Keep it Simple

When I started my first anti-HIV drug combination in 1996, it consisted of Crixivan (nine pills a day), Viramune (two pills a day), Epivir (two pills a day) and, if you add on my prophylaxis plus vitamins, I was well into over 20 pills, not to mention having to remember the times of day to take them. We have actually come a long way since then. Most drug combinations being used today only need to be taken twice daily, with several drugs both available now and on the horizon that only need to be taken once a day. More importantly, the number of pills HIV-positive people need to take is getting lower, which is helping to reduce their pill burden and pill fatigue.

Some pharmaceutical companies have combined some of their anti-HIV medications into single tablets or capsules, called "combination drugs." With Food & Drug Administration approval this summer of two new combination drugs -- GlaxoSmithKline's Epzicom and Gilead Sciences' Truvada -- there are now four combo drugs available. (The other two are Combivir and Trizivir.) This article highlights the two new combo drugs.

What is Epzicom?

Epzicom is an acronym for Epivir and Ziagen in combination; it is marketed by GlaxoSmithKline. Epzicom is a combination of 600 mg of Ziagen and 300 mg of Epivir.

How is it taken?

• Epzicom is taken once a day, with or without food by mouth as a tablet.

• It must be combined with at least one other anti-HIV drug, usually a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI).

What about side effects?

• The most serious side effect of abacavir (one of two nucleoside analogues found in Epzicom) is a hypersensitivity reaction. About 8% of people who take abacavir have these reactions (fever, rash, headaches, no energy, nausea, vomiting, diarrhea, stomach pain, cough, shortness of breath, sore throat). If you develop any of these symptoms, call your doctor immediately.

• Levels of lactic acid in the blood (lactic acidosis, which can be fatal).

• Liver problems, including "fatty liver," may also occur.

What about drug interaction?

• Should not be taken with ddC (Hivid), d4T (Zerit), Emtriva or Truvada

What is Truvada?

• Truvada is a pill that contains two drugs used to fight HIV: tenofovir (Viread) and emtrictabine (Emtriva). Truvada is manufactured by Gilead Sciences.

How is it taken?

• Is taken by mouth as a tablet, once a day, with food or between meals.

• Truvada should not be used as part of a triple-nucleoside regimen.

What about side effects?

• The most common side effects are the same as with tenofovir (headache, nausea, vomiting, rash and loss of appetite). In some people, tenofovir can increase creatinine and transaminases. These are enzymes related to kidneys and liver. High levels can indicate damage to these organs.

• The Viread in Truvada may cause bone problems.

What about drug interaction?

• Should not be taken with ddI (Videx), 3TC (Epivir) or any other combination drugs (Combivir, Trizivir) containing 3TC.

To get more information on these new anti-HIV drugs and others, please visit our Treatment Resource Center here at AIDS Survival Project, call (404) 874-7926 ext. 13 or 19, or go to these Web sites:

• www.AIDSmeds.com

• www.TheBody.com

• www.aidsinfonet.org

As always, KEEP SAFE!