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gastrointestinal problems with ratonavir & Saquinavir
Mar 4, 1997

Dr Gallant, Is there anything you know of, that can be taken or done for the gastrointestinal problems caused from ratonavir and saquinavir combo.? I am refering to the stomach cramps and extreme flatulance. I am taking 3 phaysyme tablets a day and I am still swollen and look somewhat pregnant. I cannot wear any of my clothes and it is causing a major cramp in my lifestyle ( pardon the pun ). Is there any oral medication I can take to help this problem? Perhaps altering my diet in some way. Do you reccomend any special diet for this problem?

Response from Dr. Gallant

My experience with ritonavir is that people either seem to get diarrhea or flatulence. (In other words, you either suffer yourself, or you let everyone else suffer for you.)

For some of my patients with the latter problem, simethicone (which is the ingredient in Phazyme) often helps a lot. In some cases the flatulence may be partly a result of the changes people make in their diets in order to tolerate ritonavir (larger meals with a high fat content or addition of fiber supplements, for example). You may want to experiment a little with your diet and see if there is anything you can come up with to improve your symptoms.

I would welcome input from readers who have conquered this problem. I would also add that the gastrointestinal side effects of ritonavir do tend to get better with time.

If worse comes to worse, you could get a new job, one where flatulence doesn't matter... become a forest ranger or a solo round-the-world sailor or something like that.

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