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failure on crixivan, where to turn
Oct 2, 1996

if you are unable to tolerate crixivan after a long-term trial of taking it in combination with AZT and ddi, to what medication do you now turn? Will your virus have developed resistance to the other two protease inhibitors? Are they better toleratedlong-term?Anything new on the horizon?

Response from Dr. Cohen

If the reason you can't take Crixivan (indinavir) is intolerance, then you may be able to switch drugs, because provided you were taking it regularly, you may not have develped resistance. There's no good way to know this for sure, other than to measure the viral load. If it is very low on the Crixivan, then you are probably not resistant, and can switch to another protease inhibitor (such as ritonavir). If, however, you have a high viral load while taking the Crixivan, then there is less likelihood that ritonavir or saquinavir will work.

By the way, as I've mentioned before, Crixivan is a tough drug to take with ddI, because the buffer in ddI interferes with the absorption of Crixivan, meaning that you can't take them at the same time. But that can be difficult, because they both have to be taken at least an hour before a meal or two hours after, on an empty stomach. To take both ddI and Crixivan can make for a pretty complicated meal and pill schedule!



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