Available Drugs to fight AIDS.

Who Should Take Antiretroviral Drugs?

Antiretroviral drugs are approved for people with HIV infection. There are no absolute rules about when to start antiretroviral drugs. You and your doctor should consider your T-cell count, your viral load, any symptoms you are having, and your attitude about taking HIV medications. 

If you take antiretroviral drugs in combination, you can reduce your viral load to extremely low levels, and increase your T-cell counts. This should mean staying healthier longer.


What About Drug Resistance?

Many new copies of HIV are mutations. They are slightly different from the original virus. Some mutations can keep multiplying even when you are taking an antiviral drug. When this happens, the drug will stop working. This is called "developing resistance" to the drug. 

Sometimes, if your virus develops resistance to one drug, it will also have resistance to other antiviral drugs. This is called "cross-resistance".

Resistance can develop quickly. It is very important to take antiviral medications according to instructions, on schedule, and not to skip or reduce doses.


What Are Temporary Side Effects?

When you start any antiviral treatment, you may have temporary side effects such as headaches, high blood pressure, or a general sense of feeling ill. These side effects usually get better or disappear over time.


What Is 3tc (Lamivudine)?

3TC is a drug used for antiviral therapy, is also known as Lamivudine.

3TC is a nucleoside analog reverse transcriptase inhibitor, or nuke. These drugs block the reverse transcriptase enzyme. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This has to occur before HIV's genetic code gets inserted into an infected cell's own genetic codes.

3TC seems to be able to reduce resistance to AZT. That is, after people develop resistance to AZT and then take 3TC, AZT seems to work better for them.


How Is 3tc Taken?

3TC is available in tablets of 150mg. The normal dose of 3TC is 300 mg daily. The dosage should be reduced for people who weigh less than 50 kilograms (110 pounds).

3TC can be taken with food or between meals.

Be sure your doctor knows if you have had kidney problems: your dose of 3TC may need to be lowered.

3TC is also available in from of CAMUDINE, CAMALANS, CAMAL-Z. CAMAL-Z contains AZT and 3TC. CAMALANS contains 3TC, Nevirepine, d4T (Stavudine). CAMUDINE is of 3TC only.


What Are The Side Effects?

The most common side effects of 3TC are nausea, vomiting, fatigue, and headaches. Some people have trouble sleeping. There have been rare cases of hair loss.


How Does 3tc React With Other Drugs?

Blood levels of 3TC may be increased by bactrim or septra.


What Is Azt (Zidovudine)?

AZT is a drug used for antiviral therapy and is also known as azido-deoxythymidine zidovudine or ZDV.

AZT was the first drug approved for the treatment of HIV. It is a nucleoside analog reverse transcriptase inhibitor, or nuke. These drugs block the reverse transcriptase enzyme. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This has to occur before HIV's genetic code gets inserted into an infected cell's own genetic codes. 

Because AZT was the first anti-HIV drug approved, it has been studied more than any other drug. New drugs have been tested by comparing them to AZT. And because there is more research on AZT than on any other anti-HIV drug, it is prescribed the most often.

"Early treatment" with AZT was tested in people with no symptoms of HIV disease. The study showed no benefit to taking AZT. But AZT is used as part of combination therapy for people who are exposed to HIV through a workplace accident (needle stick or splash).

AZT greatly reduces transmission of HIV from the mother to her child. It is given to HIV-positive pregnant women from the 4th month of pregnancy until their baby is born, and to the newborn baby for 6 weeks.


How Is Azt Taken?

The recommended dose of AZT for adults is 500mg to 600mg daily. AZT comes in 300 mg Capsules (CAMOZUDINE). AZT is also available as CAMAL-Z. CAMAL-Z contains AZT and 3TC (Lamivudine).

What are the Side Effects?

Some patients taking AZT continue to have nausea, vomiting, headaches and fatigue.

The most serious side effects of AZT are anemia, granulocytopenia, and myopathy. Very few people have these side effects.

