VIDEX EC, VIRACEPT, VIREAD Food/Timing Requirements
Mar 24, 2003
Im currently taking VIDEX EC (250 mg), VIREAD (300 mg) and VIRACEPT (1250 mg). My question is based on the following two abstracts presented at the 10th Retroviruses Conference held February 10-14, 2003 in Boston, MA.
The first study indicated that VIREAD (300 mg) and VIDEX EC (250 mg) should be taken with a light meal (373 Kcal/20 Fat). When taken with a light meal, VIDEX ECs area-under-the-curve (AUC) was slightly lowered by -11, although this was not found to be a significant reduction. I am assuming, however, that a greater caloric and fat intake would lower VIDEX ECs AUC even more and thus it would not be wise to take VIDEX EC in this manner.
The second abstract present at the conference stated that VIRACEPT needs to be taken with a meal consisting of 500 to 1000 kilocalories and 20 to 50 percent fat as this achieved AUC values for VIRACEPT that were from 3 to 5 times those achieved in the fasting state. As such, it appears that a light meal (373 Kcal/20 Fat) would not be appropriate when taking VIRACEPT.
Thus, if I take VIREAD and VIRACEPT together with a substantial meal (749 Kcal, 38 Fat), as indicated for both in their package inserts, how many hours prior to eating and taking these two drugs should I wait before taking VIDEX EC to ensure the meal will not affect VIDEX (250 mg) ECs proper absorption?
Thank you for your answer.
Response from Dr. Young
Thanks for your questions. You've clearly read the literature well.
The studies about ddI and tenofovir showed that there was little difference between taking the two together with a light meal or fasting; indeed, there was little difference when taken apart or together. This is different, than when taken with a substantial, fatty meal, as previously shown.
As for Viracept (nelfinavir), drug levels are increased when taken with a fatty meal, but lowered if taken fasting or with a light meal. Historically, most patients have taken their Viracept with a light meal, perhaps this explains why some persons have done very well on the drug and others have had premature virological failure.
Now for the speculation part-- if you were to take the tenofovir and nelfinavir with a fatty meal, then I'd proably wait a couple of hours to take the ddI. (This is how we operationally define a "fasted" state.) -BY
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