hello dr,

i have been on the new needless Fuzeon Bioinjector for 2 weeks now and while working out at the gym today I realized I may be working somewhat at cross purposes to the requirements of the injection (i.e available body fat). I am extremely lean, 6'1", 170 lbs, very defined and muscular with little or no body fat. I find the Bioinjector hits muscle or residual cyst-like tissue (from previous injections) a lot of the time and I lose some of the dosage (i.e. "dribble"). I am concerned that as i tend to develop muscle easily (i am on oxandrin and androgel) I am taking away necessary body fat I need for the injections. I am currently enrolled in the new Tibotec TMC 114/TMC 125 trial. My background regimen includes the aforementioned Fuzeon and Truvada.

Has anyone heard anything about this? I am wondering if I ought to consider the old-fashioned syringe. Woudl that be any better? Any help is much appreciated. thanks!

--Paul

Dear Paul,

Fuzeon is absorbed best from the fatty tissue (subcutaneous or "sub-q) under your skin. The sites most commonly used are the abdomen, back of the arms and thighs. Unfortunately, you are not alone in this problem. Fuzeon sometimes oozes out of the skin with even a regular needle injection. The bioinjector is the best case scenario for delivering a sub-q injection and dispersing it evenly under the skin into the sub-q tissue. A regular needle injection creates a concentrated amount of liquid under the skin into the sub-q tissue (also called a bolus). This may form a nodule or bump which needs to be rubbed vigorously to improve the absorption of the Fuzeon and prevent these nodules/bumps from forming.

I spoke with a pharmacist about this leaking out issue and he said that the vials have enough Fuzeon to compensate for this problem. Therefore a little leaking is not a problem with getting enough medication delivery. Another site used is the flank or commonly called "love handles"; this might give the other sites a break... It is important not to inject in the same place each time. A rotation of injection sites is advised for best absorption.

The company which makes Fuzeon has a "Nurse Connection" program which is funded with a grant and is at no cost to the patient. This service is available to all patients injecting Fuzeon regardless of insurance. A registered nurse (RN) would make a home visit and could repeat this service up to four times without cost to you. The RN is highly trained in the delivery of Fuzeon injections and might provide information to improve your injection technique. If you are in the U.S., to find the nearest site to you call 1-888-321-2233. I would highly recommend you take advantage of this program. Your health care practitioner may also have information on this service. I hope this provides you with some assurance.

Carol