THE 2013 COMPLETE HIV TREATMENT GUIDE
’80s LADIES
TROUBLE PAYING FOR MEDS? OUR STATE-BY-STATE LOOK AT DRUG ASSISTANCE PROGRAMS CAN HELP
Pop icons Cyndi Lauper, Debbie Gibson, & Paula Poundstone on why they’re still committed to the fight against AIDS
CRAMER CAMERA VS.
SMART, SEXY, FUNNY, AND HIVPOSITIVE PHOTOGRAPHER DUANE CRAMER TELLS US ABOUT HIS BATTLE TO COME OUT, FIGHTING STIGMA, AND LOSING HIS FATHER TO AIDS
JULY/AUGUST 2013
www.hivplusmag.com
What is STRIBILD? STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. It combines 4 medicines into 1 pill to be taken once a day with food. STRIBILD is a complete single-tablet regimen and should not be used with other HIV-1 medicines. STRIBILD does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking STRIBILD. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others. Always practice safer sex and use condoms to lower the chance of sexual contact with body fluids. Never reuse or share needles or other items that have body fluids on them.
IMPORTANT SAFETY INFORMATION What is the most important information I should know about STRIBILD? STRIBILD can cause serious side effects: t Build-up of an acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual (not normal) muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold especially in your arms and legs, feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. t Serious liver problems. The liver may become large (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. t You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking STRIBILD for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions.
t Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking STRIBILD, your hepatitis may suddenly get worse. Do not stop taking STRIBILD without first talking to your healthcare provider, as they will need to monitor your health. STRIBILD is not approved for the treatment of HBV. Who should not take STRIBILD? Do not take STRIBILD if you: t Take a medicine that contains: alfuzosin, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, pimozide, sildenafil when used for lung problems (Revatio®), triazolam, oral midazolam, rifampin or the herb St. John’s wort. t For a list of brand names for these medicines, please see the Brief Summary on the following pages. t Take any other medicines to treat HIV-1 infection, or the medicine adefovir (Hepsera®). What are the other possible side effects of STRIBILD? Serious side effects of STRIBILD may also include: t New or worse kidney problems, including kidney failure. Your healthcare provider should do regular blood and urine tests to check your kidneys before and during treatment with STRIBILD. If you develop kidney problems, your healthcare provider may tell you to stop taking STRIBILD. t Bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones. t Changes in body fat can happen in people taking HIV-1 medicines. t Changes in your immune system. Your immune system may get stronger and begin to fight infections. Tell your healthcare provider if you have any new symptoms after you start taking STRIBILD. The most common side effects of STRIBILD include nausea and diarrhea. Tell your healthcare provider if you have any side effects that bother you or don’t go away.
What should I tell my healthcare provider before taking STRIBILD? t All your health problems. Be sure to tell your healthcare provider if you have or had any kidney, bone, or liver problems, including hepatitis virus infection. t All the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. STRIBILD may affect the way other medicines work, and other medicines may affect how STRIBILD works. Keep a list of all your medicines and show it to your healthcare provider and pharmacist. Do not start any new medicines while taking STRIBILD without first talking with your healthcare provider. t If you take hormone-based birth control (pills, patches, rings, shots, etc). t If you take antacids. Take antacids at least 2 hours before or after you take STRIBILD. t If you are pregnant or plan to become pregnant. It is not known if STRIBILD can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking STRIBILD. t If you are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk. Also, some medicines in STRIBILD can pass into breast milk, and it is not known if this can harm the baby. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Please see Brief Summary of full Prescribing Information with important warnings on the following pages.
STRIBILD is a prescription medicine used as a complete single-tablet regimen to treat HIV-1 in adults who have never taken HIV-1 medicines before. STRIBILD does not cure HIV-1 or AIDS.
I started my personal revolution Talk to your healthcare provider about starting treatment. STRIBILD is a complete HIV-1 treatment in 1 pill, once a day.
Ask if it’s right for you.
