I'm getting major side effects from the liquid version of Ritonavir
since being forced to switch from the capsules by Abbot.  The symptoms
include heavy diarrhea (10-15 times/day), cramping, and nausea.  I had
no symptoms at all with the capsules.  Ritonavir has kept my viral
load undectable for 2 years.  Are there any reasonable alternatives?
I'm not crazy about living my life around when I can eat with
Crixivan, and I've heard that Viracept does not work as well.

There is no evidence that viracept (nelfinavir) does not work as well
as the other proteases. This is because there has never been a
head-to-head comparison between PIs comparing their clinical benefits.
In the CPCRA we are currently conducting a trial comparing ritonavir
to nelfinavir, but we don't expect results for at least a year more.
One factor to consider, however, is that nelfinavir does cause
diarrhea in some patients. If you already are suffering with
weight loss and/or dirrhea (other than what ritonavir is causing)
you might want to try another drug. One possibility is amprenavir
(agenerase), made by Glaxo-Wellcome. An expanded access program
opened recently, and it is likely this drug will be approved by the
FDA this fall.

Carlton

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 |   Carlton Hogan  (carl...@gopher.ccbr.umn.edu)                         |
 |   Community Programs for Clinical Research on AIDS Statistical Center  |
 |   Coordinating Center for Biometric Research                           |
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   Affilation provided for purpose of identification, not representation.

You can add my name to the list of persons who have been switched to the
liquid version of Rotonavir and have, I believe as a consequence, developed
the same side effects.  I've been checking the Abbot Labs Website
periodically in the hope that I'll find something posted about when the
capsules will be available.  As three months has passed, and I have found no
updates posted on this problem, I'm getting cynical about what is really
going on. Can anybody shed any light???

In article <52...@sci.med.aids>, RICHARD AAGAARD
<raaga...@earthlink.net> writes

Sorry to hear all the bad news and hate to add to it but I think I read
somehere Abbott estimated it would be December before capsule production
would recommence and the writer indicated he felt this indicated more
likely it meant more like April/May next year.

Then last weeks DrFax put out by AIDS Treatment Project in UK indicated
they heard that capsule production was not going to recommence ever.

I've been in hospital last four days in Manchester UK and was talking
with the Pharmacist who said teh Uk rep was in over lunch Monday and
just went 'schtum' when asked about this report ...'no comment' in other
words.

As for side effects, I've just come off ritonavir as I developed an
alcohol intolerance and it was felt that i might not tolerate the liquid
formulation which has 45% ethanol content.....don't know if the side
effects can be ameliorated in the same way with the lquid as the
capsules but I always found eating half a meal, taking the capsules and
then eating the other half of the meal , i.e. sandwiching...minimised
the 'trots' for me...you might try that.

Alternatives? Well I transferred to Abacavir and Sustiva. First four
days had vivid dreams but not the nightmares or anxiety attacks some
experience. Next four days had the headaches from hell that required 8
co-dydramol a day to contain the pain before they too disappeared as
quickly as they came. Next week and a half I had dreadful flu which the
ID doc didn't think related to the two drugs but I have been having
dizziness and blood pressure drops which appear to have settled somewhat
but they are checking for adrenal gland working to be certain...on the
plus side...PI paunch apears to be gowing...chest hair returning and
libido lost for the last two Ritonavir years has come back with a
veangance in the last two days...but VL has gone from 40 to 400 in two
weeks....it's one of those trade off games I guess and hopefully I can
get a vodka or two before Xmas...googd luck

--
Stephen J Barksby

Just from personal experience --Since Ritonavir
has kept your viral load "undetectable" for two
years,
it's important to continue with it.
First, try to tolerate the side effects to see if
they subside within a month.
If the side effects are still intolerable, one
option is to take onehalf dose
of Ritonivir and onehalf dose of Fortovase (the
new and improved
saquinavir).  Both these medications are to be
taken with food and
only twice daily which makes for an easy drug
regimen.
Best of luck to you -- Aaron