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Protease Inhibitors & POPPeRs |
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By John S. James Publisher, AIDS Treatment News
VIAGRA(R) (sildenafil) doses must be low when the drug is
used with HIV protease inhibitors (especially ritonavir),
because these antiretrovirals reduce the metabolism of
sildenafil in the liver, resulting in abnormally high blood
levels which can cause adverse effects. The combination
apparently does not affect blood levels of protease
inhibitors.
Sildenafil, used to treat erectile dysfunction, is supplied as tablets in three doses: 25, 50, and 100 mg, and is taken half an hour to four hours before intercourse; physicians often start with 50 mg and then lower or raise the dose if needed.
[Note: The current labeling, dated February 1999, is considerably less cautious than the Pfizer backgrounder quoted above. The backgrounder is conservative because discussions with the FDA are ongoing, and it is not known what the final recommendations will be. Technical information will be posted by the National AIDS Treatment Advocacy Project, www.natap.org.] The labeling also warns that anyone with an erection lasting more than four hours needs medical assistance immediately, because of the risk of tissue damage to the penis which could cause permanent loss of potency. VIAGRA and Poppers VIAGRA must not be combined with nitrite inhalants ("poppers") or any form of nitrates, because the combination may result in dangerously low blood pressure, which could be fatal. AIDS Treatment News Published twice monthly Subscription and Editorial Office: P.O. Box 411256 San Francisco, CA 94141 800/TREAT-1-2 toll-free U.S. and Canada 415/255-0588 regular office number Fax: 415/255-4659 Email: aidsnews@aidsnews.org Editor and Publisher: John S. James Associate Editor: Tadd T. Tobias Reader Services: Tom Fontaine and Denny Smith Operations Manager: Danalan Richard Copeland Statement of Purpose: AIDS TREATMENT NEWS reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. ISSN # 1052-4207 Copyright 1999 by John S. James. |
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