Anti-HIV agents. AIDS

Nucleoside Reverse Transcriptase Inhibitors

abacavir
Ziagen ®

Dosing (adult): The recommended oral dose of ZIAGEN for adults is 600 mg daily, administered as either 300 mg twice daily or 600 mg once daily, in combination with other antiretroviral agents. Warn about hypersensitivity reactions which can be lethal with rechallenge.

Atripla™
Efavirenz, emtricitabine, and tenofovir

Dosing (adult): Oral: One tablet once daily to be taken on an empty stomach (at bedtime is recommended).

Renal Dosing: — Moderate-to-severe renal impairment (CrCl <50 mL/minute): Use not recommended.

Admin: Should be taken on an empty stomach, normally at bedtime to increase gastrointestinal tolerance and
decrease nervous system manifestations.

Supplied: Tablet: Efavirenz 600 mg, emtricitabine 200 mg, and tenofovir disoproxil fumarate 300 mg.

Combivir ® (AZT 300mg+150 mg lamivudine):

Dosing (adult): 1 tablet orally twice daily
Supplied: coated tablet (zidovudine 300mg + lamivudine 150mg). Renal failure: Use each agent independently and adjust accordingly.

didanosine
Videx ®

Dosing (adult): Medication must be given on an empty stomach. In order to provide adequate buffering, patients must take at least 2 of the appropriate strength tablets at each dose when using either the once daily or twice daily regimens. Patient weight <60 kg: (Tablets): 125 mg orally twice daily or 250mg once daily or 167 mg (Buffered powder) twice daily. Patient weight > 60kg: (Tablets): 200mg orally twice daily or 400mg orally once daily. (Buffered Powder): 250mg orally twice daily. Supplied: chewable tablet: (25, 50, 100, 150, and 200mg); Oral powder for solution (100, 167, and 200mg packets).
Renal Dosing:

Patients > 60 kg
	Tablets	Powder
30-59	100 bid or 200mg qd	100 mg bid
10-29	150mg qd	167mg qd
<10	100mg qd	100mg qd
Patients < 60kg
	Tablets	Powder
30-59	75mg bid or 150mg qd	100mg bid
10-29	100 mg qd	100 mg qd
<10	75 mg qd	100mg qd

emtricitabine
Emtriva ®

Dosing (adult): 200 mg orally once daily

Renal Dosing:
crcl 30-49 ml/min: 200 mg every 48 hours.
crcl 15-29 ml/min: 200 mg every 72 hours.
crcl <15 ml/min: 200 mg every 96 hours.
Supplied: Capsule: 200 mg

Epzicom ® (abacavir 600mg + lamivudine 300mg):

Dosing (adult): One tablet (abacavir 600 mg and lamivudine 300 mg) once daily.

Renal Dosing: crcl <50 ml/min: Use not recommended.
Hepatic Impairment: Use not recommended.
Supplied: Tablet: Abacavir 600 mg & lamivudine 300 mg

lamivudine
Epivir ®

Dosing (adult): 150 mg orally twice daily.
Supplied: [150mg tablet; 10 mg/ml oral solution]. Lamivudine should not be co-administered with zalcitabine. Renal dosing: crcl >50/ no change; 30-49/ 150mg once daily; 15-29/ 150mg x1, then 100mg once daily; 5-14/ 150mg x 1, then 50 mg once daily; <5/ 50mg x1, then 25mg once daily.

stavudine
Zerit ®

Dosing: Patient weight >60 kg: 40mg orally twice daily . Patient weight < 60kg: 30mg orally twice daily. Dosages may be decreased by 50% if peripheral neuropathy occurs. May be taken without regard to meals. Must decrease dose in renal dysfunction. Stavudine and Zidovudine should not be co-administered.
Supplied: [15, 20, 30, 40mg capsules; 1 mg/ml oral powder for solution].
Renal dosing:

CRCL (ml/min)	WT > 60kg	WT <60kg
> 50	40mg q12h	30mg q12h
26-50	20mg q12h	15mg q12h
10-25	20mg q24h	15mg q24

tenofovir
Viread ®

Dosing (adult): 300 mg orally once daily with a meal.

Renal Dosing:
crcl 30-49 ml/min: 300 mg every 48 hours
crcl 10-29 ml/min: 300 mg twice weekly
crcl <10 ml/min: No recommendation available.
Hemodialysis: 300 mg every 7 days or after a total of 12 hours of dialysis (usually once weekly assuming 3 dialysis sessions lasting about 4 hours each).
Supplied: Tablet: 300 mg

Trizivir ®
abacavir 300mg + lamivudine 150mg + zidovudine 300mg

(>40 kg): 1 tablet orally twice daily.

Truvada ®
(emtricitabine 200mg + tenofovir 300mg):

Dosing (adult): One tablet (emtricitabine 200 mg and tenofovir 300 mg) once daily.

