Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

Once-daily Lexiva w/low-dose Norvir

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richie:
Just returned from a quarterly checkup, and the Doc suggested a change to my regimen to fine-tune (eliminate) more side affects.  I started lexiva 700 w/norvir 100 twice daily (+ once-daily truvada)  a few years ago.  I switched a year ago to once-daily, 1400/200.  Very nice.  Good results.  We want to fine-tune to 1400/100, to reduce side effects of norvir (headaches, diarhea, etc.).  I only found one article about Glaxo investigating this option with some success from a small cohort:

http://www.catie.ca/tu.nsf/df739470490ae50d8525717f0061769d/345e7441be944c7d852571c70072d3d0!OpenDocument

Anyone else tried this w/success?  I am non-detectable, 100% compliant, 600T, very stable.  I trust my doc's experience (he treats over 500 HIV patients), but I do my research nonetheless.

Thanks for any feedback from anyone who's tried this.

penguin:
Hello
I not done this dosing myself, but…there was a small study, presented at 2004’s icaac, by P.Ruane, which adds support to the use of the lower norvir booster dose - both interms of side effect reduction & ability to achieve drug levels

Last bit, from the abstract:

“Mean increases in triglycerides were lower (39 vs 61 mg/dL) and gastrointestinal AEs were less frequent with FPV/r100 than FPV/r200.
Conclusions: FPV/r100 provided tolerability advantages compared to FPV/r200 and achieved equivalent plasma APV AUCτ,ss and Cmax,ss. Although plasma APV Cτ,ss was 38% lower for FPV/r100, it remained 5.9-fold higher than the 0.146 μg/mL protein-binding adjusted IC50 for wild type virus and was also 2.5-fold higher than the reported Cτ,ss for unboosted FPV 1400mg BID, which is approved in the US for use in PI-naïve adults. Further HIV clinical studies are warranted to explore the potential advantages of using FPV/r100.”

You can see the whole thing by going
here

& putting “Ruane” into the upper left search box. If you do change the dosage, you can use therapeutic drug monitoring to check the lexiva levels.

kate

richie:
GREAT FIND -- just what I was looking for (but didn't find through searching the net).  Thanks VERY much.  Looks like my Doc is up on his research.

 ;D

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