What is a good replacement drug for Aluvia. (I am resistant to nevirapine family). I have continuous chronic diarrhea as side effect of ALUVIA (taken with Truvada). Diarrhea persists for 24 months now. The drug works very well in suppressing HIV but renders me totally disabled otherwise. Since I have taken Aluvia, I am always tired, constantly soil myself, and have dreaded diarrhea. I take meds for diarrhea but inbetween moments of constipation have unexpected socially embarrassing moments of diarrhea.
Alternative to Aluvia (Kaletra in US) depends on where you are and what drugs are available. With NNRTI resistance (nevirapine family) choices are limited. In US would consider alternative protease inhibitor (particularly darunavir/ritonavir but atazanavir/ritonavir might be OK as well and often less in the way of gut/loose stool problems). Etravirine (another NNRTI), integrase inhibitor (raltegravir), mariviroc (CCR5 inhibitor), and enfuvirtide (fusion inhibitor) would be considered in our clinic depending on known resistance /genotype history and tolerability history. For some patients with Aluvia related diarrhea who are stuck with it, calcium supplements, oat brain, sometimes active culture yogurt, sometimes help manage the loose stools in some patients.KH