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ACID REFLUX OPTIONS-REYATAZ / PREZISTA/OTHER PI
Apr 30, 2010

I have been on Reyataz, Norvir and Truvada since I was diagnosed, almost 3 years. I went to an ENT who recommended that I step up the acid reflux medication. I am currently using Zantac, maximum dose. I feel fine and have not had belching, or that extreme acid that comes up wihch I had in the past. So his diagnosis was surprising. He wants me to take a proton pump inhibitor, which I understand to interfere with the absorption of Reyataz and can cause resistance. What are my options if I stay on Reyataz? Any other non ppi acid controllers, natural things, etc.? My id doc keeps pushing Prezista, which I see some people get diahrrea from, rashes,constipation etc. I have not reacted to sulfur antibiotics well and am not sure Prezista would react well with me. Are there any other PI's out there like Reyataz? I really do not want to change my regimen, it has been working very well.

I am also going to a gastro guy for an endoscopy, colonoscopy and to check h. pylori disease. Do you think it would be wise to wait for his assessment before considering a change of meds?

Thanks

Response from Dr. Henry

I have generally had good experiences with Prezista/darunavir which in general is tolerated similarly to atazanavir/Reyataz (more rash but less jauncide with Prezista). Lexiva and Kaletra are other PIs to consider as would be NNRTIs (efavirenz or nevirapine) or raltegravir (integrase inhibitor) depending on past treatment history/resistance status. There are many options to consider in most cases. Getting more info regarding cause of your acid reflex is generally a good idea regardless in order to optimally manage that condition (ie intense treatment for H pylori if that is present). KH



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