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Once- and Twice-a-Day HIV Medications

Part of HIV Medications: When to Start and What to Take

March 2009

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Twice-a-Day NRTIs
Drug		Food Restrictions	Key Considerations
	Combivir® (combination of Epivir + Retrovir)	No food restrictions	Should not be taken with Epivir, Retrovir or Zerit Specific side effects*: see Epivir and Retrovir
	Retrovir® (AZT, zidovudine)	No food restrictions	One of the meds used in the combination pills Combivir and Trizivir (see note for Ziagen above) First anti-HIV drug approved; studied more than any other drug Should not be taken with Zerit Reduces mother-to-child transmission of HIV in pregnancy Specific side effects*: headache, nausea, anemia, fatigue, lipoatrophy (wasting)
	Trizivir® (combination of Epivir + Retrovir + Ziagen)	No food restrictions	Should not be taken with Epivir, Retrovir or Ziagen More likely to cause side effects than Combivir For a complete initial regimen, strengthen with an additional PI or NNRTI Specific side effects*: severe allergic reaction to Ziagen; also see Epivir and Retrovir
	Videx® (ddI, didanosine)	Take on an empty stomach	See Videx EC, above
	Zerit® (d4T, stavudine)	No food restrictions	Should not be taken with Retrovir or Videx Specific side effects*: neuropathy, lipoatrophy (wasting), hypertension, elevated cholesterol/triglycerides
Twice-a-Day NNRTIs
Drug		Food Restrictions	Key Considerations
	Viramune® (NVP, nevirapine)	No food restrictions	See Viramune, above
Twice-a-Day PIs
Drug		Food Restrictions	Key Considerations
	Aptivus® (TPV, tipranavir)	Take with food	Must be taken with Norvir Only recommended for use in treatment-experienced people Liver function should be monitored continually Specific side effects*: serious liver problems, elevations in cholesterol/triglycerides, rash, diarrhea, nausea, vomiting, unusual tiredness
	Crixivan® (IDV, indinavir)	No food restrictions when taken boosted with Norvir When not boosted, don't take with high calorie or high-fat meal or drink	Should not be taken with Reyataz; avoid Crixivan if pregnant Normally a three-times-daily med, can be twice-daily when "boosted" with Norvir Specific side effects*: kidney stones, anemia, upset stomach, bloating, skin rash, lipid and glucose disorders
	Invirase® (SQV-HGC, saquinavir)	Take within two hours after a meal	Almost always "boosted" with Norvir Specific side effects*: bloating, diarrhea, nausea; fewer lipid problems than other older PIs
	Kaletra® (combination of lopinavir + Norvir)	Must be taken with food	See Kaletra, above
	Lexiva® (FPV, fosamprenavir)	No food restrictions	See Lexiva, above
	Norvir® (RTV, ritonavir)	Take with high-fat food if possible Refrigeration is preferred, although it can also be kept at room temperature for up to 30 days	Used primarily to "boost" the effectiveness of other PIs Norvir-boosted PIs are associated with increases in triglycerides and cholesterol Specific side effects*: nausea, diarrhea, vomiting, gas
	Prezista® (TMC114, darunavir)	Take with food	Must be taken with Norvir Primarily used by people who have already taken other treatment regimens Specific side effects*: diarrhea, nausea, headache, skin rashes
	Viracept® (NFV, nelfinavir)	Should be taken with food	Weaker than boosted PIs or NNRTIs Specific side effects*: diarrhea, headache, nausea
Twice-a-Day FIs
Drug		Food Restrictions	Key Considerations
	Fuzeon® (T-20, enfuvirtide)	No food restrictions	Primarily used in people who have already taken a lot of HIV drug regimens It is a powder that needs to be mixed with sterile water and injected under the skin Specific side effects*: most people get a skin reaction where the shot is given
* Typical Side Effects of Different Medication Classes NNRTI side effects include, with Sustiva, nervous system and psychiatric side effects, diarrhea, rash, fever. With Viramune, rash and liver complications can be seen. NNRTIs lower effectiveness of birth control pills, so other contraceptives should be used. Possible side effects for NRTIs: pancreatitis, lactic acidosis and mitochondrial toxicity, which can cause neuropathy and wasting. Some NRTIs also contribute to high cholesterol and triglycerides. Possible side effects of protease inhibitors include: high cholesterol and triglycerides, lipodystrophy (body fat changes), high blood sugar with development or worsening of diabetes and increases in liver function tests. PIs also lower effectiveness of birth control pills, so other contraceptives should be used.

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This article was provided by The Body. It is a part of the publication HIV Medications: When to Start and What to Take -- A Roadmap to Success.

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