Warning about Tylenol, Retrovir, Nasarel and Norvir

[paul_c_davis@pacbell.net]

Warning about Tylenol, Retrovir, Nasarel, and Norvir 

Tylenol (acetaminophen, paracetamol, others) usage during Retrovir
treatment led to a higher rate of neutropenia (low white cells) in
one placebo-controlled study. The effect was more pronounced when
Tylenol was taken chronically. When levels of Retrovir and its
metabolite were measured in similar patients, no increase in these
compounds was detected (standard Tylenol dosing was used). Chronic
usage of Tylenol should be approached with caution when Retrovir or
Combivir is taken. More frequent blood count measurements may be
indicated, or an alternative to Tylenol, or an alternative to
Retrovir or Combivir should be considered. Medications that are
metabolized by the same mechanism as the Retrovir component of
Combivir ("glucuronidation") should be used with caution. It is
possible that higher levels of Retrovir might result, with possible
toxicity. This would be more likely to occur if taken chronically
(days or longer), rather than a few doses. The types of medications
include certain ones for pain relief, anti-inflammation, sedatives,
and one each from three classes of medications (acid release blocker,
antibiotic, and high cholesterol). Such medications include: aspirin
(acetyl salicylic acid, many brand names); codeine (for pain, many
brand names); morphine (MS Contin, Oramorph SR, Roxanol, others);
Indocin (indomethacin); ketoprofen (Orudis, Oruvail); naproxen
(Aleve, Anaprox, Naprosyn, Naprelan); oxazepam; Ativan (lorazepam);
Tagamet (cimetidine); Atromid-S (clofibrate, for high cholesterol);
and dapsone (antibiotic).Epivir

Tylenol (acetaminophen, paracetamol, others) has a 3 phase metabolism, Phase 1 is CYP1A2, Phase 2 is CYP3A4, which is inhibited by Norvir (Ritonavir), and can thus increase Tylenol serum levels to an unknown toxic degree, Phase 3 is CYP2D6.

I  found that Tylenol usage raised my ALT levels (liver enzyme)
3x when taking regular normal dosages of Tylenol or Tylenol
containing products.

Nasarel (flunisolide) is  a corticosteroid that is metabolized by CYP3A4, which Norvir Inhibits. Flunisolide is well absorbed systemically and when taken regularly the serum levels of flunisolide are boosted by Norvir to an unknown but immune suppressive degree. When I stopped taking Nasarel my CD4+ count went from 224 to 547 and my lymphocyte count from 810 to 2230

[newt]

paracetamol is the most toxic med going liver wise sez the WHO...

The AZT interactions noted above are from this page on HIV & Hepatitis I believe (a handy site)

http://www.hivandhepatitis.com/hiv_and_aids/combivir_interactions.html << fixed

- matt

[J.R.E.]

Hi there,

Good article, thanks for sharing. I ususally try to avoid Tylenol as much as possible, especially since I was into heavy and excessive use of Tylenol back in 2002-2003.


Matt... You link needs fixing !



Take care----Ray