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Agenerase with Norvir
Nov 2, 2000

Is 600mg Agenerase with 100mg Norvir better than 900mg Agenerase with 200mg Norvir and if so why?

Thanks -- a guy taking who doesn't think he's taking too much Agenerase and Norvir because he's done it for a year without any adverse side effects and has lipid profiles that are in the normal range without fasting.

Response from Dr. Stryker

We are not sure what the ideal combination of amprenavir/norvir should be, and several different regimens are under investigation. The answer will depend in part on the particular patient, his/her past treatment, and the extent to which the virus may be resistant to amprenavir.

For patients with no resistance to protease, 600/100 (amprenavir/norvir) twice daily should provided adequate blood levels of amprenavir to inhibit HIV effectively. This may even be an effective dose in patients with some resistance, but many physicians, myself included, would tend to increase the amount of amprenavir to better inhibit the resistant virus. In this case, 900/100, 900/200, or even 1200/200 have been used. The only way to know for sure would be to obtain a phenotype test, which would give a number (the IC50) that correlates with the amount of amprenavir needed to inhibit your own particular virus strain. This could then be compared to your amprenavir blood level (another test), and adjustments to the doses could be made based on rational principles. Unfortunately, these tests are not widely available outside of research settings, and are not standardized. In the future, these kind of analyses will enable us to answer questions like yours more accurately, and tailored to your own circumstances.

In the mean time, there is much to be said for "staying the course" if you are doing well and not having significant side effects. Good Luck RAS

Rick Stryker, M.D., M.P.H.

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