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Crixivan Dosage - 2x3 a Days or 3x2 a Day?

Feb 11, 1998

Dear Dr. Gallant:

I recently read in a New York Times article (Friday, February 6, 1998) that Merck has reported a similar level of efficacy in a modified dosage of three 400 mg. capsules of Crixivan twice a day vs. two 400 mg. capsules three times a day. Is there anything to this? I would prefer to take my meds on schedule, and, ideally, together -- thus avoiding the "missed" dosages that occur when I mistime one or the other. I'm currently taking Zerit and Epivir in addition to Crixivan.

On another note, literature I've received from Merck states that hair loss, severe skin reactions and other side effects have been reported as part of their post-marketing experience. I'm curious if the new anti-baldness drug Propecia (also made by Merck) is worthwhile investigating to offset the rather humiliating, although hardly "life-threatening," side effect of hair loss. I have to admit being a bit chagrined by the added insult to injury (never mind the attendant skin problems) of Crixivan-induced hair loss. I will freely admit, however, that I'd rather lose some hair and bit of self-esteem than CD4 cells or risk increasing my viral load because of a perceived loss of attractiveness.

As a closing note, I think the service you provide is exemplary as well as comforting for the many sufferers of HIV. Please keep up the good and worthy work, Dr. Gallant. You certainly live up to your name.


"Short of Hair but Not Hope" in Washington, D.C.

Response from Dr. Gallant

Well thanks! It's true that there's growing evidence to support twice daily dosing of Crixivan. However, the trial this is based on is a small one. There's a much larger trial in progress, which is more akin to the one that was recently reported regarding twice-daily dosing of Viracept; however, we don't have any results yet.

Given that the half-life of Crixivan is shorter than Viracept, and that the twice-daily dosing trial of Crixivan is smaller and less definitive than the Viracept trial, I think it would be prudent to wait for more results before changing the way you dose your Crixivan.

I'm afraid I can't really comment on Propecia-- it's very new and I don't have enough information about drug interactions. JG

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