Drug

Adult Dosing

Possible Side Effects

Notes

Aptivus (tipranavir), by Boehringer Ingelheim

Two 250mg capsules plus two 100mg Norvir capsules, twice a day (a total of 8 pills a day).

Special warnings:* bleeding in the brain; hepatitis (extra care needed for HIV-positive people with hepatitis B or hepatitis C).

Rash, increased cholesterol, increased triglycerides, lipodystrophy, increased bleeding in patients with hemophilia.

Aptivus and Norvir should be taken with food, preferably a full nutritious meal (e.g., breakfast and dinner). Aptivus/Norvir should not be taken with other protease inhibitors. If taken with ddI (Videx or Videx EC), Aptivus/Norvir should be taken at least two hours before or two hours after taking ddI.

Crixivan (indinavir), by Merck & Co.

Two 400mg capsules, every 8 hours (a total of 6 pills a day), or two 400mg Crixivan capsules with either one or two 100mg Norvir capsules twice a day (preferred dosing).

Kidney stones, nausea, vomiting, diarrhea, increased cholesterol, increased triglycerides, increased glucose (sugar), lipodystrophy, increased bilirubin (not harmful), increased bleeding in patients with hemophilia. Others: headache, weakness, blurred vision, dizziness, rash, metallic taste, low platelets, hair loss, anemia.

Without Norvir: Take on an empty stomach (no food two hours before or one hour after dosing), or with a light, low-fat snack.

With Norvir: Take with or without food.

Drink at least 48 ounces (six 8-oz. glasses) of water daily to prevent kidney stones.

Invirase (saquinavir), by Hoffmann-La Roche

Invirase must be used in combination with Norvir. The approved dose is two 500mg Invirase tablets plus one 100mg Norvir capsule, twice a day (a total of 6 pills a day).

Nausea, diarrhea, stomach discomfort, headache, increased cholesterol, increased triglycerides, lipodystrophy, increased glucose (sugar), increased liver enzyme levels, and increased bleeding in patients with hemophilia

Invirase and Norvir should be taken with food, preferably a full nutritious meal (e.g., breakfast and dinner), or within 2 hours after a meal.

Kaletra* (lopinavir + ritonavir), by Abbott Laboratories

* Also sold as Aluvia in some parts of the world.

Two tablets, twice a day (a total of 4 pills a day), or, if starting therapy for the first time, four tablets once a day (see Notes for exceptions). Each tablet contains 200mg lopinavir + 50mg ritonavir. A pediatric formulation is also available.

Nausea, diarrhea, stomach discomfort, weakness, increased cholesterol, increased triglycerides, lipodystrophy, increased glucose (sugar), increased liver enzyme levels, and increased bleeding in patients with hemophilia

Can be taken with or without food. Does not need to be refrigerated.

Sustiva (efavirenz), Viramune (nevirapine), Lexiva (fosamprenavir), and Viracept (nelfinavir) may lower the amount of Kaletra in the bloodstream. If you have tried and failed other anti-HIV medications in the past, especially other protease inhibitors, it may be necessary to increase your dose of Kaletra if you are also taking any of these four drugs (three tablets twice a day). Kaletra should not be taken once-daily with these drugs.

Lexiva (fosamprenavir), by GlaxoSmithKline

* Also sold as Telzir in some parts of the world.

Two 700mg tablets, twice a day (a total of 4 pills a day), or two 700mg tablets plus one 100mg Norvir capsule, once a day (a total of 3 pills a day), or one 700mg tablet plus one 100mg Norvir capsule twice a day (a total of 4 pills a day). This last dosing option should be used for patients who have tried and failed other protease inhibitors in the past. A pediatric formulation is also available.

Skin rash, nausea, diarrhea, stomach discomfort, headache, increased cholesterol, increased triglycerides, lipodystrophy, increased glucose (sugar), increased liver enzyme levels, and increased bleeding in patients with hemophilia

Take with or without food. Patients who have previously taken a protease inhibitor should take one 700mg tablet plus one 100mg Norvir capsule twice a day (a total of 4 pills a day).

