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Although there is no cure for HIV or AIDS, a number of medications, when used in combination, can help stop the growth and reproduction of the virus and lower the amount of HIV in the body.
The goals of combination HIV medication therapy include the following:
- Lowering the amount of HIV in the body to levels that are undetectable
- Preserving the body’s ability to fight off infection
- Improving quality of life
- Limiting health problems that develop as a result of HIV/AIDS
- Prolonging life
Several antiretroviral medications, or medications that help prevent the reproduction of viruses like HIV, can help slow the progression of the condition and treat symptoms:
- NRTIs and NtRTIs — nucleoside/nucleotide reverse transcriptase inhibitors or nucleoside analogues
- NNRTIs — non-nucleoside reverse transcriptase inhibitors
- Integrase inhibitors
- PIs — protease inhibitors
- Entry inhibitors
NRTIs, NNRTIs, NtRTIs, PIs, and integrase inhibitors work to stop HIV from multiplying once it has infected a T-cell. Entry inhibitors work to prevent the virus from entering healthy cells.
The recommended treatment for HIV/AIDS is a combination of three or more of these medications, which is called Highly Active Antiretroviral Therapy, or HAART. Sometimes called “cocktails,” these medication combinations work to reduce the amount of HIV in the body for an extended period of time.
There is no single treatment plan for treating HIV/AIDS that is recommended for everyone. Some medications used to treat HIV/AIDS may have side effects that can affect overall health and quality of life. Medication therapy is tailored to each individual, and it will be important for you to work with your doctor to determine what works best for you.
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Following are storage and handling guidelines for several medications:
Aptivus® (tipranavir)
Capsules should be stored in a refrigerator at 36°F to 46° before the bottle is opened.
After opening the bottle, the capsules may be stored at 77°F with excursions permitted to 59°F to 86°F, but must be used within 60 days.
Crixivan® (indinavir)
Capsules should be dispensed and stored in the original container at room temperature, 59°F to 86°F. Because the capsules are sensitive to moisture, the packet included to prevent moisture should remain in the original bottle.
Emtriva® (emtricitabine, FTC)
Oral solution should be refrigerated at 36° F to 46°F. The oral solution should be used within 3 months if stored at 77°F, with excursions permitted to 59°F to 86°F. Capsules should be stored at 77°F, with excursions permitted to 59°F to 86°F.
Fuzeon® (enfuvirtide, T-20)
Store at 77°F, with excursions permitted to 59°F to 86°F.
Reconstituted solution should be refrigerated at 36° F to 46°F and used within 24 hours.
Kaletra® (lopinavir/ritonavir)
Kaletra® oral solution should be refrigerated at 36°F to 46°F until used. Refrigerated solution remains stable until the expiration date printed on the label. However, if stored at room temperature, up to 77°F, solution should be used within two months.
Norvir® (ritonavir)
Soft gelatin capsules should be refrigerated at 36°F to 46°F, but are stable if stored below 77°F for up to 30 days.
Norvir® oral solution should be stored and dispensed in the original container at room temperature (68°F to 77°F). Do not refrigerate.
Retrovir® (zidovudine, AZT)
Injection: After dilution, the solution is chemically and physically stable for 24 hours at room temperature and 48 hours when refrigerated (36°F to 46°F). After dilution, the solution should be used within eight hours if stored at 77°F or 24 hours if refrigerated.
Store tablets, capsules, and syrup at 59°F to 77°F.
Videx® (didanosine, ddI)
Buffered tablets were discontinued in 2006.
Chewable and dispersible buffered tablets should be stored at room temperature. If mixed with water or clear apple juice, the dose can stay at room temperature for up to an hour.
Pediatric powder for oral solution should be stored at 59°F to 86°F, but the final mixture may be refrigerated at 36°F to 46°F and used within 30 days.
Viracept® (nelfinavir)
Tablets and oral powder should be stored at 59°F to 86°F and must be dispensed in the original container.
If the oral powder is not used immediately after mixing, it should be refrigerated and used within six hours.
Oral powder should not be mixed with water in its original container.
Zerit® (stavudine, d4T)
Oral powder for solution should be stored at 77°F with excursions permitted between 59°F and 86°F. Following reconstitution, solution must be refrigerated (36°F to 46°F) and used within 30 days.
Ziagen® (abacavir)
Store at controlled room temperature (68°F to 77°F).
Oral solution should not be frozen but may be refrigerated.
Note: HIV medications not listed may not have special storage requirements
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It is a good idea to consult with a pharmacist about food restrictions with your medication regimen. Medications not listed below can be taken with or without food.
Agenerase® (amprenavir)
Can take with or without food, but do not take with high-fat meals.
Atripla®
Take on an empty stomach (at least 30 minutes before or two hours after eating), preferably at bedtime.
Aptivus® (tipranavir)
Take with food at the same time as Norvir®.
Crixivan® (indinavir)
Take without food but with water an hour before or two hours after a meal.
Can be taken with a light meal (dry toast with jelly, coffee with skim or nonfat milk and sugar, corn flakes with skim or nonfat milk and sugar).
Do not take with meals high in calories, fat, or protein.
Adults should drink at least 1.5 liters of fluids every 24 hours to maintain adequate hydration.
No food restrictions if taken in combination with Norvir®.
Invirase® (saquinavir)
Should always be taken with Norvir® and with food or within two hours after a meal.
Kaletra® (lopinavir/ritonavir)
Capsules discontinued in 2005.
Take oral solution with food.
Norvir (ritonavir)
Take with food.
If taken in combination with Crixivan, can be taken with or without food.
Prezista® (darunavir)
Take with food at the same time as Norvir®.
Reyataz® (atazanavir)
Take with food.
Sustiva (efavirenz)
Take on an empty stomach (at least 30 minutes before or two hours after eating), preferably at bedtime.
Videx® EC and pediatric powder (didanosine)
Take on an empty stomach (at least 30 minutes before or two hours after eating).
Viracept® (nelfinavir)
Take with food.
Acidic food or juices (for example, orange juice, apple juice, or apple sauce) are not recommended to be used in combination with Viracept® because the combination may result in a bitter taste.
Note: HIV medications not listed may not have food restrictions.
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It can’t be emphasized enough: Do not miss any doses of your medications. If you miss a dose, take it as soon as you remember. In most cases, if it is almost time for your next dose when you remember, you should not take the missed dose or take two doses of the medication. Contact your doctor or pharmacist for assistance with specific directions.
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The following guidelines are important in effectively managing HIV/AIDS:
- Take medications exactly as prescribed by your doctor.
- Maintain a healthy and nutritious diet.
- Avoid high-risk behaviors.
- Keep regularly scheduled appointments with your doctor.
Taking medications exactly as prescribed by the doctor is the most important way to prevent the progression of HIV. Not taking medications properly or missing doses can cause treatment to stop working. It can also cause drug resistance, a condition where the HIV in the body changes into a form that can no longer be treated by the prescribed medication.
Maintaining a healthy and nutritious diet also is important in managing HIV. Good nutrition can help you properly absorb your medications, reduce side effects, and maintain your body weight.
It is also important to continue to avoid high-risk behaviors to prevent the spread of the virus to others. A person receiving treatment for HIV/AIDS can still transmit the virus to others and can still become infected with another strain of HIV.
Finally, it is very important to keep all scheduled appointments with your doctor. Your doctor can tell if the medication regimen is effective by monitoring your viral load and T-cell count. You should plan on seeing the doctor regularly.
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