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Information

Taking Current Antiretroviral Drugs

September 26, 2014

  1. Nucleoside and Nucleotide Analog Reverse Transcriptase Inhibitors (Nukes)
  2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  3. Combination Therapy
  4. Protease Inhibitors
  5. Fusion Inhibitors
  6. Integrase Inhibitors


1. Nucleoside and Nucleotide Analog Reverse Transcriptase Inhibitors (Nukes)

DrugDaily Pills
(Adults)*
How to Take
and Store
Side EffectsNotes
Abacavir (Ziagen)2 (300 mg: 1, 2x/day or 2, 1x/day)No food restrictions; alcohol boosts abacavir levels.Hypersensitivity reaction in about 8% of patientsDon't use with ust two other nucleoside analogs unless additional drugs are used.
Combivir
(Combination pill)
2 (150 mg lamivudine + 300 mg zidovudine: 1, 2x/day)No food restrictions.Anemia, nausea, vomiting, headache, fatigue, muscle aches, bone marrow toxicity,.Do not take with zidovudine, stavudine or lamivudine.
Didanosine (ddI, Videx, Videx-EC)Buffered tablet: 4 (100 mg: 2, 2x/day or 4, 1x/day)

Videx-EC: 1 pill daily; patients over 60 kg/132 lbs; 250 mg if below

Chew or dissolve in water; take on empty stomach; not within 1 hour of indinavir or 2.5 hours of ritonavir.Diarrhea, pancreatitis, abdominal pain, neuropathy, nausea & vomitingDon't combine with stavudine (d4T). Check with your health care provider if taking tenofovir.
Emtricitabine (FTC, Emtriva)1 (200 mg; 1, once a day)No food restrictions.Headache, diarrhea, nausea, and rash.Do not take with lamivudine (Epivir) or Truvada.
Epzicom
(Combination pill)
1 (600 mg abacavir + 300 mg 3TC: 1, 1x/day)No food restrictions.Nausea, vomiting, fatigue, headachesBlood levels may be increased by bactrim/septra; don't take with (emtricitabine (FTC) or Zerit, d4T;) don't combine with just two other nucleoside analogs unless additional drugs are used.
Lamivudine (3TC, Epivir)2 (150 mg: 1, 2x/day) or

1 (300 mg; 1, 1x/day)

No food restrictions.Nausea, vomiting, fatigue, headaches.Can reduce resistance to AZT. Don't use with abacavir (Ziagen) and tenofovir (Viread) unless additional drugs are used.
Stavudine (d4T, Zerit)2 (40 mg for people over 60 kg/132 lbs body weight, 30 mg if below; 1, 2x/day)No food restrictions.Peripheral neuropathy, headache, chills & fever, diarrhea, nausea, fat loss in arms, legs or face.Don't combine with zidovudine (Retrovir) or didanosine (Videx.)
Tenofovir (Viread)1 (300 mg: 1, 1x/day)No food restrictions.Mild side effects; some nausea, vomiting, loss of appetite. May decrease bone mineral density.Don't combine with ddI. Don't combine with just two other nucleoside analogs unless additional drugs are used. Don't take with Truvada.
Trizivir
(Combination pill)
2 (150 mg 3TC + 300 mg AZT + 300 mg abacavir: 1, 2x/day)No food restrictions.See zidovudine (Retrovir), lamivudine (Epivir) and abacavir (Ziagen) above.Do not take with abacavir (Ziagen), emtricitabine (Emtriva), lamivudina (Epivir), stavudine (Zerit), or zidovudine (Retrovir).
Truvada
(Combination pill)
1 (300 mg tenofovir + 200 mg emtricitabine: 1, 1x/day)No food restrictionsHeadache, nausea, vomiting, rash, loss of appetiteDo not take with ddI (Videx), emtricitabine (Emtriva) or lamivudina (Epivir).
Zalcitabine (ddC, Hivid)Manufacture terminated in 2006
Zidovudine (AZT, Retrovir)6 (100 mg: 2, 3x/day) or

2 (300 mg: 1, 2x/day)

No food restrictions.Anemia, nausea, vomiting, headache, fatigue, muscle aches, bone marrow toxicityDon't combine with d4T.