Renal Dosing:
crcl 30-49 ml/min: 1 tab every 48 hours
crcl <30 ml/min: Not recommended.
Supplied:Tablet: Emtricitabine 200 mg and tenofovir 300mg.

zalcitabine
Hivid ®

Dosing (adult): 0.75 mg orally three times daily. Lamivudine should not be co-administered with zalcitabine.
Renal dosing: >40/ no change; 10-40/ 0.75 mg twice daily; <10/ 0.75 mg once daily. Supplied: [0.375mg , 0.75mg tablet]

zidovudine
Retrovir ®

Dosing (adult): 300mg orally twice daily or 200mg orally three times daily or 100mg every 4 hours 5 times daily. Stavudine and Zidovudine should not be co-administered. Supplied: 100mg capsule; 300mg tablet; 50mg/5ml oral solution. Dosing in renal failure (<10 ml/min): 100mg every 6 to 8 hours. GI intolerance is common and may improve if given with meals or more frequent smaller doses. Also may cause headaches and asthenia. Main side effects are anemia and neutropenia.

Protease inhibitors
amprenavir Agenerase ®	Protease Inhibitor. Dosing (adult): 1200 mg orally twice daily. Supplied: [50, 150 mg caps. 15mg/ml oral solution.] ( large pill burden. Must warn of gastrointestinal (GI) intolerance and rash.)
atazanavir Reyataz ®	Protease Inhibitor. Dosing (adult): Antiretroviral-naive patients: 400 mg once daily with food. Antiretroviral-experienced patients: 300 mg once daily plus ritonavir 100 mg once daily with food. Coadministration with efavirenz: Antiretroviral-naive patients: It is recommended that atazanavir 300 mg plus ritonavir 100 mg be given with efavirenz 600 mg (all as a single daily dose). Administer with food. Antiretroviral-experienced patients: Recommendations have not been established. Coadministration with didanosine buffered formulations: Administer atazanavir 2 hours before or 1 hour after didanosine buffered formulations. Coadministration with tenofovir: The manufacturer recommends that atazanavir 300 mg plus ritonavir 100 mg be given with tenofovir 300 mg (all as a single daily dose). Administer with food. Supplied: Capsule: 100 mg, 150 mg, 200 mg.
fosamprenavir Lexiva ®	Protease Inhibitor. Dosing (adult): Antiretroviral therapy-naive patients: Unboosted regimen: 1400 mg twice daily (without ritonavir). Ritonavir-boosted regimens: Once-daily regimen: Fosamprenavir 1400 mg plus ritonavir 200 mg once daily. Twice-daily regimen: Fosamprenavir 700 mg plus ritonavir 100 mg twice daily. Note: Also used in protease inhibitor-experienced patients. Protease inhibitor-experienced patients: Fosamprenavir 700 mg plus ritonavir 100 mg twice daily. Note: Once-daily administration is not recommended in protease inhibitor-experienced patients. Combination therapy with efavirenz (ritonavir-boosted regimen): Once-daily regimen: Fosamprenavir 1400 mg daily plus ritonavir 300 mg once daily. Twice-daily regimen: No dosage adjustment recommended for twice-daily regimen. Supplied: 700 mg tablet.
indinavir Crixivan ®	Protease Inhibitor. Dosing (adult): 800mg orally every 8 hours without food or 1200mg orally every 12 hours. (must be taken on an empty stomach). Supplied: [200, 333, and 400mg capsules].
Kaletra ® (Lopinavir 133 mg + Ritonavir 33.3 mg ):	Protease Inhibitor. Dosing (adult): (take with food): Therapy-naive: Lopinavir 800 mg/ritonavir 200 mg once daily or lopinavir 400 mg/ritonavir 100 mg twice daily. Therapy-experienced: Lopinavir 400 mg/ritonavir 100 mg twice daily. Note: Once-daily dosing regimen has not been evaluated with concurrent indinavir or saquinavir and should not be used with concomitant phenytoin, carbamazepine, or phenobarbital therapy. Dosage adjustment when taken with amprenavir, efavirenz. nelfinavir, or nevirapine: Lopinavir 533 mg/ritonavir 133 mg twice daily. Note: Once-daily dosing regimen should not be used when concomitantly taking amprenavir, efavirenz, nelfinavir, or nevirapine therapy. Supplied: Capsule: Lopinavir 133.3 mg and ritonavir 33.3 mg. oral soln: Lopinavir 80 mg and ritonavir 20 mg/ml.
nelfinavir Viracept ®	750 mg orally three times a day or 1250mg orally twice daily. Take with high fat meal and warn of diarrhea that usually responds to loperamide or calcium. Supplied: [250mg tablet].
ritonavir Norvir ®	Protease Inhibitor. Dosing (adult): (Day 1): 300mg orally twice daily (Days 2-4): 400 mg orally twice daily. (Day 5): 500mg orally twice daily; (Day 6 or longer): 600mg orally twice a day. Take with food. Supplied: [100mg capsule; 80mg/ml -240ml soln] GI intolerance is a major problem and is dose-related.
saquinavir Fortovase ® , Invirase ®	Protease Inhibitor. Dosing (adult): Fortovase: 1200mg orally three times a day after meals. Invirase: 600mg orally three times a day with meals. Supplied: [200mg capsule]
tipranavir Aptivus ®	Protease Inhibitor. Dosing (adult): 500 mg twice daily with a high-fat meal. Note: Coadministration with ritonavir (200 mg twice daily) is required. Supplied: 250 mg capsule.

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