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Do Kaletra, Viread and Zerit cause Hydroxyzine PAM and Generic Paxil to become elevated? Your "nephew" :) needs to be put on it... How safe?
Oct 25, 2010

Hello my beloved "big brother". (I pray that it's ok with you. I ALWAYS wanted a BIG BROTHER as special and trust worthy as you!) I hope you are doing wonderfully always!!!!!Your nephew was recently prescribed generic PAXIL along with Hydroxyzine PAM for anxiety, depression disorder. He is on Kaletra, Zerit and Viread. Are there any contraindications for these combinations? He is, THANKS TO MY GOD and a fastidious, OCD, meticulous mother :) undetectable and a T-Cell count of almost 900. Thank you by the way, for your replying to my scare and your kind reassurance. I BELIEVE YOU (keep in mind I have OCD) but SCARED OUT OF MY MIND because, I completely understand that out of its perfect required environment, HIV cannot survive for a period of time, but my beloved Doctor, even with circumstances being, "right after relations", if my husband after touching me there (oh my gosh, now I am truly blushing!) and then touching let us say the bed post or door knob etc before washing his hands etc. and the boys come right in while I am taking a bath and touch the same area immediately and maybe touch their eyes, mouth, nose etc. can they not become infected? Wouldn't it then be via the mucous membranes that they could? I literally get sick over this. I anxiously await your reply and wish you a WONDERFUL DAY! Hugs and Kisses Always!!!!!

Response from Dr. Frascino

Hello "Little Brother" and "Nephew,"

As a general rule, if a physician other than your HIV specialist prescribes additional medicaments, it's always prudent to check with your HIV specialist physician to be sure there are no drug-drug interactions. I see no reason for concern for adding Paxil and hydroxyzine PAM to a regimen of Kaletra, Zerit and Viread. Your trio of antiretrovirals itself does have some drug-drug interactions that your HIV specialist should be aware of:

1. Viread increases blood levels of Videx.

2. Kaletra increases blood levels of Viread (therefore monitoring for Viread-related side effects is warranted).

3. When Kaletra and Videx are combined, it's recommended that Videx be taken one hour before or two hours after Kaletra.

Regarding your ongoing fears of second hand vaginal fluids on your husband's hands "right after relations" and his then touching bedposts, doorknobs, etc., this poses absolutely no risk to your kids! These fears remain completely unwarranted and totally irrational. If HIV were spread that easily, it would have wiped out the planet (beginning with everyone who has ever visited a strip club or had a lap dance). So no matter how worried (irrationally) you are or how many times you ask the same question, the answer remains the same: NO RISK!

Dr. Bob



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