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videx/viread dosing and meals
Oct 20, 2002

Dr. Aberg-

I noticed your earlier response to a question about videx/viread dosing and you mentioned that you do use this combination with the lower dose of videx as recommended. My doctor has suggested we also start this regimen and he too recommends the lower dose (250mg). This woiuld be part of a triple NUC regimen given only once per day (so easy!). My question is: what about the meal restrictions between videx and viread? Videx is supposed to be taken on empty stomach. When used in combo with Viread can it be taken with food at same time or do I need to wait until 2 hours after a meal for the videx? Otherwise it kind of defeats the purpose of the once per day if i need to have a 2 hour window between pills.

Thanks for your help-

Response from Dr. Aberg

You are correct about the need for the 2 hour dosing interval bewteen Videx EC (didanosine, DDI) and Viread (tenofovir, TDF). It still is a potent regimen although not a true once-daily regimen. If Epivir (lamivudine, 3TC) is an option, one could take 3TC/TDF with a non-nucleoside reverse transcriptase inhibitor (NNRTI) such as Viramune (nevirapine, NVP) or Sustiva (efavirenz, EFV). The sustained release zerit (stavudine, D4T)will be available soon. The makers of retrovir (zidovudine, AZT, ZDV) and ziagen (abacavir, ABC)are investigating once daily formulations and hopefully will be available in the future. There is an FDA warning about the use of D4T and DDI together, so I would avoid that unless there were no other options. Some of the protease inhibitors can be dosed once daily. Also, a new once daily protease inhibitor, atazanavir, should be on the market within the next 6 months so there will be more options for once daily.



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