Anemia is a shortage of red blood cells caused by damage to bone marrow. If you get anemia, your doctor might reduce your dose or switch AZT for another antiviral drug. If the anemia is severe and you have to keep taking AZT, you may need a blood transfusion, or you might take the drug erythropoietin.

Granulocytopenia is a shortage of white blood cells caused by damage to bone marrow. If it occurs, your doctor should switch from AZT. It can be treated with a "colony stimulating factor" called G-CSF, which stimulates the production of white blood cells. But G-CSF is very expensive. Changing drugs may be a better choice.

Myopathy is muscle pain and weakness. There is no specific treatment for myopathy.

How Does Azt React With Other Drugs?

AZT is more effective if taken with other antiviral drugs.

AZT should not be combined with d4T (stavudine).

AZT's side effects may be worse if taken with several other drugs. Be sure your doctor knows about all the medications you are taking.

What Is Nevirapine?

Nevirapine is a drug used for antiviral therapy. It is also called Viramune

Nevirapine is a non-nucleoside reverse transcripts inhibitor (a "non-nuke" or NNRTI). These drugs stop HIV from multiplying by preventing the reverse transcripts enzyme from working. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This step has to occur before HIV's genetic code gets inserted into an infected cell's genetic codes. 

Who Should Take It?

Nevirapine can be used to prevent transmission of HIV from a pregnant woman to her new child. Although AZT (another anti-HIV drug) prevents more infections, nevirapine costs less and works better where women breast-feed their babies. The mother gets one dose when she arrives at the hospital in labor, and the newborn gets one dose during the first three days of life. This approach could be very beneficial in developing countries.

Unfortunately, resistance to nevirapine develops in many women who use it when they are pregnant. This resistance can be transmitted through breast feeding. Researchers are reviewing whether a short course of nevirapine should be used to prevent transmission of HIV to a newborn. 

How Is It Taken?

Nevirapine is available in 200-milligram (mg) pills. The recommended dose for adults is 200 mg per day for two weeks (the lead-in period), then 400mg per day (200mg twice per day). Nevirapine is available as CAMLANS, which contains 3TC (Lamivudine) 150 mg, Nevirapine 200mg and d4T Stavudine 30 mg. It is important to follow this schedule to reduce the risk of serious side effects.

What Are The Side Effects?

The most common side effect of Nevirapine is a skin rash, which develops in about 25 percent of people taking the drug. This side effect is much more common for women than for men. If you develop a rash during the lead-in (lower dose) period, you should not increase to the full dose. If the rash is uncomfortable, you should stop taking the drug. Some doctors used the drug prednisone to treat the rash. However, research showed that it could actually make the rash worse. A rare side effect is Stevens-Johnson syndrome. This is a serious skin rash that can be fatal.

Nevirapine can also cause liver damage. Patients should be carefully monitored during the first two months taking the drug to watch for signs of skin or liver problems. Nevirapine can also cause liver damage. Patients should be carefully monitored during the first two months of taking Nevirapine to watch for signs of skin or liver problems. Because of the risk of liver damage, Nevirapine should not be used for post-exposure prophylaxis (treatment after exposure to HIV, or PEP).

How Does It React With Other Drugs?

Nevirapine is broken down by the liver and can interact with other drugs that also use the liver. Combining these drugs can change the amount of each drug in your bloodstream and cause an under- or overdose. Drugs to watch out for include several antihistamines, sedatives, and anti-fungal drugs. Make sure that your doctor knows about ALL drugs you are taking.

Nevirapine makes the liver work faster. This reduces the blood levels of most protease inhibitors. There is very little information about combining Nevirapine with protease inhibitors.

It also lowers blood levels of some birth control medications, which could make them ineffective.

Nevirapine also lowers blood levels of methadone. This can cause symptoms of drug withdrawal. Methadone doses may need to be increased for people taking Nevirapine.


What Is Efavirenz?

Efavirenz is a drug used for antiviral therapy. Efavirenz is a non-nucleoside reverse transcriptase inhibitor (a "non-nuke" or NNRTI). These drugs stop HIV from multiplying by preventing the reverse transcriptase enzyme from working. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This step has to occur before HIV's genetic code gets inserted into an infected cell's genetic codes.

