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Lexiva
Lexiva, the brand name for fosamprenavir, is an antiretroviral medication used to treat HIV-1 infection in combination with other antiretroviral drugs. It belongs to a class of medications known as protease inhibitors, which work by preventing the virus from replicating in the body. While Lexiva does not cure HIV or AIDS, it helps to lower the viral load in the blood, maintain immune function, and reduce the risk of HIV-related complications.
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Frequently Asked Questions
How long does it take for Lexiva to start working?
Lexiva begins working immediately to lower the amount of HIV in the blood, but it may take several weeks or months of consistent treatment to reach undetectable viral levels.
Can I take Lexiva without ritonavir?
Yes, Lexiva can be taken without ritonavir, but the dosing schedule and effectiveness may differ. Discuss with your doctor whether ritonavir should be included in your treatment plan.
What should I do if I miss a dose of Lexiva?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Is Lexiva safe during pregnancy?
Lexiva should be used during pregnancy only if the potential benefits outweigh the risks. Discuss with your doctor if you are pregnant or planning to become pregnant while on Lexiva.
Can Lexiva cure HIV?
No, Lexiva does not cure HIV. It helps manage the infection by reducing the viral load in the body, but it is essential to continue taking it as part of a lifelong treatment regimen to control the virus and prevent the progression to AIDS.
Comprehensive Drug Guide
How Does Lexiva Work?
Lexiva works by inhibiting the HIV-1 protease enzyme, which is essential for the virus to replicate and mature. By blocking this enzyme, Lexiva prevents the production of infectious HIV particles, thereby reducing the amount of the virus in the body (viral load). This helps to prevent the progression of HIV to AIDS and allows the immune system to function more effectively.
Common Dosages
- 700 mg oral tablets
- 50 mg/mL oral suspension
The dosing regimen depends on whether Lexiva is being used with a boosting agent like ritonavir and the patient’s previous HIV treatment history.
Typical Dosing
- For adults:
- Without ritonavir: The usual dose is 1,400 mg (two 700 mg tablets) twice daily.
- With ritonavir: The dose is 700 mg of Lexiva with 100 mg of ritonavir taken once daily or twice daily, depending on the patient's treatment plan.
- For pediatric patients (aged 4 weeks and older): The dosage is based on body weight and is typically given in combination with ritonavir.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and pediatric patients aged 4 weeks and older in combination with other antiretroviral agents.
Who Shouldn't Take Lexiva?
- Severe liver impairment.
- Known hypersensitivity or allergic reaction to fosamprenavir, amprenavir, or any of the components in the formulation.
- Concomitant use of certain medications that can interact with Lexiva and increase the risk of side effects, including ergot derivatives, cisapride, pimozide, and certain sedatives like midazolam.
Advice From The Pharmacist
- Take Lexiva with or without food, but avoid taking it with a high-fat meal as it may reduce the effectiveness of the medication.
- If prescribed ritonavir alongside Lexiva, be sure to follow the dosing schedule exactly as prescribed to ensure maximum effectiveness of the treatment.
- If using the oral suspension, shake the bottle well before each dose, and use the provided dosing tool for accurate measurement.
- Adherence is critical in HIV treatment—take Lexiva as prescribed every day to maintain viral suppression.
- Lexiva may interact with many medications. Inform your healthcare provider of all medications you are taking, including over-the-counter drugs and supplements.
- Do not stop taking Lexiva or any of your HIV medications without consulting your doctor, as doing so can lead to viral resistance and treatment failure.
Side Effects of Lexiva
Common Side Effects
- Diarrhea
- Nausea
- Headache
- Vomiting
- Rash
Uncommon/Severe Side Effects
- Liver problems, indicated by yellowing of the skin or eyes (jaundice), dark urine, or severe stomach pain.
- Severe allergic reactions, such as swelling of the face, lips, or tongue, difficulty breathing, or a severe rash.
- Skin reactions, particularly in patients with sulfa allergy, as Lexiva contains a sulfonamide moiety.
- Increased blood sugar levels or worsening of pre-existing diabetes.
- Fat redistribution, where fat is lost from some areas of the body (e.g., face, arms, legs) and gained in others (e.g., abdomen, breasts).
Risks and Warnings of Lexiva
- Liver Toxicity: Lexiva can cause liver damage, especially in patients with pre-existing liver conditions like hepatitis B or C. Routine liver function tests are recommended during treatment.
- Sulfa Allergy: Lexiva contains a sulfa component, which may cause allergic reactions in individuals with a sulfa allergy. Caution is advised, and alternative treatments may be considered in such patients.
- Hyperlipidemia and Hyperglycemia: Lexiva may cause elevated levels of cholesterol and triglycerides, as well as increased blood sugar levels. Patients with existing lipid disorders or diabetes should be closely monitored.
- Immune Reconstitution Syndrome: In some cases, patients starting antiretroviral therapy may experience an immune reconstitution inflammatory syndrome (IRIS), where the immune system begins to recover and respond to previously undiagnosed infections.
Interactions with Lexiva
Common Drug Interactions
- Ritonavir: Used as a "booster" to enhance the effectiveness of Lexiva by slowing its metabolism.
- Oral contraceptives: Lexiva can reduce the effectiveness of birth control pills. Use an alternative, non-hormonal form of contraception while taking Lexiva.
- Antacids: These may reduce the absorption of Lexiva; take them at a different time of day if needed.
- St. John’s Wort: May reduce the levels of Lexiva in the blood, decreasing its effectiveness. Avoid using this herbal supplement while on Lexiva.
Alternatives to Lexiva
- Darunavir (Prezista): Another protease inhibitor used in the treatment of HIV, often combined with a boosting agent like ritonavir or cobicistat.
- Atazanavir (Reyataz): A once-daily protease inhibitor used to treat HIV infection.
- Biktarvy: A single-tablet regimen combining an integrase inhibitor with other antiretrovirals for HIV treatment.
- Triumeq: Another single-tablet regimen combining an integrase inhibitor with two nucleoside reverse transcriptase inhibitors.
