Dec 8, 1998
I am currently on Crixivan, Epivir, and Zerit. So far, so good for about 3 months. I have been drinking a lot of fluids in order to prevent kidney stones from the Crix. I drink approximately 2-3 liters a day of water, iced tea. My bladder has really been getting a workout and is sometimes painful. I also have an enlarged prostate that causes the normal urinary problems especially at night. My question(s): How much fluids is enough to prevent kidney stones? Can I cut down a little? How much do you recommend? Is there a lab test on urine to see if there are large amounts of crystals in the urine. Does Viracept also cause kidney stones? Thanks in advance. BOB
Response from Dr. Cohen
Hey Bob. Sounds like lotsa Ice Tea. Three quarts is MORE than you need - the recommendation is to drink about 48 ounces a day - that is one and a half quarts. So you can decrease it a bit. And Ice Tea does have caffeine - so you might notice being a bit buzzy with all that caffeine going on...? and there was one report that cranberry juice in particular might decrease the chance of stones by acidifying the urine - since this can help keep the Crix from forming into crystals.
No good urine test to know how well you are doing as far as I know. You can check a urine analysis - but there are no results that predict that you are doing fine or need more water to prevent an impending stone.
And last - this issue in only a problem for Crix. The other PI's - viracept/nelfinavir, saquinavir/fortovase, and norvir/ritonavir - don't have this issue. So if this is more a burden that you can swallow - then you can consider alternatives. We know that those who switch from one med to another are usually - though not always - successful. So switches should be done when you need to - but not just "casually".
Hope that helps. CC
Nelfinavir - can swap from 3 x a day to twice a day?
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