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Unusual combo
Jul 22, 2005

I'm writing concerning a patient of mine who was admitted in the hospital with these meds; Reyataz 400mg qd+ Videx 200mg BID+ Viread 300mg qd...The pt is following his doc's orders and I can't get in touch with them...I see so many problems with that combo;Unboosted Reyataz because of Videx, Videx and Viread and Reyataz and buffered tabs Videx which he takes in the morning together...I am at loss...Is there ANY rationnal to this combo?? Thank you so much Stephan

Response from Dr. Wohl

You are correct. Tenofovir reduces atazanavir levels as well as increases ddI levels.

Typically, the atazanavir would be dosed at 300 mg daily and boosted with 100 mg of ritonavir. The ddI should be changed to Videx-EC at 250 mg and tenofovir can stay the same at 300 mg.

Taking the buffered ddI and the atazanavir together is a problem, as you point out, as atazanavir needs an acidic gastric pH to be absorbed. A change to Videx-EC should take care of the problem especially with boosted atazanavir.

Even then it is a tricky combination but one that one sometimes needs to resort to.


what to do in case of accidental exposure
To replace Azt with Viread

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