Apr 25, 2004
Hi! I have been + for 18 years, never any symptoms. After 10 years of DDI/D4T (combined with before Crixivan, then Viracept due to some toxity) and being undetectable for 8 years, my doctor wants to change me (for my lypoatrofie) to Viramune/Viread/Norvir boosted Reyataz. Is this a good combo? Am I obliged to take them all at the same time or can I take eg viramune/viread in the morning and norvir/Reyataz in the evening (with food)? I do not like once daily because if you forget once... (I was since I started treatment in 1987 100% adherent) Would there be a change in my face (atrophy) or not because of the Norvir? Is Reyataz twice 200 mg a day without Norvir as good as the 300mg once a day with Norvir?
I'd like to thank you for an answer Best regards from Belgium!! L/44 y.o. 69 kilo.
Best regards Luc
Response from Dr. Boyle
Due to problems with doing the studies, i.e., you can't give Viramune to healthy volunteers, the pharmacokinetic interaction of Viramune and Reyataz has not yet been reported. It is likely to be similar to that of Sustiva/Reyataz, a combination that causes a signficant decrease in Reyataz levels. Since Viread also causes a decrease in Reyataz levels, I would be reluctant to use the combination your doctor suggests, even if the Reyataz is boosted with Norvir, and if you decide to go ahead with it you probably should have Reyataz levels deteremined to assure adequate levels. There are no data at this point on the toxicity and long-term problems of Reyataz + Norvir, but I suspect the mini-dose of Norvir shouldn't cause much of a problem. Norvir-boosted Reyataz is thought to be more potent than unboosted Reyataz, but regardless, if you use it with Viread or Sustiva (and probably Viramune too), you have to boost it to overcome the pharmacokinetic interaction discussed above.
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