Twice a day Viracept
Feb 5, 1998
I just read that Argouron announced at the Chicago Retrovirus Conference that Viracept can indeed be given bid. Would you recommend to your patients to immediately start the twice a day dosage at 1125mg (4.5 tabs)? It was also reported that the new dosing will cost $500/year more. Aren't the shareholders getting big enough dividends?
Response from Dr. Gallant
The results presented in Chicago by the European Nelfinavir Clinical Trial Group were interim results of an ongoing trial, but they were encouraging. They compared twice daily and three times daily doses of Viracept in combination with d4T/3TC in 241 patients. Originally there were three different twice-daily dose arms, but as of November, all the patients were getting either standard dose Viracept or 5 tabs (1250 mg) twice a day.
The results, in terms of viral load reduction, were similar between the two groups, with about 80% becoming undetectable by the standard assay (
Keep in mind that these are preliminary results (33 weeks) of a long-term trial that should be continuing for at least 96 weeks. Nevertheless, the viral load data combined with what we know about the half-life of this drug, certainly suggest that twice-daily is probably going to be the way to go.
I'll be talking this over with my patients--at this point I'd probably feel comfortable letting them switch to twice daily dosing, either at 4.5 or 5 tabs twice a day. I don't know the details on the pricing decision, and won't attempt to speak for Agouron!
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