SEPTEMBER 27, 1996 GAY PEOPLE'S CHRONICLE 13

COMMUNITY GROUPS

What we know about the three protease inhibitors

Cleveland-Greetings from the front. It will be our intent in this article to give some basic information on some of the latest weapons in the fight against HIV/AIDS: protease inhibitors.

new

It is first most important to note that these drug therapies are not a cure for HIV infection. While they are powerful weapons, they are very complicated and their proper use is not yet fully understood.

Early in 1996, the FDA approved, in quick succession, three protease in-

hibitors: Invirase

(Roche

Labs),

this drug by year's end that will have better bioavailability.

Concerns: The diminished effectiveness of this drug may result in drug resistance to the later version, as well as a cross resistance to the other available protease inhibitors. Drug Interactions: Serious.

Cost: This drug is the most expensive of the three protease inhibitors now on the mar-

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Norvir (Abbott), and THE AIDS COALITION TO UNLEASH POWER

Crixivan (Merck).

All three of these

drugs are far more

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powerful than any other drug therapies previously available to people living with HIV/ AIDS.

That being said, it is important to note that none of these drugs are to be used alone. The best recommendations to date are that these three very different drugs need to be used in a triple combination therapy with two older anti-HIV drug therapies. At least two of the three drugs need to be drugs that are newly introduced to the individual.

The difference in every aspect of these drugs and the numerous combinations possible are far too complex to cover in this short article, so we will give some basic information here on each of the three drugs.

Invirase: The first protease inhibitor approved by the FDA appears to be effective when used in triple combination. There is a severe problem with the bioavailability of this drug (the body does not absorb enough of it). Roche has promised a new version of

ket, up to $7,000

per year.

Norvir: This drug appears to be very effective in a triple combination therapy. It is also the most difficult of the three protease inhibitors to take. Concerns:

Cross-resistance to other protease inhibitors if drug failure (when HIV developing resistance to it) occurs. There are reports that more than 50 percent of individuals who attempt to use this drug are unable to tolerate the side effects (very high rate of initial diarrhea, nausea, vomiting, and numbness) for more than one to two weeks. Initial dosage recommendations were that individuals start taking 600 milligrams twice daily. Since so many were unable to tolerate this dosage, a recommended gradual dosage build up over several weeks appears to be more successful, but not significantly.

Drug interactions: This drug warrants great concern in regards to drug interactions. The list of interacting drugs is long, and reactions very severe.

Cost: $5,000 to 6,000/ per year.

Crixivan: Early testing seems to indicate that in the best possible triple combination therapy this protease inhibitor may be the

•

most effective of the three. While it even had surprisingly good results when used by itself as monotherapy, this is not recommended due to possible drug failure and ensuing drug resistance to other protease inhibitors.

Due to demand and insufficient production levels, Crixivan has been only available from Stadlanders Pharmacy, 800-927-8888 until October.

Concerns: This drug must be taken three times a day on an empty stomach, one hour before or two hours after eating a full meal. This discipline is difficult for many, but most be followed to ensure effectiveness.

Drug interactions: Minimal, but serious. Cost: $4,000 to 5,000 per year.

We know that, when used properly in a triple combination therapy, protease inhibitors are very effective. What we also know is that these drugs must be taken in a very regimented routine. Failure to use these drugs properly is more than likely going to result in drug failure, thus a lost window of opportu-

•

nity to stave off further disease progression. What we also know is that due to the great expense of these three-drug therapies combined with the expensive viral load tests necessary to use them properly, most of the poor and working poor will never receive the benefits of these strong weapons in the fight against HIV/AIDS.

To date the most effective weapon in fighting HIV/AIDS has been our intellect and our combined voices! Again we urge you to call or write Governor George Voinovich and your state representative and demand that money be made available to ensure that every person living with HIV/ AIDS receives the benefit of these hard-won medical advances.

We also urge every person who cares about, and those living with HIV/AIDS to further educate yourselves on these medical advances.

Knowledge = life! Act up! Fight back! Fight AIDS!

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For HIV/AIDS information call (216) 664 AIDS.

Free condoms available,

free and anonymous HIV testing:

J. Glenn Smith

Health Center

11100 St. Clair Avenue

(216) 249-4100

Thomas F. McCafferty Health Center

4242 Lorain Avenue (216) 651-5005

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