Fuzeon Burnout

[sherm]

Looking for a replacement for Fuzeon
On Fuzeon, Truvada, Isentress and  Ziagen
anyone?

[allanq]

Because of the difficulty of injecting and also the expense, Fuzeon is usually a choice of last resort, used when you have high-level resistance to the other HIV drugs.

Without knowing your resistance profile, it is not possible to make a meaningful suggestion for an alternative to Fuzeon. This is something you need to talk to your doctor about.

I was on Fuzeon for 3.5 years, so I can understand why you want to change.

Allan

[LES Jake]

My heart  goes out to you. I was on Fuzeon for a few months and then told my doctor those injection sights were too much for me. I switched to Merck's Integrase Inhibitor and have remained undetectable since March of 2007 and my Tcells have gone up to 241 (from 160 or so back in March). Much easier to tolerate. This Merck drug is now available to the public, just off of post Phase III Expanded Acess.

Good luck!

[allopathicholistic]

Here's a thread you might be interested in
http://forums.poz.com/index.php?topic=17180.0

[Miss Philicia]

Uh, he's already on Isentress, allopath.

Otherwise he's on almost the same combo as me, except for the Ziagen.  I'm on Prezista instead of that, but because Ziagen is an NRTI and Prezista is a PI I must assume that his resistance profile is very different than mine, and I assume that's why allanq said what he did.  IIRC allanq and I are on similar regimens.

[+Man]

I have been on Fuzeon for more than 6 months, and I have to say my site reactions went away after a while.  They were ugly and severe and painful for a few months, but then they just stopped happening at all.  No swelling, no itching, nothing.  I don't know how often that happens, or if it wil happen for you, but perseverance paid off for me.  I can take the drug with no side effects.  I also take Isentress, Epzicom, Norvir, and Lexiva.  I am newly infected, undetectable and the only side effect I REALLY suffer with is diarrhea.

[Graway925]

Hello,

I have been on Fuzeon for over three years.  I was told that Fuzeon can be administered using a BIOJECTOR.  I got onto the trial study for that (I live in Indiana)and am still using the biojector method of administering the Fuzeon.

I stull use the needles(my doc got me the smaller gauge insulin needles which are much less painful) for some of the injections in the stomach region.

My doc now tells me I can substitute ISENTRESS for Fuzeon in my drug regime.  I currently take Fuzeon, Lexiva & Viread.  My viral load is near undetectable and my CD4 count is 88.

I noticed some are taking Fuzeon AND Isentress.......  I have had to stop treatment due to liver issues....The liver issues are related to the HIV meds...not alcohol or illegal drug usage.

Since we started this drug regime(about a year ago) all has been well....liver function tests come back in the "normal" range.

My doc tells me I can substitute Isentress for the Fuzeon...I am having problems with long term site reactions from the Fuzeon.  My "regular" doc fears cellulitis problems with the continued use of the Fuzeon.

My Infectious disease doc tells me I could easily switch back to Fuzeon if the Isentress causes any problems...

Any advise?

PS...I was diagnosed back in 1985...and was told at that time I had probably been "infected" as far back as 1981.  The docs at that time used my CD4/CD8 ratio to come up with that conclusion.

[Miss Philicia]

Graway925, I did the switch like your doctor is recommending back in November, substituting Isentress for Fuzeon.  Most people I know have gone that route, and yes your doctor is correct that you should be able to go back to Fuzeon in the event that you need to in the future.

Additionally, my first lab results taken 5 weeks after starting Isentress maintained my VL suppression (and I was one of those people who'd never achieved VL suppression until going on Fuzeon) and my cd4's even received a modest bump up.  I've also had no side effects from Isentress, and it's been the most tolerable HIV med I've taken in the past 15 years of treatment.

[allanq]

Graway925,

Add me to the list of testimonials in favor of switching from Fuzeon to Isentress. I switched last March, thanks to the expanded access program. My viral load has continued to be  undetectable. Like you, I was on Fuzeon for over three years. Toward the end, the injection site reactions hurt so much that I was in tears every time I had to do an injection.

Everyone I've heard from who has made the switch has had a successful transition in terms of keeping their viral load undetectable. It has made a HUGE and very welcome improvement in my life.

The only thing that concerns me is that you say that your viral load is "near undetectable" rather than undetectable. I don't know how important that is. What else are you taking? I would want to know if if it's possible to intensify your regimen to get the viral load to undetectable.

Good luck. Keep us posted.

Allan

[erin]

Thanks for the recommendations on switching from Fuzeon to Isentress.  I’ve been thinking about switching since Isentress came out, but for me, it’s more about the fact that the injections are a pain in the ass than about intolerable injection site reactions (which I only rarely get).
 
Sherm – have you thought about taking Intelence (etravirine)?  It looks like it can safely be combined with Isentress and nukes (there are some PI interactions, but since you’re not on any, that shouldn’t be an issue for you :-)).  From what I’ve read, it still works in people whose viruses are resistant to the other 3 NNRTIs, but depending on the specific NNRTI-mutations that you have, and how many of them, it may not work as well.  The prescribing data is here, so you can see if there are any other reasons it might not work for you: http://www.intelence-info.com/intelence/assets/pdf/INTELENCE_PI.pdf .  It has to be taken with a pretty big meal, which might be kind of annoying.   It’s only been out for about a month, but if anyone’s started on it, please let us know how it’s going so far!

Have you taken a tropism test?  If your virus is CCR5-tropic, you may be able to switch to Selzentry (maraviroc).  The test is pretty expensive, and not always reliable if your viral load is very low, but if your virus is CCR5-tropic (that means that the HIV uses the CCR5 co-receptor to attach to the T-cell), it may be an option. 

I don’t know if you have private insurance, and have to pay co-pays (my insurance has a “special” higher co-pay for Fuzeon, but I haven't checked yet to see if it's any lower for Selzentry or Isentress), but if you are covering a straight percentage of your drug costs, and don't have a ceiling at which your co-pay ends, just about anything you switch to will be WAY cheaper than Fuzeon!

[Graway925]

   Hello Philly267 & Allang,

THANKS so much for the replies.  I was ready to telephone the pharmacy to let them know I needed more Biojector syringes.....  I find that I stay up WAY too late...in order to get my evening Fuzeon injected.  I have actually gotten accustomed to the needles...AND...somewhere in my brain I put off doing it as long as possible.  The same thing goes for the am injection...I do it...cuz...I know what NOT doing it means.

I am thankful for Fuzeon...because in my case it was a drug of last resort...and I totally believe it saved my life.

Anyway....I will telephone my doc in the morning and have her switch me to the Isentress.  I see someone mentioned the need for a full meal. when using Isentress..oh well.....I guess I'll just have to suffer through that....  I am joking...eating is -at least now- something I enjoy.

Several years ago I went through a wasting syndrome period...and food was the last thing on my mind.  Ironic...now I have about twenty pounds that "could" go away...and I would not mind.   Back during the "wasting" period I got nearly forty pounds underweight.  I looked like an WWII Nazi concentration camp prisoner...So I guess a bit of extra weight is better compared to a skeleton look.

Thanks again... 

[Miss Philicia]

The instruction label for Isentress clearly states that it can be taken with or without food.