Oct 4, 2005
I just stopped all my meds two weeks ago including prophlaxis, due to high Lactic Acid( 4.7 ) Now I'm about to start a brand new regimen of Dapsone100mg 1 tablet daily, Diflucan100mg 1 tablet daily,Viramune 200mg 1 tablet 14days then 1 twice daily, Reyataz 150mg 2 capsules once daily, Combivir450mg 1 tab twice daily, Norvir 100mg once daily, Klonopin 0.5mg twice daily! Are there any serious concerns I should be aware of?
Response from Dr. Henry
The risk for lactic acidosis with your new regimen is very low. There is concern about liver/hypersensitivity reaction with nevirapine (so close monitoring is important during first several months). Perhaps 5% of patients will develop a high bilirubin level from the Reyataz so that needs to be monitored carefully. There is also a concern about a negative interaction between nevirapine and Reyataz (lower Reyataz levels). The level of the Klonopin can be increased due to the protease inhibitor so that has to be watched carefully as well. I sometime will avoid thymidine analogues after a case of severe lactic acidosis (avoiding D4T or the AZT in combivir) and use abacavir or tenofovir but there is some experience reported (and in my own practice) where AZT has been used with OK results. KH
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