Patient Information STRIBILDTM (STRY-bild) (elvitegravir 150 mg/cobicistat 150 mg/emtricitabine 200 mg/ tenofovir disoproxil fumarate 300 mg) tablets #SJFG TVNNBSZ PG GVMM 1SFTDSJCJOH *OGPSNBUJPO 'PS NPSF JOGPSNBUJPO QMFBTF TFF UIF GVMM 1SFTDSJCJOH *OGPSNBUJPO JODMVEJOH 1BUJFOU *OGPSNBUJPO What is STRIBILD? t STRIBILD is a prescription medicine used to treat HIV-1 in adults who have never taken HIV-1 medicines before. 453*#*-% JT B DPNQMFUF SFHJNFO BOE TIPVME OPU CF VTFE XJUI PUIFS )*7 NFEJDJOFT t STRIBILD does not cure HIV-1 or AIDS. :PV NVTU TUBZ PO DPOUJOVPVT )*7 UIFSBQZ UP DPOUSPM )*7 JOGFDUJPO BOE EFDSFBTF )*7 SFMBUFE JMMOFTTFT t Ask your healthcare provider about how to prevent passing HIV-1 to others. %P OPU TIBSF PS SFVTF OFFEMFT JOKFDUJPO FRVJQNFOU PS QFSTPOBM JUFNT UIBU DBO IBWF CMPPE PS CPEZ þ VJET PO UIFN %P OPU IBWF TFY XJUIPVU QSPUFDUJPO "MXBZT QSBDUJDF TBGFS TFY CZ VTJOH B MBUFY PS QPMZVSFUIBOF DPOEPN UP MPXFS UIF DIBODF PG TFYVBM DPOUBDU XJUI TFNFO WBHJOBM TFDSFUJPOT PS CMPPE
t %P OPU TUPQ UBLJOH 453*#*-% XJUIPVU ý STU UBMLJOH UP ZPVS IFBMUIDBSF QSPWJEFS t *G ZPV TUPQ UBLJOH 453*#*-% ZPVS IFBMUIDBSF QSPWJEFS XJMM OFFE UP DIFDL ZPVS IFBMUI PGUFO BOE EP CMPPE UFTUT SFHVMBSMZ GPS TFWFSBM NPOUIT UP DIFDL ZPVS )#7 JOGFDUJPO 5FMM ZPVS IFBMUIDBSF QSPWJEFS BCPVU BOZ OFX PS VOVTVBM TZNQUPNT ZPV NBZ IBWF BGUFS ZPV TUPQ UBLJOH 453*#*-% Who should not take STRIBILD? Do not take STRIBILD if you also take a medicine that contains: t BEFGPWJS )FQTFSB®
t BMGV[PTJO IZESPDIMPSJEF 6SPYBUSBM®
t DJTBQSJEF 1SPQVMTJE® 1SPQVMTJE 2VJDLTPMW®
t FSHPU DPOUBJOJOH NFEJDJOFT JODMVEJOH EJIZESPFSHPUBNJOF NFTZMBUF % ) & ® .JHSBOBM® FSHPUBNJOF UBSUSBUF $BGFSHPU® .JHFSHPU® &SHPTUBU® .FEJIBMFS &SHPUBNJOF® 8JHSBJOF® 8JHSFUUFT® BOE NFUIZMFSHPOPWJOF NBMFBUF &SHPUSBUF® .FUIFSHJOF®
t MPWBTUBUJO "EWJDPS® "MUPQSFW® .FWBDPS®
t PSBM NJEB[PMBN
What is the most important information I should know about STRIBILD?
