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Combivir/Norvir
Jan 4, 2004

Follow-up: Dr Pierone, thank you so much for your response about adjusting my Combivir/Norvir treatment to a new timezone. You asked about why I am taking this combination - I am from Eastern Europe and I was given this medication by my doctor. No other options were discussed with me. Is there any known issue with this combination?

Response from Dr. Pierone

Some people are able to tolerate full-dose Norvir (I assume you are on either 400 or 600 mg twice daily) without problems and do well for many years. But this regimen has fallen out of favor because of simpler and better tolerated alternatives. For example, with Combivir and Sustiva the pill burden is three pills per day instead of 10 or 12 with your regimen. Full dose Norvir is also associated with a greater likelihood of gastrointestinal problems, metabolic issues like insulin resistance, diabetes, high triglycerides, and cholesterol elevations.

To add insult to injury, Abbott, the maker of Norvir, just raised the price of Norvir by about 500 percent last month in the United States. Here, Norvir is primarily used to boost the levels of other protease inhibitors and is used with medications that are competitors to Abbott's Kaletra (itself a combination of lopinavir and Norvir). It is generally believed that Abbott raised the price of Norvir because of increasing competition from other newer medications like Reyataz and Lexiva. Hopefully they will realize that this was a bad decision for patients and will rescind the price increase before more damage is done.



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