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All about: Agenerase

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Generic name: Amprenavir
Brand names: Agenerase

Why is Agenerase prescribed?

Agenerase is one of the many drugs now used to combat human immunodeficiency virus (HIV) infection. HIV undermines the immune system, reducing the body's ability to fight off other infections and eventually leading to the deadly condition known as acquired immune deficiency syndrome (AIDS).

Agenerase slows the progress of HIV by interfering with an important step in the virus's reproductive cycle. The drug is a member of the group of "protease inhibitors" famous for having successfully halted the advance of the virus in many HIV-positive individuals. Agenerase is prescribed only as part of a "drug cocktail" that attacks the virus on several fronts. It is not used alone.

Most important fact about Agenerase

Agenerase is not a cure for HIV infection or AIDS. It does not completely eliminate HIV from the body or totally restore the immune system. There is still a danger of developing serious opportunistic infections (infections that develop when the immune system falters). It's important, therefore, to continue seeing your doctor for regular blood counts and tests. And notify your doctor immediately of any changes in your general health.

How should you take Agenerase?

With the exception of high-fat meals, Agenerase may be taken with or without food. (Excessive fat decreases the amount of medicine that gets into the bloodstream.)

It is important to keep adequate levels of the drug in your bloodstream at all times, so be sure to take Agenerase exactly as prescribed, even when you're feeling better. Do not substitute Agenerase oral solution for the capsules. The two are not interchangeable.

If you are also taking antacids or the HIV drug didanosine (Videx), be sure to allow at least 1 hour between a dose of either medicine and a dose of Agenerase.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Both the capsules and the oral solution can be stored at room temperature. Do not refrigerate the oral solution.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Agenerase.

  • More common side effects may include:
    Abdominal discomfort or pain, diarrhea, fatigue, gas, headache, nausea, skin rash, vomiting, mouth tingling

Why should Agenerase not be prescribed?

If Agenerase gives you an allergic reaction, you will not be able to use it. Agenerase oral solution should be taken only when the capsule form is not an option. The oral solution contains an ingredient, propylene glycol, that some people have difficulty processing. It should not be taken by children under age 4, pregnant women, people with kidney or liver failure, or anyone who is also taking disulfiram (Antabuse) or metronidazole (Flagyl). It should be used with caution by women and individuals who have an Asian, Eskimo, or Native American ethnic background. Possible reactions to the propylene glycol in Agenerase oral solution include seizures, drowsiness, and fast heartbeat.

Special warnings about Agenerase

Remember that Agenerase does not completely eliminate HIV, and that it is still possible to pass the virus to others through sexual contact or blood contamination. Continue to practice safe sex while using Agenerase.

Agenerase can interfere with oral contraceptives. Use a backup form of birth control (such as condoms) to avoid an unwanted pregnancy.

Agenerase must be used with caution if you have kidney or liver problems. If you have such a disorder, make sure your doctor is aware of it.

Do not take vitamin E supplements with Agenerase. Agenerase is already fortified with vitamin E.

One serious potential side effect of Agenerase is a rash that occasionally becomes so severe as to be life-threatening. If you notice any signs of rash, inform your doctor immediately. If the rash gets worse or is accompanied by fever, blisters, mouth sores, red eyes, swelling, or flu-like symptoms, stop taking the drug and call your doctor.

Agenerase may trigger diabetes or make it worse. If this occurs, you may have to start taking insulin or oral diabetes drugs, or have your dosage of these medications adjusted. Agenerase can also increase cholesterol levels, possibly resulting in the need for treatment.

Like other protease inhibitors, Agenerase may also lead to a redistribution of body fat, with an increase in weight around the middle and on the upper back, and a loss of fat in the arms and legs. The long-term health effects of this change are still unknown.

Agenerase belongs to the sulfonamide family of drugs. If you have an allergy to other sulfa drugs, such as Bactrim or Septra, be sure to tell your doctor.

Possible food and drug interactions when taking Agenerase

Be sure to check with your doctor about the medicines and herbal remedies that should NOT be taken with Agenerase. Due to the danger of life-threatening side effects, Agenerase should never be combined with dihydroergotamine (Migranal), ergonovine (Ergotrate), ergotamine (Ergostat), methylergonovine (Methergine), pimozide (Orap), midazolam (Versed), or triazolam (Halcion). Serious or life-threatening side effects can also occur when Agenerase is taken with amiodarone (Cordarone), lidocaine, lovastatin (Mevacor), quinidine (Quinidex), simvastatin (Zocor), or tricyclic antidepressants such as Elavil and Tofranil. If you are taking both Agenerase and the HIV drug ritonavir (Norvir), you must be careful to avoid the heart medications flecainide (Tambocor) and propafenone (Rythmol).