2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)**

DrugDaily Pills
(Adults)*
How to Take
and Store
Side EffectsNotes
Delavirdine (Rescriptor)12 (100 mg; 4, 3x/day) or

6 (200 mg; 2, 3x/day)

No food restrictions. 100 mg pills can be dissolved in water. Take one hour apart from ddI or antacids.Skin rash, nausea, diarrhea, vomiting, headache, fatigue 
Efavirenz (Sustiva)3 (200 mg; 3, 1x/day) or

1 (600 mg; 1, 1x/day)

Take on an empty stomach before going to sleep.Vivid dreams, anxiety, rash, nausea, dizziness, diarrhea, headache and insomnia

May cause false positive result on test for marijuana use.

Etravirine (Intelence)4 (100 mg, 2, 2x/day)Take after a mealRash, nausea, abdominal pain 
Nevirapine (Viramune)1 (200 mg; 1, 1x/day for the first two weeks) then 2 (200 mg; 1, 2x/day)No food restrictions.Skin rash, fever, headache, nausea.Watch for liver problems.
Rilpivirine (Edurant)1 (25 mg; 1, 1x/day)Take with mealDepression, insomnia, headache, rash 
** NNRTI's are metabolized by the liver, as are many other commonly used drugs. Drug interactions can cause large increases or decreases in the blood levels of drugs you are taking, leading to under-doses that are ineffective, or overdoses that can be fatal. Make sure your health care provider knows about all medications you are taking.


3. Combination Therapy

(Several classes of drugs in one pill)

DrugDaily Pills
(Adults)*
How to Take
and Store
Side EffectsNotes
Atripla (emtricitabine + tenofovir + efavirenz)1 (600 mg efavirenz + 200 mg emtricitabine + 300 mg tenofovir)Take on an empty stomach before going to sleep.Vivid dreams, anxiety, rash, nausea, dizziness, diarrhea, headache and insomnia, vomiting, loss of appetite.May cause false positive result on test for marijuana use.
Complera (emtricitabine + rilpivirine + tenofovir)1 (200 mg emtricitabine + 25 mg rilpivirine + 300 mg tenofovir)Take with a mealDepression, insomnia, headache, rash, diarrhea, vomitingShould not be initiated in people with viral loads over 100,000 copies/mL.
Stribild (emtricitabine + tenofovir + elvitegravir + cobicistat) 1 (150 mg elvitegravir,+ 150 mg cobicistat + 200 mg of emtricitabine, + 300 mg of tenofovir)Take with food; 2 hours apart from antacidsHeadache, diarrhea, nausea, vomiting, vivid dreams, anxiety, rash, dizziness, insomnia, and loss of appetite. Loss of bone mineral densityShould not be started in people with severe kidney injury.
Triumeq (dolutegravir+abacavir+lamivudine)1 (50 mg dolutegravir + 600 mg abacavir + 300 mg lamivudine)No food restrictions. Take with food if also taking multivitamins or certain antacids or supplements.Diarrhea, nausea and headache.Genetic screening for abacavir allergy should be performed.


4. Protease Inhibitors

DrugDaily Pills
(Adults)*
How to Take
and Store
Side EffectsNotes
Amprenavir (Agenerase)Manufacture terminated in 2007. Replaced by fosamprenavir (see below).Protease inhibitors are metabolized by the liver, as are many other commonly used drugs. Drug interactions can cause large increases or decreases in the blood levels of drugs you are taking, Interactions can cause under-doses that are ineffective, or overdoses that can be fatal. Make sure your health care provider knows about all medications and supplements you are taking.
Atazanavir (Reyataz)2 (300 mg, 1 + 1 ritonavir 100 mg) once a day or 2 (200 mg, once a day)

Take with food.

