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Can meds be blenderized ?
Jul 29, 2001

I tested positive April of this year and I am 14 weeks along with the following regimen in ACTG 371 : AMP, ABC, D4T, 3TC, RTV, bi-daily.

I am planning orthognathic surgery for this coming Fall. My mouth/jaw will be wired shut for approximately 6 weeks. Consequently, I will subsist on a liquid diet. Are the above meds able to be delivered effectively after crushing?

Another alternative migh be to schedule my surgery with my structured treatment interruption; however, a recent news report (NYT 7/19/01) suggested that treatment interruptions are not as beneficial as once thought.

As I mentioned above, I am essentially treatment naive (ACTG 371 participant) yet I am interested in your answer to both of my questions:

1. crushing and suspended delivery of the meds.

2. opinion of structured treatment interruptions

Thank you.

Response from Dr. Pavia

I have never been optimistic about structured treatment interuption for chronically infected patients. The data are now suggesting that the immunologic benefits are rare and inconsistent, and the risk of resistance is real. Drug holidays are an alternative when necessary but that is a different question.

D4T can be emptied from the capsule and mixed with food and 3TC tablets can be easily crushed. Abacavir can also be crushed. All three are also available as pediatric liquids that would be good alternatives.

The amprenavir and ritonavir are more of a problem because they are essentially gel caps with semi liquids inside. I would certainly suggest talking with a pharmacist about the amprenavir pediatric solution which tastes benign. Ritonavir is a little more of a problem. The liquid solution is the best alternative to ensure the right dose but it tastes vile. I am not sure that draining the capsule is acceptable. I would call Abbott, or have your pharmacist do so. Good luck with your surgery

ATP



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