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Ritonavir, 3TC, D4T combination ? Ritonavir and travels through time zones?
Apr 29, 1997

Hello Dr. Gallant and thank you for answering my question : I was for 4 month on 3TC, AZT therapie after CD4 count drop to 480 /ml and RNA count 60,000. After 1 month of this therapy RNA was less then 100(undedectable). In the 4 th month, I had flu symptoms loss of white blood cells, fever 39,6! C during 3 days and RNA went up to 3800. I stopped therapy with advice of doctor. Now I start new therapy with Ritonavir, 3TC, D4T. What do you think of that "cocktail" ?. I'm a Flight Attendant is it OK to take a week dose of Ritonavir out and keep it at room temperature ? With the time differences what would you recommend : Stick to the 12 hours to 12 hours schedule (even I have to wake up in the middle of the night sometimes and take all meds on empty stomach; or adapt to local breakfast and dinner times but have sometimes a few extra hours in between doses or 2 doses within 8-10 hours time ? Thanks once again if you can answer these questions

Response from Dr. Gallant

Ritonavir, 3TC, and d4T is generally an effective regimen, though you were probably already resistant to 3TC when you started it. Nevertheless, there is evidence that 3TC can still be beneficial even after you've developed resistance, because 3TC-resistant virus replicates more slowly.

Ritonavir does not need to be dosed exactly every 12 hours. It's more important that it be taken with food. I would say that as long as you take it within 2 hours of your normal time, it should be OK, though I'm just making that number up.

There's no recommendation about how long ritonavir can be kept at room temperature, but one week seems like a long time. I'd try to refrigerate it if possible.

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