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Switching Meds
Aug 19, 2007

To avoid effects of AZT, will switching from Trizivir to Epzicom/Viramune be a smart move. Currently 1100 TC undectable for 9 years

Response from Dr. Young

Thanks for your post.

While switching off of Trizivir to avoid AZT side effects is reasonable (you've not mentioned what symptoms your experiencing). I have some concerns about the regimen that you've listed.

It is perfectly reasonable to use Epzicom (Kivexa) since you have tolerated it's parts (abacavir+3TC) for many years.

My concern is over the use of nevirapine (Viramune), since you'd be starting this with a high CD4 cell count. Patients like you are at significantly greater risk of developing liver injury in the weeks following starting nevirapine. As such, I wouldn't recommend this as the medication that replaces the AZT in your Trizivir regimen.

There are a number of other alternatives- efavirenz (Sustiva) or one of the ritonavir-boosted protease inhibitors (PIs), like fosamprenavir (Lexiva) or atazanavir (Reyataz). Lastly, some doctors have commented on success using Epzicom with unboosted atazanavir- a regimen that would be ritonavir-free and three pills once-daily.

Hope this helps. BY

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