Fosamprenavir Efavirenz

Lopinavir/Ritonavir (Kaletra) [Anrirelroviral/Protease Inhibitor] Uses HIV Infxn Action Protease inhibitor Dose Adults. Tx naive 2 tab PO daily or 1 tab PO bid Tx experiencedpt 1 tab PO bid (T dose if w/ amprenavir, efavirenz, fosamprenavir, nelfinavir, nevirapine) Peds. 7-15 kg 12/3 mg/kg PO bid 15-40 kg 10/2.5 mg/kg PO bid >40 kg Adult dose w/ food Caution [C, /-] Numerous interactions Contra w/drugs dependent on CYP3A/CYP2D6 (Table VI-8) Disp Tab, soln SE Avoid disulfiram (soln has EtOH), metronidazole GI upset, asthenia, T cholesterol/triglycerides, pancreatitis protease metabolic synd Interactions T Effects Wl clarithromycin, erythromycin T effects OF amiodarone, amprenavir, azole andfungals, bepridil, cisapride, cyclosporine, CCBs, ergot alkaloids, flecainide, flurazepam, HMG-CoA reductase inhibitors, indinavir, lidocaine, meperidine, midazolam, pimozide, propafenone, propoxyphene, quinidine, rifabutin, saquinavir, sildenafil, tacrolimus, terfenadine, triazolam, zolpidem 1 effects Wl barbiturates, carbamazepine, dexamethasone, didanosine, efavirenz, nevirapine, phenytoin, rifabutin, rifampin, St. John s wort 1 effects OF OCPs, warfarin EMS Use andarrhythmics and benzodiazepines... 

Zidovudine Didanosine Stavudine Lamivudine Abacavir Tenofovir Emtricitabine Nevirapine Efavirenz TMC125 Saquinavir Indinavir Lopinavir Fosamprenavir Atazanavir Tipranavir Darunavir Raltegravir Elvitegravir Enluvirtide Maraviroc Vicriviroc Bevirimat... 

Current recommendations for treating HIV infection advocate a minimum of three antiretroviral agents. The typical regimen consists of two NtRTIs and either a ritonavir-boosted PI or NNRTI. The dual NtRTI backbone should include tenofovir plus emtricitabine (coformulated as Truvada) or zidovudine plus lamivudine (coformulated as Combivir). Abacavir plus lamivudine is an alternative. Recommended initial NtRTIs include atazana-vir-ritonavir, lopinavir-ritonavir, or fosamprenavir-ritonavir. Efavirenz is the recommended NNRTI except for women who plan to become pregnant or who do not have adequate contraception. 

Concomitant therapy with efavirenz, nevirapine, fosamprenavir, or nelfinavir-Consider a dose increase to 533/133 mg lopinavir/ritonavir (4 capsules or 6.5 mL) twice daily taken with food when used in combination with efavirenz, nevirapine, amprenavir, or nelfinavir, or 600/150 mg (3 tablets) twice daily with or without food when used in combination with efavirenz, nevirapine, fosamprenavir without ritonavir, or nelfinavir in treatment-experienced patients where decreased susceptibility to lopinavir is clinically suspected (by treatment history or laboratory evidence). 

Ritonavir dose adjustment when fosamprenavir plus ritonavir are administered with efavirenz An additional 100 mg/day (300 mg total) of ritonavir is recommended when efavirenz is administered with fosamprenavir plus ritonavir once daily. 

Fosamprenavir plus ritonavir may interact with flecainide, propafenone, efavirenz plus ritonavir, and lopinavir plus ritonavir. Efavirenz may affect fosamprenavir with or without ritonavir. 

Abacavir (Ziagen) Amprenavir (Agenerase) Delavirdine (Rescriptor) Didanosine [ddl] (Videx) Efavirenz (Sustiva) Efavirenz/Emtricitabine/ Tenofovir (Atripla) Fosamprenavir (Lexiva)... 

Concurrent therapy with efavirenz PO In patients receiving fosamprenavir plus once-daily ritonavir in combination with efavirenz, an additional 100 mg/day ritonavir (300 mg total/day) should be given. 

Atazanavir Ritonavir Fosamprenavir, didanosine, efavirenz, etravirine, stavudine, tenofovir... 

Fosamprenavir Abacavir, atazanavir, delavirdine, etravirine, indinavir, lopinavir, ritonavir, tipranavir, zidovudine Didanosine, efavirenz, nevirapine, saquinavir... 

Lopinavir Delavirdine, indinavir, ritonavir, darunavir Fosamprenavir, efavirenz, nelfinavir, nevirapine, tenofovir... 

Nelfinavir Fosamprenavir, delavirdine, efavirenz, indinavir, ritonavir, saquinavir ... 

Taltobulin, 11 Tamibarotene, 76 Tandutinib, 183 Tanomastat, 47 Tezacitabine, 131 Tipifamib, 172 Topixantrone, 227 Troxacitabine, 131 Vandetanib, 181 Antipsoriatic Ecalcidine, 38 Antiviral Amdoxovir, 199 Amprenavir, 4 Aplaviroc, 134 Atazanavir, 7 Capravirine, 95 Clevudine, 130 Daninavir, 5 Efavirenz, 177 Emivirine, 123 Emtricitabine, 132 Etravirine, 123 Fosamprenavir, 6 Lopinavir, 7 Maraviroc, 107 Maribavir, 158 Omaciclovir, 199 Oseltamivir, 25 Peramavir, 53 Rupinavir, 9 Tenofovir, 197 Tiprinavir, 120 Anxiolytic Sunepitron, 209 Apetite Supressant Rimonabant, 99 Cardiotonic Naxifylline, 203 Torborinone, 172 Collagenase Inhibitor Cipemastat, 99 Diuretic Lixivaptan, 222 Tolvaptan, 186 Elastase Inhibitor Sivelstat, 54... 

Clinically important, potentially hazardous interactions with almotriptan, amprenavir, clarithromycin, darunavir, delavirdine, efavirenz, erythromycin, fosamprenavir, indinavir, naratriptan, nelfinavir, nilotinib, ritonavir, rizatriptan, saquinavir, sibutramine, sumatriptan, telithromycin, tipranavir, troleandomycin, zolmitriptan... 

ABBREVIATIONS EFV, efavirenz 3TC, lamivudine AZT, zidovudine TDF, tenofovir disoproxil fumarate d4T, stavudine LPV/r, lopinavir/ritonavir coformulation FTC, emtricitabine NVP, nevirapine ddl, didanosine ATV, atazanavir fosAPV, fosamprenavir RTV, ritonavir IDV, indinavir NFV, nelfinavir SQV, saquinavir. 

The AUC, minimum, and maximum levels of amprenavir 1.2 g twice daily were increased by 131%, 484%, and 33%, respectively, by ritonavir 200 mg twice daily. This agrees with in vitro data. The manufacturer recommends that doses of both protease inhibitors be reduced when they are used together. Based on modelling of pharmacokinetic data, a dose of amprenavir 600 mg with ritonavir 100 mg, both twice daily, has been suggested. This combination has shown good clinical efficacy in at least one study, and resulted in satisfactory amprenavir levels when efavirenz was also used" (see also NNRTIs + ftotease inhibitors , p.785). Amprenavir levels with fosamprenavir/ritonavir 700/100 mg twice daily were similar to those achieved with amprenavir/ritonavir 600/100 mg twice daily. ... 

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