HIV DRUGS
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| Videx | Didanosine | Nukes(Reverse Transcriptase Inhibitor) | Pancreatitis, peripheral neuropathy, nausea, vomiting, fatigue, myalgia, bone marrow suppression, mitochondrial dysfunction | Tenofovir-Increase AUC but 66-75% dose-60kg-250mg qd, <60kg 200mg qd Additive mito tox with AZT and d4T | ddI | WT >= 60kg 400 mg qd WT<60kg 250mg qd Renal Dose Adjust |
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| Sustiva | Efavirenz | Non-Nukes(Reverse Transcriptase Inhibitor) | Mental Status Changes(worsens Depression/mania) Dreams-hungover feeling, Manic Feeling, Rash, Drug Interactions, | D | CYP450-Mixed-St. John's Wort, Midazolam, triazolam, Methadone, Rifabutin, Posaconazole, Voriconazole, Itraconazole, | EFV | 600 mg qhs |
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| Viramune | Nevirapine | Non-Nukes(Reverse Transcriptase Inhibitor) | Rash, Itching BBW-Liver Toxicity Men- CD4>400Women-CD4>250 | CYP450-InducerSt. John's Wort | NVP | 200 mg bid for 14 days then 400 mg qd |
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| Rescriptor | Delaviridine | Non-Nukes(Reverse Transcriptase Inhibitor) | Liver Dysfunction, Drug Interactions BBW-Liver Toxicity Men-CD4>400, Women-CD4>250 | CYP450-Inhibitor St. John's Wort | DLV | 1200 mg qd |
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| Edurant | Rilpivirine | Non-Nukes(Reverse Transcriptase Inhibitor) | Drug Interactions, Risk for Virologic Failure when VL>100,000, Side effects less than Efavirenz, Rash, Depression, Insomnia, Headache, Can increase resistance in 1st generation NNRTI and Etravirine | B | St. John's Wort, Antacids-2h before 4h after, h2-12h before, 4h after, PPI-dont use,Carbamazepine, Phenobarbitol, Phenytoin, Dexamethasone Rifabutin | RPV | 25 mg qd w/meal |
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| Intelence | Etravirine | 2nd generation Non-Nukes(Reverse Transcriptase Inhibitor) | Food Increase Absorption by 50% Works against 1st gen resistant virus, Can cause resistance in all NNRTI's | B | St. John's Wort, Carbamazepine, Phenobarbitol, Phenytoin | ETR | 200 mg bid w/meals |
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| Combivir | Zidovudine and Lamivudine | Combo Nukes(Reverse Transcriptase Inhibitor) | Nausea, vomiting, headaches, myalgia, anemia, mitochondrial dysfunction(less when combined with epivir, Pancreatitis, AST/ALT (very well tolerated) | Stavudine-require same enzyme don not give together-additive Mito tox with d4T and ddI, Ganciclovir, Interferon, Chemotherapy, | 1 T bid (300mg/150mg)Renal Dose Adjust |
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| Epzicom | Abacavir and Lamivudine | Combo Nukes(Reverse Transcriptase Inhibitor) | Hypersensitivity RXN in 8% rash, fever, fatigue, nausea, vomiting, abdominal cramping, respiratory symptoms, Death-hypotension (less frequent in afro-americans)Pancreatitis, AST/ALT (very well tolerated) | 1 T qd (600mg/300mg)Renal and Hepatic Dose Adjust |
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| Truvada | Tenofovir and Emtricitabine | Combo Nukes(Reverse Transcriptase Inhibitor) | Minimal(well tolerated) liver, GI, Renal-Hispanics and Afro-Americans, worse with other nephrotoxins, Scr < 50ml/min requires dosing changes, Nausea, Rash, diarrhea, headache, skin discoloration, (very well tolerated) | 1 T qd (200mg/300mg)Renal Dose Adjust |
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| Trizivir | Abacavir, Lamivudine, and Zidovudine | Combo Nukes(Reverse Transcriptase Inhibitor) | Hypersensitivity RXN in 8% rash, fever, fatigue, nauseavomitingal crampingrespiratory symptomsDeath-hypotension (less frequent in afro-americans) Pancreatitis, AST/AL headaches, myalgia, anemia, mitochondrial dysfunction(less when combined with epivir) | 1 T BID Renal and Hepatic Dose Adjust |
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| Atripla | Efavirenz, Tenofovir, and Emtricitabine | Combo Nukes(Reverse Transcriptase Inhibitor) | Mental Status ChangesworsensDepression/mania Dreams-hungoverfeelingManic FeelingDrug Interactions liverGIRenal-Hispanics and Afro-Americansworse with other nephrotoxins, Scr < 50ml/min requires dosing changesNausea, Rash, diarrhea, headache, skin discolor | Renal Dose Adjust |