High levels of bilirubin. Nausea, headache, rash, stomach pain, vomiting, diarrhea, tingling in hands or feet, and depression. Changes in heart rhythm.

Darunavir (Prezista)6 (300 mg, 2 + 1 ritonavir, twice a day)Take with food.Diarrhea, nausea, vomiting, headache and common cold. Rash which in rare cases may be serious.
Fosamprenavir (Lexiva)4 (700 mg; 2, twice a day) or 4 (700 mg, 2 + 2 ritonavir, once a day; or 700 mg, 1 + 1 ritonavir twice a day)No food restrictions.Nausea, diarrhea, vomiting, rash, numbness around mouth, abdominal pain. Increase in cholesterol and triglycerides.
Indinavir (Crixivan)6 (400 mg: 2, every 8 hrs, not 3x/day) or

9 (333 mg; 3 every 8 hours)

Take with lots of water, on empty stomach or with low-fat snack. Keep cool and dry.

Headache, nausea, abdominal pain, kidney stones.

Lopinavir/ritonavir (Kaletra, Aluvia)4 (200 mg lopinavir + 50 mg ritonavir: 2, 2x/day)

No food restrictions for tablets; take liquid with food. Keep at room temperature.

Diarrhea, fatigue, headache, nausea. Increase in cholesterol and triglycerides.

Nelfinavir (Viracept)9 (250 mg; 3, 3x/day) or 10 (5, 2x/day) or 4 (625 mg; 2, 2x/day)

Take with meals or a snack.

Diarrhea, nausea, gas, abdominal pain, weakness.

Ritonavir (Norvir)12 (100 mg: 6, 2x/day); small doses used to boost other protease inhibitors

Take with food if possible. Keep refrigerated. Take 2 hours apart from ddI.

Nausea, vomiting, diarrhea, tingling & numbness around mouth. Increase in cholesterol and triglycerides.

Saquinavir (Invirase)6 (500 mg: 2 + 1 100 mg ritonavir, 2x/day)

Take within two hours of a full meal or large snack. In hot climates, keep refrigerated.

Minimal nausea, diarrhea, abdominal discomfort.

Tipranavir (Aptivus)8 (250 mg, 2 + 2 ritonavir 100 mg, twice a day)

Take with food. Refrigerate, or keep at room temperature up to 60 days.

Diarrhea, rash, nausea, vomiting, stomach pain, tiredness and headache. Worsening of liver problems. Increase in cholesterol and triglycerides.


5. Fusion Inhibitors

DrugDaily Pills
(Adults)*
How to Take
and Store
Side EffectsNotes
Enfuvirtide (Fuzeon)2 injections each day. 90 mg per injection for adults.

No food restrictions.

Skin reactions where drug is injected ranging from redness and itching to hard lumps. 
Maraviroc (Selzentry, Celsentri)1 or 2 tablets twice each day. 150, 300 or 600 mg per tablet.

No food restrictions.

Cough, fever, upper respiratory infections, rash, sore muscles, abdominal pain, and dizziness. Can be hard on the liver.Dosage depends on other medications being taken.


6. Integrase Inhibitors

DrugDaily Pills
(Adults)*
How to Take
and Store
Side EffectsNotes
Raltegravir (Isentress)2 tablets (400 mg, 1, 2x/day)

No food restrictions.

Diarrhea, nausea and headache; elevated levels of creatine kinase (relates to muscle problems 
Dolutegravir (Tivicay)1 tablet (50 mg, 1, 1x day)

No food restrictions. Take with food if also taking multivitamins or certain antacids or supplements.

Insomnia, headachesDosed 50 mg 1, 2 x/day in patients with suspected integrase inhibitor resistance

* These pill counts reflect the "normal" use of each drug. However, doctors are now combining antiretroviral medications in new ways. Doses of each drug may be higher or lower in the new combinations.



  
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This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.
 
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