Treatment Alert: How to Use Protease Inhibitors the Right Way

pil NoteBy the end of 1997, it is expected that Invirase will
come in a different form. The new form will be a soft-gel capsule
that will have a different dose and schedule. If the new soft-gel version of Invirase is approved by the Food and Drug Administration,
the new dose and schedule will be 1200 mg every 8 hours (3 times a
day).

* Enkaid (encainide)
* ergotamine
* Feldene (piroxicam)
* Halcion (triazolam)
* Hismanal (astemizole)

* Tranxene(clorazepate)
* Valium (diazepam)
* Vascor (bepridil)
* Versed (midazolam)
* Wellbutrin (bupropion)
* Xanax (aprazolam)

Manufacturer: Abbott Laboratories
Call 1-800-441-4987 for general information about Norvir.
Call i-800-659-9050 for patient assistance program information.
Dose Adults: 6oo mg (6 capsules ioo mg each)
Children: Norvir is approved for use in children. The dose varies
according to the size of the child.
Dose Frequiency:Every 12 hours (2 times per day)
Special Considerations: Norvir comes in both pill and liquid
form. The pills must be refrigerated. The liquid form
should also be refrigerated, but can be stored in a cool
place if used within 30 days.
Norvir must be taken with a full meal high in fat and protein. Do not take Norvir on an empty stomach.
When starting Norvir, "dose escalation" is recommended. This
means that rather than starting off with 6oo mg taken 2 times
per day, someone starting Norvir should start by taking 300
mg doses 2 times per day. Over a 14 day period, the doses
should be increased until 6oo mg doses are achieved. "Dose
escalation" minimizes the side effects, which can be very strong
when starting Norvir, and increase the likelihood that Norvir
will be tolerated. The "dose escalation" schedule recommended is the following:
Days I and 2: 300 mg (3 pills) every 12 hours (2 times per day)
Days 3 and 4: 400 mg (4 pills) every 12 hours (2 times per day)
Days 5 through 13: 5oo mg (5 pills) every 12 hours (2 times per day)
Day 14 and on: 6oo mg (6 pills) every 12 hours (2 times per day)
Side Effects: The most common side effects of Norvir are nausea,
vomiting, diarrhea, and weakness. These side effects can be minimized by using "dose escalation" when starting Norvir. Norvir may
also cause a tingling or numbness of the mouth and fatigue. All of
these side effects may lessen over time.
Another side effect of Norvir is elevated liver enzymes, which should
be monitored by your doctor.
Drug Interactions - Do not take Norvir with:

Because Norvir contains a small amount of alcohol, be aware that
any drugs that react with alcohol should not be administered with
Norvir.
Use of tobacco is associated with a decrease in Norvir in the blood.
This means that Norvir will be less potent if you use tobacco products.
Manufacturer: Merck
Call 1-800-238-1548 for general information about Crixivan.
Call 1-8oo-850-3430 for patient assistance program information.
Dose 8oo mg (2 capsules 400 mg each)
Dose Frequency: Every 8 hours (3 times per day)
Special Considerations: Because food prevents Crixivan from
getting into your body effectively, Crixivan should be taken
on an empty stomach (i hour before or 2 hours after a meal).
If you must eat something, Crixivan may be taken with very
small and light snacks that are low in fat, protein and calories:
juice, coffee, tea, skim milk, dry toast or bagel (with jelly or
jam, but no butter or margarine), etc.
Crixivan should be taken with at least i cup of water. In
addition, anyone taking Crixivan must drink at least 1.5 liters
(about 6 cups) of water throughout the day to prevent the
formation of kidney stones.
Crixivan is sensitive to moisture and must be kept dry. Keep
Crixivan at room temperature in its original container with the desiccant (a moisture absorbing agent).
Side Effects: The most common side effects of Crixivan are nausea,
stomach discomfort, headache, and insomnia.
Potential side effects of Crixivan include discomfort in the lower
back and sides, discomfort during urination, blood in the urine, and
kidney stones. Drinking plenty of water may prevent these side
effects.
Crixivan may also cause elevated bilirubin levels, which should be
monitored by you doctor.
Drug Interactions - Do not take Crixivan with:

* Halcion (triazolam)
* Hismanal (astemizole)
* Propulsid (cisapride)

* Ambien (zolpidem)
* Antabuse (disulfiram)
* Clozaril (clozapine)
* Cordarone (amiodarone)
* Dalmane (flurazepam)
* Darvon (propoxyphene)
* Demerol (meperedine)
* dihydroergotamine

* Mycobutin (rifabutin)
* Orap (pimozide)
* Propulsid (cisapride)
* Prosom (estazolam)
* quinidine
* Rythmol (propafenone)
* Seldane (terfenadine)
* Tambocor (flecainide)

* rifampin (Rifadin, Rimactane,
Rifamate, and Rifater)
* Seldane (terfenadine)
* Versed (midazolem)

Mycobutin (rifabutin) - Mycobutin requires a dose reduction by
one half when taken with Crixivan. Consult with your doctor, if you
are taking Crixivan and Mycobutin.
Nizoral (ketoconazole) - Crixivan levels in the blood are increased