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| Complera | Rilpivirine, Tenofovir, and Emtricitabine | Combo Nukes(Reverse Transcriptase Inhibitor) | Nausea, Rash, diarrhea, headache, skin discolor liver, GI, Renal-Hispanics and Afro-Americansworse with other nephrotoxins, Scr < 50ml/minrequiredosingchangesDrug Int Risk for VirologicFailurewhen VL>100,000SideeffectslessthanEfavirenzDepression Insomnia | Renal Dose Adjust |
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| Stribild | Elvitegravir, cobicistat, tenofovir and emtricitabine | combo Nukes(Reverse Transcriptase Inhibitor) Integrase Inhibitor | Nausea, diarrhea, gas, Increased Scr.1-.2mg/dL-cobicistat effect-.4mg/dL or more renal toxicity | CYPdrugintCobicistatCYP450InhibitorAlfuzosinSildenafilforPulHtnCisapridepimozideergotstriazolammidazolamsimvastlovastRifampinStJohnWortCarbamazepinePhenobarbPhenytoinAtorvapitivistatinColchicineFluticasoneDexamethasoneSalmeterolAntiarrythmaAntifungImmunos | 1 T qd w/food-Renal Dose Adjust |
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| Fuzeon | Enfuvirtide | Entry Inhibitor, Fusion Inhibitor | Injection site reactions, Injection Fatigue | T-20 | 90 mg bid SUBQ-must be reconstituted and injected-24 hour stability in refrigerator |
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| Selzentry | Maraviroc | Entry Inhibitor, Co-receptor Antagonist | BBW-Hepatotoxicity, Systemic Allergic Reactions, Fever, abdominal Pain, muscle and joint pain. skin rash, cough, upper respiratory tract infection, sleep disturbances | B | Carbamazepine, Phenobarbitol, Phenytoin-use MCV 600mg bid, Clarithromycin-use MCV 150 mg bid St. John's Wort, Voriconazole, Use MCV 150mg bid, Rifabutin-MCV 300mg bid, Rifampin | MCV | w/boostedPI Strong 3A inhibitor-150mg bid-with tipraniavir/nrtis/Nevirapine neither inducer or inhibitor, 300mg bid-with efavirenz strong 3A inducer, 600mg bid |
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| Isentress | Raltregravir | Integrase Inhibitor | Good side effect profile, not a cyp450 3A4 problem. | Do not use with Rifampin | RAL | 400 mg T bid no food restrictions, well tolerated |
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| Invirase | Saquinavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis | CYPSubstratePhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecreasedose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonelevel | SQV | 1000mg/100mg bid SQV/r | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil, flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Norvir | Ritonavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis, Vomiting, Drug Interaction, CIRCUMORAL PARASTHESIAS-From Boosting PI's | CYP450 SubstrateInhibitorPhenytoinCarbemazepinePhenobarbitolMonitorSerumlevAtorvastatinDecdoseby50%SildenafilVardenafilTadalafilAUCincDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonelevel | RTV | 600 mg q12h w/food (capsule 100mg) | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Crixivan | Indinavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis, Nephrolitiasis, Jaundice, Skin changes | CYP450 SubstratePhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecdose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonelevel | IDV | 800mg po q8h on empty stomach | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Viracept | Nelfinavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis | PhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecreasedose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonelevel | NFV | 750mg tid or 1250 mg bid | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Lexiva | Fosamprenavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis, RASH-12-19% | CYP450 SubstratePhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecreasedose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonelevel | FPV | 1400mg bid, 1400mg/200mg qd 700mg/100mg bid FPV/r | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Kaletra | Lopinavir and Ritonavir | Combo Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis | CYP450 SubstratePhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecreasedose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonel | LPV/r | 2 T bid or 4 qd -200mg/50mg per Tab LPV/r | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Reyataz | Atazanavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis, Hyperbilirubinemia, Jaundice, Not same effect cholesterol and triglycerides other PI's | Tenofovir-Dec ATA and AUC levels by 25%, boost with r 100 mg qd ATV 300mg qd CYP450 Substrate-SameasPI's and can't begiven with other PI's. H2-decabsor of ATV, sep by 12h and boost ATV. Antacids Dec Abs ATV antacid 2hs before and 1h after ATV-Raltegravir | ATV | 400 mg qd 300mg/100mg qd ATV/r | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Aptivus | Tipranivir | Protease Inhibitor | Most difficult PI to take. Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis, CNS bleeding, | CYP450 Substrate-InducerPhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecreasedose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreaseme | TPV | 2 bid with 2 Norvir-500mg/200mg TPV/r | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Prezista | Darunavir | Protease Inhibitor | Can have any but not all-Nausea,diarrhea, gas, bloating, increased serum lipids, increased blood sugar, lipodystrophy, dry skin, increased liver enzymes, osteonecrosis | CYP450 SubstratePhenytoinCarbemazepinePhenobarbitolMonitorSerumlevelsAtorvastatinDecreasedose by50% SildenafilVardenafilTadalafilAUCincreasedDONOTUSEforPul HTNColchicinedoseadjustmentneededFluticasoneadrenalsuppressionMethadoneBoostedPisdecreasemethadonel | DRV | 2 T bid with Norvir 600mg/100mg DRV/r or 2 T qd with Norvir 800mg/100mg DRV/r (Naive) | PI'sDecmet/Incserum-cisapride,pimozide,ergots,triazolam,midazolam,simvast,lovast,pitvas,amiodarone,bepridil,flecainide,propafenone,quinidine,salmeterol,ethinylestridiolIncrease PI met and dec.scr-Rifampin,rifabutin,stJohn'swort,garlicpills
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| Retrovir | Zidovudine | Nukes(Reverse Transcriptase Inhibitor) | Nausea, vomiting, headaches, myalgia, anemia, mitochondrial dysfunction(less when combined with epivir) | Stavudine-require same enzyme don not give together-additive Mito tox with d4T and ddI, Ganciclovir, Interferon, Chemotherapy | AZT, ZVD | 200 mg tid or 300 mg bid 100 mg 5 times qd Renal Dose Adjust |
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| Zerit | Stavudine | Nukes(Reverse Transcriptase Inhibitor) | Pancreatitis, peripheral neuropathy, nausea, vomiting, fatigue, myalgia, bone marrow suppression, mitochondrial dysfunction | Zidovudine-require same enzyme do not give together -additive mito tox with ddI and AZT | d4T | Wt>= 60 kg 40 mg bid Wt<60 kg 30 mg bid Renal Dose Adjust |
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| Epivir | Lamivudine | Nukes(Reverse Transcriptase Inhibitor) | Pancreatitis, AST/ALT (very well tolerated) | 3TC | 150 mg bid or 300 mg qd Renal Dose Adjust |
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| Ziagen | Abacavir | Nukes(Reverse Transcriptase Inhibitor) | Hypersensitivity RXN in 8% rash, fever, fatigue, nausea, vomiting, abdominal cramping, respiratory symptoms, Death-hypotension (less frequent in afro-americans) | ABC | 300 mg bid, 600 mg qd Hepatic Dose Adjust |
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| Emtriva | Emtricitabine | Nukes(Reverse Transcriptase Inhibitor) | Nausea, Rash, diarrhea, headache, skin discoloration, (very well tolerated) | FTC | 200 mg qd Renal Dose Adjust |
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| Viread | Tenofovir | Nucleotide reverse transcriptase inhibitor | Minimal(well tolerated) liver, GI, Renal-Hispanics and Afro-Americans, worse with other nephrotoxins, Scr < 50ml/min requires dosing changes | Increases Didanosine AUC by 66-75%-Atazanavir, Decreases ATA levels and AUC by 25% | TDF | 300mg qd Renal Dose Adjust |
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