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Crixivan versus Kaletra - AP

Feb 11, 2001

Dr. Pavia, Thank you for answering my question from a week or so ago ("Concerned about a Viral Load of 53"). It was, apparently, just a blip. I'm back to below 50 now. But I am trying to make a decision: As I wrote, I was first tested 14 years ago; my viral load has been stable for a number of years. My doctor says I should think about switching from Crixivan to Kaletra -- not because Crixivan isn't working but because Kaletra is a better drug, he thinks, and better absorbed. I really have no problem taking Crixivan (or Zerit or the study drug FTC). But I DO want to be careful of the changes I make because I want to stay well for years and years. Thank you for your help. Scott

Response from Dr. Pavia

Dear Scott,

You don't mention if you are taking crixivan the "old fashioned way" of 800 mg every 8 hours on an empty stomach, or the "new and improved way" of 800 mg twice a day with 100 mg of ritonavir (with or without food). Crixivan is harder to maintain good blood levels on the old way, both because of the rapid clearance from your blood, and the difficulty of the schedule. However, every doc has patients who have been on crixivan and doing great since the early days of 96 (or at our place, from the trials in 95).

Kaletra is an impressive drug because of the good tolerability and the high levels. However, these characteristics also make it a valuable drug for people who have failed one protease. We don't know if there are any differences in long term side effects.

My general preference is not to change drugs when they are working and there are no side effects. One option to consider, if you are not already doing it, is to use the ritonavir boosted crixivan regimen, and save Kaletra as a later option. Good luck


to be (on meds) or not to be? - AP
no childhood vaccinations

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