Reyataz & Prilosec

[hypozsc]

I've been HIV+ for a year and of my meds is Reyataz. About 6 weeks ago I developed a cough and 1st saw my GP who put me on an inhaler for asthma and Zpac as a precaution. Later I went to my ID physician who changed me to Advair. After those treatments failed to relieve my non-productive cough the ID dr said I could have acid reflux and wrote a prescription for Prilosec.

The pharmacist would not fill the prescription because of the high risk of drug interaction saying that they'd have to consult my dr. I'm not sure what to do. I have not gotten the prescription filled (neither the dr or the pharmacist have contacted me to update the situation). I don't know if I should talk to my dr about my concerns and stay with that office or if I should just seek out a different dr and switch. I know it's my choice alone to make but I'd really like some advice.

[gerry]

It's good that the pharmacist picked up on the drug interaction issue between Reyataz and Prilosec (and other proton pump inhibitors).  Doctors do make mistakes.  It's very possible that the pharmacist has not contacted the doctor yet.  My advice would be to talk to your doc expressing your concerns about this; after that, then you could make a decision on whether or not to stay with the same clinic.

[hypozsc]

So the latest on this issue is this: The ID nurse called me to say that they talked to the pharmacy and that as long as I took the Prilosec at a different time from the Reyataz then it should be OK. Do I trust the doctor and take the Prilosec or heed the warning and avoid the chance of drug interaction? 

I should mention that we don't know for sure that I even have acid reflux.

[J.R.E.]

Hello,

The following is from the lessons  on the meds ;

http://www.aidsmeds.com/drugs/Reyataz.htm


"  The following medications should not be taken while you are being treated with Reyataz:
Acid reflux/heartburn medications: Propulsid® (cisapride), Prevacid® (lansoprazole), Nexium® (esomeprazole), Prilosec® (omeprazole), Protonix® (pantoprazole), and all other proton-pump inhibitors.
Antibiotics: Priftin® (rifapentine) and Rifadin® (rifampin)
Cancer chemotherapeutics: Camptosar® (irinotecan)
Antimigraine medications: Ergostat®, Cafergot®, Ercaf®, Wigraine® (ergotamine) or D.H.E. 45® (dihydroergotamine)
Antihistamines: Hismanal® (astemizole) or Seldane® (terfenadine)
Calcium channel blockers: Vascor® (bepridil)
Cholesterol-lowering drugs (statins): Zocor® (simvastatin) and Mevacor® (lovastatin)
Antipsychotics: Orap® (pimozide)
Sedatives: Versed® (midazolam) and Halcion® (triazolam)


Perhaps more tests are needed to actualyt confirm if you have an acid reflux problem :

http://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/article.htm

Take care-----Ray

[gerry]

So the latest on this issue is this: The ID nurse called me to say that they talked to the pharmacy and that as long as I took the Prilosec at a different time from the Reyataz then it should be OK. Do I trust the doctor and take the Prilosec or heed the warning and avoid the chance of drug interaction? 

I should mention that we don't know for sure that I even have acid reflux.

Ok, I take back my previous advise then.  That statement from the nurse is applicable if you were taking antacids or H2 blockers (like Zantac or Pepcid), but not for proton-pump inhibitors like Prilosec.  Table 20 of the US DHHS Treatment Guidelines list proton pump inhibitors as drugs that should not be used with Reyataz.  If you want to get a second opinion, now would be a good time to do so.  Or have your GP refer you to a gastroenterologist to do some tests to ascertain whether or not you really have acid reflux.

[Jacques]

Hello Hipozsc,

    If I were in your situation  I would run away from that doctor.

Jacques

[brian davis]

nice job jre but  farther down on the same page https://www.poz.com/drug/reyataz

is this :  While Reyataz should not be combined with proton-pump inhibitors (used to treat heartburn and acid reflux), it can be combined with medications known as H2-receptor antagonists. Examples of H2-receptor antagonists include: Tagamet® (cimetidine), Pepcid® (famotidine), Axid® (nizatidine), and Zantac® (ranitidine). However, these medications must be used very carefully with Reyataz because they can decrease the amount of Reyataz absorbed into the bloodstream.

For HIV-positive people new to anti-HIV treatment using the 400mg dose of Reyataz (without Norvir), an H2-receptor antagonist should be taken at least ten hours before or two hours after Reyataz. For example, if you usually take your Reyataz at 8:00am, you shouldn't take an H2-receptor antagonist any later than 10:00pm the night before or any early that 10:00am that morning.

For HIV-positive people new to anti-HIV treatment using 300mg Reyataz combined with 100mg Norvir, the H2-receptor antagonist can be taken at the same time as the Reyataz/Norvir.

For HIV-positive people who have tried and failed other treatments in the past, if an H2-receptor antagonist is to be used, Reyataz (300mg) must be combined with Norvir (100mg). What's more, the H2-receptor antagonist should only be taken at least ten hours before or two hours after the daily Reyataz/Norvir dose.
 
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I  dont have a clue which type of drug prilosec is but it sounds like hats  where u wanna look . I am on it also and cant find my papers on it but mine said dont take antacids 1 hour before or 2 hours after or i may have that  teversed so i just do 2 both ways . 2 remedies i have heard is dissolve baking soda in a glass of water. the other is papaya extract thats what my sisters Dr told her when she was pregnant and he didnt want her takin antacids . I will post back soon because i am sure i will find out which if either actually works
wont rreally know about interactions but i will know if they stop the heartburn