Impotentie brengt een constant ongemak met zich mee, net als fysieke en psychologische problemen in uw leven cialis kopen terwijl generieke medicijnen al bewezen en geperfectioneerd zijn

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New York/New Jersey
AIDS Education
Helpful HIV Medication Tables for Pharmacists
& Training Center
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors www.nynjaetc.org
Patient Counseling Points - Food Effect and Adverse Effects Abacavir
Food Effect – Take without regard to meals. Adverse Effects – Patients should be warned about the abacavir
hypersensitivity reaction (HSR) which is characterized by fever, rash, nausea, vomiting, malaise or fatigue, loss of appetite, sore throat, cough, shortness of breath. Fatalities associated with the HSR have been reported, especially ifpatients are rechallenged. * Didanosine
Food Effect – Take 1/2 hour before or 2 hours after a meal.
Adverse Effects – Peripheral neuropathy, pancreatitis and nausea. *
<60kg – 250mg once daily; withtenofovir give 200mg once daily Emtricitabine
Food Effect – Take without regard to meals. Adverse Effects – Minimal; Hyperpigmentation/skin discoloration
Lamivudine
Food Effect – Take without regard to meals. Adverse Effects – Minimal; pancreatitis has been reported. *
Stavudine
Food Effect – Take without regard to meals. Adverse Effects – Peripheral neuropathy, lipodystrophy, hyperlipidemia,
pancreatitis. Rare, rapidly ascending neuromuscular weakness. * Tenofovir
Food Effect – Take without regard to meals. Adverse Effects – Asthenia, headache, diarrhea, nausea, vomiting,
Zidovudine
Food Effect – Take without regard to meals. Adverse Effects – Bone marrow suppression (macrocytic anemia,
neutropenia), headache, insomnia, gastrointestinal intolerance, asthenia. * * Lactic acidosis with hepatic steatosis is a rare, potentially life-threatening adverse event with the use of Nucleoside/Nucleotide Reverse Transcriptase Inhibitors.
Non-Nucleoside Reverse Transcriptase InhibitorsMedication Patient Counseling Points - Food Effect and Adverse Effects Delavirdine
Food Effect – Take without regard to meals. Adverse Effects – rash, increased liver function tests, headache.
(Rescriptor®)
Efavirenz
Food Effect – Take on an empty stomach. Adverse Effects – Rash, central nervous system symptoms, lasting for
approximately the first 2-4 weeks, including abnormal dreams, dizziness, somnolence and euphoria; increased liverfunction tests, false-positive cannabinoid test, teratogenic (Pregnancy Category D).
Nevirapine
Food Effect – Take without regard to meals. Adverse Effects – Rash, including Stevens-Johnson Syndrome;
symptomatic hepatitis, including fatal hepatic necrosis reported. Higher frequency of hepatic events reported in treatment naïve females with CD4 >250 cells/mm3, and treatment naive males with CD4 >400 cells/mm3.
Patient Counseling Points - Food Effect and Adverse Effects Atazanavir
Food Effect – Take with food. Adverse Effects – Indirect hyperbilirubinemia; prolonged PR interval, (use with caution
in patients with underlying conditions or concomitant medications that can cause PR prolongation); hyperglycemia, fat with Efavirenz or tenofovir: 300mg maldistribution, possible increased bleeding episodes in patients with hemophilia. with ritonavir 100mg once dailyNo data with nevirapine. Darunavir
Food Effect – Take with food. Adverse Effects – Skin rash (7%) including Stevens-Johnson Syndrome and erythrema
multiforme reported, caution in sulfa allergic patients, as darunavir contains a sulfonamide moiety; diarrhea, nausea, headache, hyperlipidemia, increased liver function tests, hyperglycemia, fat maldistribution, possible increased bleedingepisodes in patients with hemophilia. Fosamprenavir
Food Effect – Take without regard to meals. Adverse Effects – Skin rash (19%) including Stevens-Johnson Syndrome,
caution in sulfa allergic patients, as fosamprenavir contains a sulfonamide moiety; diarrhea, nausea, vomiting, headache, hyperlipidemia, increased liver function tests, hyperglycemia, fat maldistribution, possible increased bleeding episodes in patients with hemophilia.
100mg twice daily
If taken with Efavirenz:
1400mg with ritonavir 300mg once
daily* or 700mg with ritonavir
100mg twice daily *Once daily
dosing is not recommended in
ARV experienced patients.
No data with nevirapine.
Indinavir
Food Effect – Reqires 1.5 liters of fluid daily. Without ritonavir – Take 1 hour before or 2 hours after meals; may take
with skim milk or low fat meal. With ritonavir – Take with or without food. Adverse Effects – Nephrolithiasis,
GI intolerance, nausea, indirect hyperbilirubinemia, hyperlipidemia, headache, asthenia, blurred vision, dizziness, rash, metallic taste, thrombocytopenia, alopecia, hemolytic anemia, hyperglycemia, fat maldistribution, possible increased bleeding episodes in patients with hemophilia. Lopinavir/rtv
Food Effect – Take with or without food. Adverse Effects – GI intolerance, nausea, vomiting, diarrhea, asthenia,
hyperlipidemia (especially hypertriglyceridemia), increased liver function tests, hyperglycemia, fat maldistribution, possible increased bleeding episodes in patients with hemophilia. 200mg (4 tablets) once daily *
If taken with Efavirenz or
Nevirapine: Lopinavir 600mg/
ritonavir 150mg (3 tablets) twice
daily (for therapy experienced
patients) *Once daily dosing is
not recommended in ARV
experienced patients.

