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
__________________________________________________________________________
| |
| Carlton Hogan (car...@gopher.ccbr.umn.edu) |
| Community Programs for Clinical Research on AIDS Statistical Center |
| Coordinating Center for Biometric Research |
| Division of Biostatistics, School of Public Health |
| University of Minnesota http://www.biostat.umn.edu/~carlton |
| 2221 University Ave SE, Suite 200 Voice: (612) 626 8899 |
| Minneapolis MN 55414 FAX: (612) 626 8892 |
|________________________________________________________________________|
Affilation provided for purpose of identification, not representation.
Ron wrote in message <52...@sci.med.aids>...
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
> 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.
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