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Author Topic: My 2 doctors disagree on my Prezista and Norvir dosage  (Read 1436 times)

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Offline Rockin

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My 2 doctors disagree on my Prezista and Norvir dosage
« on: December 27, 2013, 05:13:54 PM »
Hello there. My doctor in the UK in March of this year recommended a slight change of regimen, he said Prezista was better for my situation so I started taking it right away. So this was the regimen I was taking until now (and was UND in May, going to take new blood test next week):

1 pill of Prezista (800g Darunavir)
1 pill of Truvada
1 pill of Norvir (100mg of Ritonavir)

However, I'm having to stay a period in South America, at least during the winter, and my doctor here is recommending a different dosage, which he says is the one according to the health system guidelines. Since there is no pill of 800mg of Prezista here and no Truvada at all, this is the one he is recommending:

1200mg of Prezista (4 pills of 300mg each)
200mg of Norvir (1 morning and 1 evening)
300mg of 3TC (2 pills of 150mg of Lamivudine each)
300mg of Viread (1 pill of Tenofovir)

A whopping 9 pills a day  :-\

I asked him about this change from 800mg to 1200mg of Darunavir and he says that's the guideline. He's not against the 800mg recommended by the UK NHS, but he told me he usually prescribes 1.200mg. As for the 2 pills of Norvir, he says in my case I may continue taking just one of 100mg along with the others in the morning and ditching the other one for the evening but I have a feeling he doesn't think it's the safest way to go, in the long run. The NHS, on the other hand, recommended just 100mg a day really, in the morning with the others.

So now, obviously, I'm slightly confused and concerned. When I started my treatment in 2011 I was taking Reyataz+3TC+Norvir+Viread (cannot take Atripla due to resistance to Effavirenz). But I had to stop Reyataz due to increased jaundice, especially in the eyes, and switched to Fosamprenavir (Lexiva).

However, the NHS claimed Lexiva was a really old medicine that was no longer being used and suggested the switch to Prezista. That was in March and I remained UND in May and I have been taking the NHS regimen until now. They never said anything about Norvir 2x a day either.

I'm just wondering if anyone has any information about this or goes through the same regimen. I don't know who to believe. The HIV clinic I used to go in the UK was wonderful and they really seem to know what they were doing. My doctor here in SA is also great so I'm really torn about this. Any help or advice would be immensely appreciated. 
« Last Edit: December 27, 2013, 05:20:19 PM by Rockin »

Offline newt

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Re: My 2 doctors disagree on my Prezista and Norvir dosage
« Reply #1 on: December 27, 2013, 07:41:39 PM »
800mg Prezista works fine for people without significant PI resistance esp folk who are undetectable, this is a dose recommended in the drug's prescribing leaflet. - matt
"The object is to be a well patient, not a good patient"

Offline Rockin

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Re: My 2 doctors disagree on my Prezista and Norvir dosage
« Reply #2 on: December 28, 2013, 05:24:16 AM »
Newt, I was hoping you'd answer, since I've always admired your knowledge on all things HIV. Thanks a lot, I was thinking the same thing.

What about the 2 pills of Norvir a day? Do you know why is there some controversy towards it?

Offline newt

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Re: My 2 doctors disagree on my Prezista and Norvir dosage
« Reply #3 on: December 28, 2013, 10:15:21 AM »
The 2 x day dosing (600mg Prezista + 100mg Norvir 2 times a day) is recommended for people with some PI resistance.

The 1 x day dosing (800mg Prezista + 100mg Norvir) is recommended for people with no PI resistance.

If you were undetectable on Lexiva then you have no/insignificant PI resistance and can use the 1 x day dose.

If you can't get the 400mg or 800mg Prezista tabs where you are then a 900mg 1 x day dose is close enough (this will be 3 of the 300mg tabs). Obviously this will need a 100mg Norvir booster.

It is possible your doc's caution on dosing comes from experience, i.e. treating people with PI resistance and poor access to resistance testing. The higher dose 2 x day option is fine, but prob unnecessary. I personally would opt for less Norvir, therefore take the 1 x day lower dose, which indeed I do, having switched from a different PI like you. Still undetectable.

- matt
"The object is to be a well patient, not a good patient"

Offline Rockin

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  • Posts: 507
Re: My 2 doctors disagree on my Prezista and Norvir dosage
« Reply #4 on: December 29, 2013, 05:07:08 PM »
Thank you so much Newt, that was very enlightening.


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