Efavirenz seems to get into the central nervous system (spinal fluid). It may help prevent mental problems such as dementia.

How Is It Taken?

Efavirenz is taken by mouth as a capsule. The normal adult dose is 600 milligrams (mg) once a day at bedtime A 600 mg tablet of Efavirenz was approved in early 2002. Efavirenz is available as CAMVERENZ. CAMVERENZ contains Efavirenz 600mg.

It is recommended that you take Efavirenz on an empty stomach, at bedtime. This dosing should result in the fewest side effects.

What Are The Side Effects?

The most common side effects of Efavirenz are rash, nausea, dizziness, diarrhea, headache and insomnia. Taking Efavirenz with food increases drug levels and may increase side effects. To avoid dizziness after taking Efavirenz, take it before you go to sleep. Some people have vivid dreams when taking Efavirenz. For most people, these side effects disappear within the first two weeks.

Studies in monkeys showed that Efavirenz is likely to cause birth defects. Pregnant women should not take it.

People who take Efavirenz may falsely test positive for marijuana use. To prove that the results are false, you would have to identify the drug that you are taking. This would mean disclosing that you have HIV infection.

How Does It React With Other Drugs?

Efavirenz is broken down by the liver and can interact with other drugs that also use the liver. Combining these drugs can change the amount of each drug in your bloodstream and cause an under or overdose. Drugs to watch out for include several antihistamines, sedatives, and anti-fungal drugs. Make sure that your doctor knows about ALL drugs you are taking.

Efavirenz lowers blood levels of most protease inhibitors
Efavirenz decreases blood levels of methadone. People using both drugs will need to increase their dosage of methadone. 


What Is D4t (Stavudine)?

d4T is a drug used for antiviral therapy. d4T is also known as Stavudine or didehydro-deoxythymidine.

d4T is a nucleoside analog reverse transcriptase inhibitor, or nuke. These drugs block the reverse transcriptase enzyme. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This has to occur before HIV's genetic code gets inserted into an infected cell's own genetic codes. 

Pregnant women face special risks when taking d4T.

How Is D4t Taken?

d4T (CAMLANS) is available in tablets of 380mg in combination with 3TC 150 mg and Nevirepine 200 mg and d4T 30 mg. The normal adult dose depends on body weight. If you weigh more than 60 kilograms (132 pounds), the dose is 30 mg twice daily. If you weigh less, the dose is 30 mg daily.

There are no food restrictions with d4T.

Be sure your doctor knows if you have had liver problems. Your liver will have to be watched carefully if you take d4T, and your doctor might decide that you should not use d4T at all.

What Are The Side Effects?

The most serious side effects of d4T are Peripheral neuropathy, Lipodystrophy and lactic acidosis.
Peripheral neuropathy is a form of nerve damage. It usually shows up as tingling, numbness, or a sharp burning sensation in the feet, legs, or hands. The nerve damage is usually temporary and will go away if you stop taking d4T, or reduce the dose. If you continue to take d4T after nerve damage shows up, it may become permanent. 

Lipodystrophy is a collection of changes in body shape and blood chemistry. Several studies found that d4T is strongly linked to the loss of fat in the legs, arms and face. Many drugs seem to contribute to lipodystrophy and we don't fully understand how it occurs. However, some people are avoiding d4T because of its link to lipodystrophy.

Lactic acidosis is a buildup of lactic acid in the blood. This is a by-product of abnormal energy production by the cells. It may be caused by damage to the mitochondria.Lactic acidosis can cause severe damage to the pancreas and liver. Symptoms of lactic acidosis can include weight loss, abdominal pain, and severe fatigue. The risk of lactic acidosis is higher for women and people who have taken nucleoside analog drugs for a long time or who are obese. 

How Does D4t React With Other Drugs?

d4T should not be taken with AZT (zidovudine, CAMOZUDINE).

d4T's side effects may be worse if taken with ganciclovir or pentamidine.

Pregnant women should not take d4T and ddI at the same time due to an increased risk of lactic acidosis.


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