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Crix Dosage - 3x2 or 2x3?
Sep 21, 1998

I currently use Crixivan, 2 capsules, 3 times a day (7am, 3pm, 11pm) in combination with 3TC and d4T... undetectable VL, CD4=230. My MD suggests sticking with the current pattern, since the long term effect of 3 caps x 2 are not well known. I normally don't have a problem with the dosage, but occasionally, there is that annoying business or social lunch at 2-3 pm that throws my afternoon dose off a couple hours early or late... rather stressful. Which is better to do, if I anticipate a mid-day lunch the following day? (1) to switch to 2x3 caps for a couple days and return to the normal dose pattern afterwards or (2) juggle with the middle dose and continue the 3x treatment?

Many thanks for your answer.

Response from Dr. Cohen

Well, we don't know for sure what is best of your choices. But a recent press release suggested that taking Crix 3 caps twice a day is overall less successful than the standard 2 caps 3 times a day. So - what to do with this on a given day?

My suggestion would be to do whatever you could to take the dose as close as possible to the time of when it is due... meaning a few hours early or late is probably safer than bunching it up to three caps twice a day. Altho a change on a single day is unlikely to matter all that much, it is also key to do what you can to keep these meds working.

The other option over the long term might be to consider adding ritonavir to the indinavir - based on early study, indinavir is likely to be successful when taken just twice a day (every twelve hours) when added to ritonavir. So far the only clinical data has been taking both meds at a dose of 400 mg. twice a day (just one Crix capsule twice a day is enough when taken with four ritonavir capsules or one teaspoon of the liquid formulation) -- with food. Now with ritonavir becoming available only as a liquid for these next few months this may not be the easiest time to make this switch... but something to consider over time since we are hoping these meds will work for you for years - even decades if that is what it takes. And the less nuisance the better of course...

hope that helps. CC



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