acid, the paediatric range down to three months — are on our Reyataz page. This page is about what changes when the booster is built in.

Evotaz is prescription-only, approved on 29 January 2015 under NDA 206353 and held by Bristol Myers Squibb.²

Because both components appear in other products, duplication is a real hazard: another atazanavir product, or another cobicistat-boosted regimen, means the same molecules twice. The ingredient list rather than the brand name is what prevents it.

Two things travel with this prescription regardless of who dispenses it: the interaction check against the contraindicated table, and pretreatment renal testing. Both are in Critical warnings for Evotaz use.

Interactions that can be fatal, and interactions that silently fail

Coadministration is contraindicated with a list of drugs in the label, either because raised levels can cause serious or life-threatening events, or because the combination causes loss of therapeutic effect.¹ Both directions matter: a booster can make another medicine dangerous, and it can also make it useless.

The booster cannot be separated

Where an interaction would normally be handled by switching from cobicistat to ritonavir or by adjusting the booster, this tablet offers no such option. The response is to change the product rather than to modify it.

Kidney and gallbladder stones

Nephrolithiasis and cholelithiasis have been reported, and temporary interruption or discontinuation is considered when they occur. Renal laboratory testing is performed before treatment and continued during it.¹

Progressive renal disease

Discontinuation is considered in patients with progressive renal disease.¹ Interpreting renal numbers on this tablet requires knowing that cobicistat itself raises creatinine without harming filtration.

Hepatotoxicity in hepatitis coinfection

Patients with hepatitis B or C are at risk of increased transaminases or hepatic decompensation, and hepatic laboratory monitoring is part of their care.¹

Jaundice that is not liver failure

Most patients develop asymptomatic increases in indirect bilirubin, reversible on discontinuation. If transaminases rise at the same time, alternative causes are evaluated.¹

Immune reconstitution and metabolic effects

Immune reconstitution syndrome may occur, as may new onset or worsening of diabetes and hyperglycaemia.¹

Source: ¹

The fourth and fifth rows are the ones that decide whether this tablet is usable at all for a given person, and neither is about the antiviral component.

This is the defining section of the page. A booster exists to inhibit an enzyme, and everything that enzyme handles is affected.¹

Source:

This table is the only place on this page where interacting substances are listed. Because the contraindicated list is long and revised, it is read from the current prescribing information rather than reproduced here in a form that could go stale.

Evidence scope

What has been reported to the FDA

As of the FAERS data cut of 30 July 2026, the FDA Adverse Event Reporting System held 2,956 reports naming atazanavir, 2,809 of them coded serious. Reports for this fixed combination are pooled with those for the molecule.³

Who was this medicine studied in?

Evotaz was approved on 29 January 2015, which places it just inside the window for FDA Drug Trials Snapshots.² Where one exists it reports the demographic composition of the trial population and is worth reading alongside the label.

The evidence for a fixed-dose booster combination has a particular shape: efficacy is inherited from the boosted protease inhibitor as already established, and the new work is pharmacokinetic, showing that cobicistat delivers atazanavir exposure comparable to the older arrangement. That is why the label reads as a description of a pairing rather than as a fresh trial programme.¹

Who this is and is not appropriate for

Typically considered for: an adult or child of at least 35 kg with HIV-1, taking a nucleoside backbone alongside it, whose full medication list has been checked against the contraindicated table and whose renal function has been tested.

Not appropriate for: anyone taking a drug in the contraindicated table or a strong CYP3A inducer; anyone weighing under 35 kg, where the components are used separately; and anyone already taking another atazanavir or cobicistat product.¹

Needs a conversation first: anyone on acid-reducing medicines, including ones bought without a prescription; anyone with hepatitis B or C; and anyone whose regimen may need the booster changed, since that cannot be done inside this tablet.

Where to go next

• Report a side effect: FDA MedWatch, or MHRA Yellow Card in the UK
• Full prescribing information, including the contraindicated drug table: DailyMed
• Pregnancy-specific enquiries: MotherToBaby, or Bumps in the UK
• The molecule with a separately prescribed booster: our Reyataz page

1. FDA Prescribing Information — EVOTAZ (atazanavir and cobicistat) tablets, Bristol Myers Squibb. Indications and Usage; Dosage and Administration including pretreatment testing; Contraindications; Warnings and Precautions, including nephrolithiasis and cholelithiasis, hepatotoxicity, hyperbilirubinaemia, immune reconstitution and hyperglycaemia.
   Label revised 2025-05 · Accessed 2026-08-30
   Used for: composition and strengths, weight threshold, administration with food, renal and hepatic pretreatment testing, contraindicated interactions in both directions, bilirubin effect
   DailyMed SPL 83db29d7-5d85-49d6-8cb6-740473365cf8
2. Drugs@FDA via openFDA — NDA 206353, EVOTAZ, approved 2015-01-29, Bristol Myers Squibb, Prescription.
   Accessed 2026-08-30
   Used for: approval date, sponsor and the single application behind the product
   Drugs@FDA, products.brand_name EVOTAZ
3. FDA Adverse Event Reporting System via openFDA, query on atazanavir sulfate.
   Data cut 2026-07-30 · Accessed 2026-08-30
   Used for: report counts and most frequently coded terms, and the limitation that reports for the fixed combination cannot be separated from those for the molecule
   openFDA FAERS

This page is medical information, not medical advice. It describes a boosted protease inhibitor with a substantial interaction profile and does not replace the judgement of the clinical team managing your treatment and your other medicines.