Treatment Alert: How to Use Protease Inhibitors the Right Way

when taken with Nizoral. This might require a dose reduction of
Crixivan to 6oo mg every 8 hours. Consult with your doctor if you
are taking Crixivan and Nizoral.
Manufacturer: Agouron Pharmaceuticals
Call i-888-847-2237 for general information about Viracept
Call i-888-M-6637 for patient assistance program information.
Doe: Adults: 5o mg (3 capsules 25o mg each)
Children: Viracept is approved for use in children. The dose varies
according the weight of the child
DoseFrequency: 3 times per day
Speal Considerations: Viracept should be taken with a meal
or light snack.
Side Effects: The most common side effect of Viracept is diarrhea.
This can be controlled with over-the-counter anti-diarrhea drugs.
Drug Interactions - Do nottake hirasMittk
* Halcion (triazolam) * rifampin (Rifadin, Rimactane,
* Hismanal (astemizole) Rifamate, and Rifater)
* Propulsid (cisapride) * Seldane (terfenadine)
- Versed (midazolam)
Antiseizure medications - Antiseizure drugs such as Dilantin
(phenytoin), phenobarbital (Bellatal or Donnatal), and Tegretol (carbamazepine) reduce the blood level of Viracept and should be avoided when taking Viracept.
Mycobutin (rifabutin) - Mycobutin requires a dose reduction by
one half when taken with Viracept. Consult with your doctor, if you
are taking Viracept and Mycobutin.
Oral contraceptives - Viracept has been shown to reduce the effectiveness of oral contraceptives. Additional or alternative methods of contraception should be used
when taking Viracept.
The combination of Invirase + Norvir seems to work well in people
for a few reasons. They must both be taken with food. Because
less of each drug can be taken when both are used together, the
side effects seem to be reduced. Norvir actually seems to
Improve the body's ability to absorb Invirase, making it more
effective against HIV. j
DQSe~ 4oo mg (2 capsules 2oo mg each) of Invirase
4oo mg (4 capsules ioo mg each) of Norvir
Dose Frequny: Every12 hours (2 tmes per day)
SpeialConideatins:All special considerations listed under both
the Invirase and Norvir sections also apply here.

Invirase and Norvir must be taken with a full meal high in fat and
protein.
Follow the Norvir "dose escalation" schedule up to 4oo mg as
follows:
Days i and 2: 300Mg (3 pills) every 12 hours (2 times per day)
Days 3 and on: 4oo mg (4pills) every 12 hours (2 times per day)
Do not "dose escalate" Invirase. Begin taking full 4oo mg dose of
Invirase.
Side Effects: The side effects will be the same as those for Norvir.
However, the side effects may be lessened because a lower dose of
Norvir is taken when used in combination with Invirase.
Druz Interactions - Donot take Invrase and Norr hAN
drug interactions listed under both the Invirase and Norvir sections
also apply here.

Protease inhibitors and all anti-HIV drugs need to be taken exactly
as prescribed. Do not reduce doses. Do not skip doses. Do not
take "drug holidays." Doing any of these things will create HIV drug
resistance.
If you are unable to tolerate side effects or maintain the dose schedule, talk to your doctor or other service provider about finding a regimen that suits your lifestyle. It is not your "fault" for not being able
to use a drug because it is too complicated to take or because its
side effects are too severe.
Be sure to talk to your doctor about all of the drugs you are taking,
including over-the-counter medications, alternative or herbal remedies as well as recreational or addictive substances, including alcohol and "street" drugs.
Protease inhibitors, when used the right way,
will keep you healthier for a longer period of
time. If used incorrectly, they may limit your
options for survival.

If you have any questions about protease inhibitors,
contact:
Richard Ehara
Research and Treatment Advocacy Department
National Minority AIDS Council
193113th Street NW, Washington, DC 2oo9
Tel: (2o2) 483-6622 Fax (2o2) 483-II35
reharawnmac.org