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Dec 3, 2004

Hello-i have been on Norvir,Invirase,atazanavir,fuzeon and Viread for about one year and have been doing fairly well. Last t cell 202 and last viral load 55. My creatinine was 1.6 (its been fluctuating between 1.3 to 1.5) he estimated my clearance to be 62 ml/min and told me to decrease the dose to 300 q48h. My question is that the literature states that dose adjustment should be done if you cc is below 5oml/min. I am afraid of having a subtherapeutic drug level with this dose but of couse the doctor has me concerned about possible kidney damage. Being a former pharmacist i tend to stick with the literature. who is right? The dosing info says one thing and my doctors says another. i thought he told me the cut of was 60ml/min. please help! ps i have no previous kidney problems and do take ibuprofen sometimes.

Response from Dr. Lee

Viread can be associated with renal insufficiency or failure. Therefore, it is probably good to be a little cautious with the drug. I would first suggest increasing your fluids and cutting any other possible renal toxic drugs (such as the ibuprofen). Then, if your creatinine clearance continues to be low, consider changing your doses. Check with your doc about this.

Be well.

Should I join the Comet Study?
Sticking with Tenofovir and Abacavir only.

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