Norvir (ritonavir), by Abbott Laboratories

Six 100mg capsules, twice a day (a total of 12 pills a day). Start with 3 capsules, twice a day, and increase to full dose over 14 days. Note: the full dose of Norvir is rarely used any more. Norvir is most often used at much lower doses to "boost" the levels of other protease inhibitors in the body. A pediatric formulation is also available.

Special warning:* Taking Norvir with certain allergy medications, sedatives, heart medications, and migraine medications can increase the risk of their side effects.

Nausea, diarrhea, stomach discomfort, numbness or tingling around the mouth and in the limbs (paresthesias), increased cholesterol, increased triglycerides, lipodystrophy, hepatitis, weakness, increased glucose (sugar), increased liver enzyme levels, and increased bleeding in patients with hemophilia

Take with food. High-fat snacks may reduce side effects. Capsules and oral solution may be stored at room temperature, but should be refrigerated in hot weather. Solution can be mixed with chocolate syrup, chocolate ice cream, or Ensure to mask the taste.

Prezista (darunavir) by Tibotec

Prezista must be used in combination with Norvir. The approved dose is two 300mg Prezista tablets plus one 100mg Norvir capsule, twice a day (a total of 6 pills a day).

Nausea, diarrhea, stomach discomfort, headache, increased cholesterol, increased triglycerides, lipodystrophy, increased glucose (sugar), increased liver enzyme levels, inflammation of the nose and throat, and increased bleeding in patients with hemophilia

Prezista and Norvir should be taken with food, although the type and amount of food does not matter. If taken with ddI (Videx or Videx EC), Prezista/Norvir should be taken at least two hours before or one hour after taking ddI.

Reyataz (atazanavir), by Bristol-Myers Squibb

Two 200mg capsules, once a day (a total of 2 pills a day), or one 300mg capsule plus one 100mg Norvir capsule, once a day (a total of 2 pills a day).

Increased bilirubin (not harmful), abnormal electrocardiogram results, increased glucose (sugar), lipodystrophy, and increased bleeding in patients with hemophilia

Take with a light meal. For patients who have taken anti-HIV drugs in the past, the recommended dose is 300mg Reyataz plus 100mg Norvir (all as a single dose with food). This combination of Reyataz and Norvir is also recommended for patients who are using either Viread (tenofovir) or Sustiva (efavirenz) in a drug regimen that involves Reyataz.

Viracept (nelfinavir), by Pfizer

Two 625mg tablets, two times a day (a total of 4 pills a day), or five 250mg tablets, twice a day, or three 250mg tablets, three times a day (a total of 9-10 pills a day). A pediatric formulation is also available.

Diarrhea, increased cholesterol, increased triglycerides, lipodystrophy, increased glucose (sugar), increased liver enzyme levels, increased bleeding in patients with hemophilia, increased liver enzymes

Take with a meal or light snack. Your body absorbs the drug better with food in your stomach. If you have trouble swallowing the pills, there is a powder formulation that can be dissolved in water for easy drinking.

* "Special warnings" reflects side effects reviewed in the "Black Box Warnings" that the U.S. Food and Drug Administration (FDA) has required manufacturers to list in the package inserts for some HIV drugs. These are the most dangerous side effects that healthcare providers and people living with HIV should be aware of. However, drugs without Black Box Warnings can still have serious side effects.

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

Drug

Adult Dosing

Possible Side Effects

Notes

Atripla (Sustiva* + Viread + Emtriva), by Gilead Science and Bristol-Myers Squibb

* Sustiva is a non-nucleoside reverse transcriptase inhibitor (NNRTI)

One tablet (contains 600mg Sustiva + 300mg Viread + 200mg Emtriva), once a day (a total of one pill a day).

Similar side effects to Sustiva (efavirenz), Viread (tenofovir), and Emtriva (emtricitabine).

Please note Viread's and Emtriva's special warnings.