Nelfinavir
Food Effect – Take with meal or snack. Levels increased 2-3 fold. Adverse Effects – Diarrhea, hyperlipidemia,
hyperglycemia, fat maldistribution, increased liver function tests, possible increased bleeding episodes in patients with hemophilia. Ritonavir
Food Effect – Take with food to improve tolerability. Adverse Effects – GI intolerance, nausea, vomiting, diarrhea,
circumoral and extremity parasthesias, hyperlipidemia (especially hypertriglyceridemia), hepatitis, asthenia, taste perversion, hyperglycemia, fat maldistribution, possible increased bleeding episodes in patients with hemophilia. Saquinavir
Food Effect – Take within 2 hours of a meal when taken with ritonavir. Adverse Effects – GI intolerance, nausea,
diarrhea, headache, elevated liver function tests, hyperlipidemia, hyperglycemia, fat maldistribution, possible increased bleeding episodes in patients with hemophilia. Tipranavir
Food Effect – Take with food. High fat meals increase bioavailability. Adverse Effects – Rash, caution in sulfa
allergic patients, as tipranavir contains a sulfonamide moiety; hepatotoxicity incing hepatic decompensation reported, especially in patients with underlying liver disease; hyperlipidemia, hyperglycemia, fat madistribution, rare cases of fatal and non-fatal intracranial hemorrhages, possible increased bleeding episodes in patients with hemophilia. Patient Counseling Points - Food Effect and Adverse Effects Enfuvirtide
Food Effect – N/A. Adverse Effects – Local injection site reactions – pain, erythema, induration, nodules and cysts,
pruritis, ecchymosis, bacterial pneumonia, hypersensitivity reaction (<1%) which includes rash, fever, nausea, vomiting, chills, rigors, hypotension, or increased liver function tests. Rechallenge not recommended. Developed 5/2007
PAGE 1 of 2
New York/New Jersey
AIDS Education
Helpful HIV Medication Tables for Pharmacists
& Training Center
www.nynjaetc.org
Combination Reverse Transcriptase InhibitorsMedication Patient Counseling Points - Food Effect and Adverse Effects Efavirenz,
Food Effect – Take on an empty stomach. Adverse Effects – Rash, central nervous system symptoms, lasting for
Tenofovir, and
approximately the first 2-4 weeks, including abnormal dreams, dizziness, somnolence and euphoria; increased liver Emtricitabine
function tests, false-positive cannabinoid test, teratogenic (Pregnancy Category D), asthenia, headache, diarrhea, nausea, vomiting, flatulence, renal insufficiency, skin hyperpigmentation. * Zidovudine and One tablet twice daily
Food Effect – Take without regard to meals. Adverse Effects – Bone marrow suppression (macrocytic anemia,
Lamivudine
neutropenia), headache, insomnia, gastrointestinal intolerance, asthenia, rare pancreatitis.* (Combivir®)
Abacavir and
Food Effect – Take without regard to meals. Adverse Effects – Patients should be warned about the abacavir
Lamivudine
hypersensitivity reaction (HSR) which is characterized by fever, rash, nausea, vomiting, malaise or fatigue, loss of appetite, sore throat, cough, shortness of breath. Fatalities associated with the HSR have been reported, especially if patients are rechallenged, rare pancreatitis.* Abacavir,
Food Effect – Take without regard to meals. Adverse Effects – Patients should be warned about the abacavir
Zidovudine, and
hypersensitivity reaction (HSR) which is characterized by fever, rash, nausea, vomiting, malaise or fatigue, loss of Lamivudine
appetite, sore throat, cough, shortness of breath. Fatalities associated with the HSR have been reported, especially if patients are rechallenged. Bone marrow suppression (macrocytic anemia, neutropenia), headache, insomnia, gastrointestinal intolerance, asthenia, rare pancreatitis.* Tenofovir and
Food Effect – Take without regard to meals. Adverse Effects – asthenia, headache, diarrhea, nausea, vomiting,
Emtricitabine
flatulence, renal insufficiency, skin hyperpigmentation. * (Truvada®)* Lactic acidosis with hepatic steatosis is a rare, potentially life threatening adverse event with the use of Nucleoside/Nucleotide Reverse Transcriptase Inhibitors.
Components of an ARV Regimen Not RecommendedRegimen/Medication Atazanavir + Indinavir
Didanosine + Stavudine
High incidence of toxicities – peripheral neuropathy, pancreatitis, and hyperlactatemia. Reports of serious, even fatal, cases of lactic acidosis with hepatic steatosis with or without pancreatitis in pregnant women. Use only when no other antiretroviral options are available and potential benefits outweigh the risks.
Efavirenz in pregnancy
Teratogenic in humans and in nonhuman primates. Use only when no other antiretroviral options are available and potential benefits outweigh the risks.
Emtricitabine + lamivudine
Similar resistance profile, no potential benefit.
Nevirapine initiation in treatment-naïve women Higher incidence of symptomatic (including serious and even fatal) hepatic events in these
with CD4 >250 cells/mm3 or in treatment-naïve
patient groups. Use only if the benefits clearly outweigh the risks.
men with CD4 >400 cells/mm3
Saquinavir as single protease inhibitor

