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once-daily dose of Fortovase
Jan 24, 2000

I red last year that once-daily dose of Fortovase in combination with a mini-dose of ritonavir achieve antiviral control over a 24-hour interval.

I wonder if it is enough safe as my regimen is Fortovase TID, zerit, ddi an Hydroxurea (i am undetectable)

Thank you

Response from Dr. Cohen

Well, first - hopefully you are detectable. And HIV is not.

We recently presented results of a large trial pretty clearly showing that you can safely use Fortovase (with any two nucleosides) either three times a day (like you - that is what TID means) or just twice a day. In general, the twice a day was better tolerated - with somewhat less side effects, and equivalent degrees of viral control. So that change you can make - and if you do go to just twice a day - the dose we studied was 8 capsules (1600 mg) twice a day - while if you take it three times a day, it is 6 caps each time. And as a reminder - it needs to be with food for better absorption.

Now - what about once a day? The only info so far is just on the blood levels - and you are right - when 8 capsules of fortovase was taken with just 100 mg of ritonavir/norvir, the level of fortovase appeared to stay high enough to consider this enough for once a day use. However - you need to know that there is NO clinical info yet on how well this works to keep HIV under control - that will be addressed in studies just now getting planned and underway. You can consider joining such a study if there is one near you... but until those results are in - it is not yet proven how well this will work. It looks promising, but some want to see proof before switching.

But at the least you can consider the twice a day simplification...

CC



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