Atazanavir: New Efficacy Data and Changes in Dosage Recommendations
Because of its once-daily dosing schedule, low pill burden, and tolerability, atazanavir is the most widely used protease inhibitor among patients initiating antiretroviral therapy in the United States. Several new studies and data analyses will guide the use of this ARV medication.
A 600 mg tablet formulation of darunavir (Prezista) was approved by the FDA in February 2008 and should be available soon. This formulation will reduce pill burden for patients who take darunavir. The usual dosage of darunavir is 600 mg twice daily, with ritonavir 100 mg twice daily. The 300 mg formulation will continue to be available.
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Lamivudine: Pediatric formulation
A new pediatric formulation of lamivudine (Epivir, 3TC) was approved by the FDA in February 2008 and should be available soon. It is a 150 mg scored tablet and is intended for use by pediatric patients who can swallow pills reliably. An oral suspension is already available for pediatric patients who cannot swallow tablets. Clinicians should consult the Epivir product label for dosage recommendations.
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Lopinavir/ritonavir: Pediatric formulation
A pediatric tablet formulation of lopinavir/ritonavir (Kaletra) was approved by the FDA in November 2007 and is now available in pharmacies. It contains 100 mg of lopinavir and 25 mg of ritonavir, half the strength of the adult tablet formulation. Clinicians should consult the Kaletra product label for dosage recommendations.
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Production of amprenavir (Agenerase) was discontinued by the U.S. manufacturer in November 2007, and this drug will no longer be available in the United States. For patients who have been taking amprenavir, clinicians should substitute fosamprenavir or another suitable ARV.
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