Poor oral bioavailability (4%). Inferior antiretroviral activity when compared with other protease inhibitors.
Stavudine + zidovudine
Concurrent Medications to be Avoided with Protease Inhibitors or Non-Nucleoside Reverse Transcriptase InhibitorsMedication or Class Amiodarone
Avoid with indinavir, ritonavir and tipranavir Astemizole
Avoid with all Protease Inhibitors, delavirdine and efavirenz Benzodiazepines –
Avoid with all Protease Inhibitors, delavirdine and efavirenz Midazolam and triazolam
Bepridil

Avoid with amprenavir, fosamprenavir, atazanavir, ritonavir, tipranavir Cisapride
Avoid with all Protease Inhibitors, delavirdine, and efavirenz Ergot Alkaloids –
Avoid with all Protease Inhibitors, delavirdine, and efavirenz Dihydroergotamine,
ergotamine, ergonovine,
methylergonovine
Flecanide

Avoid with lopinavir/ritonavir, ritonavir, and tipranavir Fluticasone
Avoid with all Protease Inhibitors except unboosted indinavir and nelfinavir Garlic supplements
Irinotecan
Pimozide
Propafenone
Avoid with lopinavir/ritonavir, ritonavir, and tipranavir Proton pump inhibitors
Quinidine
Rifampin
Avoid with all Protease Inhibitors, nevirapine and delavirdine. Can be used with efavirenz; consider EFV dosage increase to 800mg daily.
St. Johns Wort
Avoid with all Protease Inhibitors and all Non-Nucleoside Reverse Transcriptase Inhibitors Terfenadine
Avoid with all Protease Inhibitors, delavirdine and efavirenz Simvastatin and lovastatin
Avoid with all Protease Inhibitors and delavirdine Reference:Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults & Adolescents. October 10, 2006. Available at: http://www.aidsinfo.nih.gov. Accessed March 5, 2007.
John J. Faragon, PharmD
Marshall J. Glesby, MD, PhD
Douglas G. Fish, MD
Christopher D. Miller, PharmD, BCPS
If you are interested in HIV pharmacy trainings such as clinical consultations, Visit the AETC’s National Resource Center Website at www.aids-etc.org. This lectures, workshops or preceptorships, please contact John Faragon, PharmD, website provides a central repository of training materials developed within the the Regional Pharmacy Director for the New York/New Jersey AETC at AETC network, including resources for pharmacists.
faragoj@mail.amc.edu or 518.262.6864. You will be referred to the appropriatetraining site in your region. Several pharmacy education materials are available from the New York/New Jersey AETC at no charge. Visit www.nynjaetc.org or call 212.304.5530.
Developed 5/2007
PAGE 2 of 2

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