Rifampin (Rifadin, Rifamate, Rifater) and St. John's wort should be avoided because they combat the antiviral effects of Agenerase. Combining Agenerase oral solution with Norvir oral solution is not recommended. And while taking Agenerase oral solution, it's best to avoid drinking alcohol.

Be cautious, too, about combining Agenerase and Viagra. The combination increases the risk of Viagra-related side effects such as low blood pressure, changes in vision, and persistent painful erection.

A variety of other drugs may also interact with Agenerase. Here is a list of the major possibilities.

Abacavir (Ziagen)
Amiodarone (Cordarone)
Antacids such as Maalox and Mylanta
Antidepressants classified as "tricyclics," such as Elavil, Pamelor, and Tofranil
Benzodiazepine drugs used to treat anxiety, including Dalmane, Tranxene, Valium, and Xanax
Calcium Channel Blockers (used for high blood pressure and angina), including Adalat, Calan, Cardene, Cardizem, Dilacor, DynaCirc, Nimotop, Norvasc, Plendil, Procardia, Sular, and Vascor
Carbamazepine (Tegretol)
Cholesterol-lowering agents such as Lipitor, Mevacor, and Zocor
Cimetidine (Tagamet)
Clarithromycin (Biaxin)
Clozapine (Clozaril)
Cyclosporine (Sandimmune; Neoral)
Dapsone
Delavirdine (Rescriptor)
Dexamethasone (Decadron)
Didanosine (Videx)
Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray)
Disulfiram (Antabuse)
Efavirenz (Sustiva)
Ergonovine (Ergotrate)
Ergotamine (Ergostat)
Erythromycin (Eryc, Ery-Tab)
Indinavir (Crixivan)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Lidocaine
Lopinavir/ritonavir (Kaletra)
Loratadine (Claritin)
Methadone
Methylergonovine (Methergine)
Metronidazole (Flagyl)
Midazolam (Versed)
Nelfinavir (Viracept)
Nevirapine (Viramune)
Oral contraceptives
Phenobarbital
Phenytoin (Dilantin)
Pimozide (Orap)
Quinidine (Quinaglute, Quinidex)
Rapamycin (Rapamune)
Rifabutin (Mycobutin)
Rifampin (Rifadin, Rimactane)
Ritonavir (Norvir)
St. John's wort
Saquinavir (Invirase)
Sildenafil (Viagra)
Tacrolimus (Prograf)
Triazolam (Halcion)
Warfarin (Coumadin)
Zidovudine (Retrovir)

Special information if you are pregnant or breastfeeding

The effects of Agenerase during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Do not take the oral solution while pregnant.

Since HIV infection can be passed to your baby through breast milk, you should avoid breastfeeding.

Recommended dosage

ADULTS

Capsules

The usual dosage for adults and adolescents 13 years of age and over is 1,200 milligrams (eight 150-milligram capsules) twice a day in combination with other anti-HIV medications. When combined with Norvir, the recommended dosage is 1,200 milligrams of Agenerase and 200 milligrams of Norvir once a day, or half that amount twice a day.

Oral Solution

The usual dose for adults and children 13 years of age and over is 1,400 milligrams twice a day in combination with other anti-HIV medications.

CHILDREN

The recommended dosage for children between 4 and 12 years old (and those over 13 who weigh 110 pounds or less) is as follows.

Capsules

20 milligrams per 2.2 pounds of body weight twice a day or 15 milligrams per 2.2 pounds of body weight 3 times daily in combination with other anti-HIV medications.

Oral Solution

22.5 milligrams per 2.2 pounds of body weight twice a day or 17.5 milligrams per 2.2 pounds of body weight 3 times daily in combination with other anti-HIV medications.

Dosage should never exceed 2,400 milligrams daily in capsule form or 2,800 milligrams daily of oral solution.

THOSE WITH REDUCED LIVER FUNCTION

The doctor will prescribe a reduced dosage ranging from 300 milligrams twice a day to 450 milligrams twice a day depending on the amount of liver damage you've suffered.

Overdosage

Little is known about the symptoms of Agenerase overdose. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

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