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HIV Drug ResistanceHIV Drug Resistance
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Jun 14, 2007

Can not eating while taking reyataz cause resistance?

Response from Dr. Sherer

Yes, the risk of resistance to Reyataz is increased if the drug is taken on an empty stomach, as compared to taking the drug with a meal. By taking 400mg with a light meal, the overall exposure to the drug increases by 70%, and the peak amount of drug in the plasma increases by 57% compared to taking the drug in the fasted state.

This difference is most important for patients who are taking Reyataz without ritonavir (Norvir), which is given to boost the plasma levels. This is an important reminder to patients and doctors alike to be sure that the rules for taking medications are well understood before the first dose is taken. In this case, if the food requirement is not understood, underdosing, incomplete viral load suppression, and drug resistance could result.

This is also a useful time to remind patients who take Reyataz that simultaneous use of P-PAR gamma inhibitors such as Omeprazole for acid reflux disease is contraindicated, because Reyataz requires an acid environment in the stomach for proper absorption. Similarly, the use of H2 blockers and antacides with Reyataz is discouraged for the same reason.

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