t QJNP[JEF 0SBQ®
STRIBILD can cause serious side effects, including: 1. Build-up of lactic acid in your blood (lactic acidosis). -BDUJD BDJEPTJT DBO IBQQFO JO TPNF QFPQMF XIP UBLF 453*#*-% PS TJNJMBS OVDMFPTJEF BOBMPHT NFEJDJOFT -BDUJD BDJEPTJT JT B TFSJPVT NFEJDBM FNFSHFODZ UIBU DBO MFBE UP EFBUI -BDUJD BDJEPTJT DBO CF IBSE UP JEFOUJGZ FBSMZ CFDBVTF UIF TZNQUPNT DPVME TFFN MJLF TZNQUPNT PG PUIFS IFBMUI QSPCMFNT Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: t GFFM WFSZ XFBL PS UJSFE t IBWF VOVTVBM OPU OPSNBM NVTDMF QBJO t IBWF USPVCMF CSFBUIJOH t IBWF TUPNBDI QBJO XJUI OBVTFB PS WPNJUJOH t GFFM DPME FTQFDJBMMZ JO ZPVS BSNT BOE MFHT t GFFM EJ[[Z PS MJHIUIFBEFE t IBWF B GBTU PS JSSFHVMBS IFBSUCFBU 2. Severe liver problems. 4FWFSF MJWFS QSPCMFNT DBO IBQQFO JO QFPQMF XIP UBLF 453*#*-% *O TPNF DBTFT UIFTF MJWFS QSPCMFNT DBO MFBE UP EFBUI :PVS MJWFS NBZ CFDPNF MBSHF IFQBUPNFHBMZ BOE ZPV NBZ EFWFMPQ GBU JO ZPVS MJWFS TUFBUPTJT Call your healthcare provider right away if you get any of the following symptoms of liver problems: t ZPVS TLJO PS UIF XIJUF QBSU PG ZPVS FZFT UVSOT ZFMMPX KBVOEJDF
t EBSL iUFB DPMPSFEw VSJOF t MJHIU DPMPSFE CPXFM NPWFNFOUT TUPPMT t MPTT PG BQQFUJUF GPS TFWFSBM EBZT PS MPOHFS t OBVTFB t TUPNBDI QBJO You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking STRIBILD for a long time. 3. Worsening of Hepatitis B infection. *G ZPV IBWF IFQBUJUJT # WJSVT )#7 JOGFDUJPO BOE UBLF 453*#*-% ZPVS )#7 NBZ HFU XPSTF þ BSF VQ JG ZPV TUPQ UBLJOH 453*#*-% " iþ BSF VQw JT XIFO ZPVS )#7 JOGFDUJPO TVEEFOMZ SFUVSOT JO B XPSTF XBZ UIBO CFGPSF t %P OPU SVO PVU PG 453*#*-% 3Fý MM ZPVS QSFTDSJQUJPO PS UBML UP ZPVS IFBMUIDBSF QSPWJEFS CFGPSF ZPVS 453*#*-% JT BMM HPOF
t TJMEFOBý M 3FWBUJP® XIFO VTFE GPS USFBUJOH MVOH QSPCMFNT
t SJGBNQJO 3JGBEJO® 3JGBNBUF® 3JGBUFS® 3JNBDUBOF®
t TJNWBTUBUJO 4JNDPS® 7ZUPSJO® ;PDPS®
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t UIF IFSC 4U +PIO T XPSU Do not take STRIBILD if you also take any other HIV-1 medicines, including: t 0UIFS NFEJDJOFT UIBU DPOUBJO UFOPGPWJS "USJQMB® $PNQMFSB® 7JSFBE® 5SVWBEB®
t 0UIFS NFEJDJOFT UIBU DPOUBJO FNUSJDJUBCJOF MBNJWVEJOF PS SJUPOBWJS $PNCJWJS® &NUSJWB® &QJWJS® PS &QJWJS )#7® &Q[JDPN® ,BMFUSB® /PSWJS® 5SJ[JWJS®
STRIBILD is not for use in people who are less than 18 years old. What are the possible side effects of STRIBILD? STRIBILD may cause the following serious side effects: t 4FF i8IBU JT UIF NPTU JNQPSUBOU JOGPSNBUJPO * TIPVME LOPX about STRIBILD?” t /FX PS XPSTF LJEOFZ QSPCMFNT JODMVEJOH LJEOFZ GBJMVSF :PVS IFBMUIDBSF QSPWJEFS TIPVME EP CMPPE BOE VSJOF UFTUT UP DIFDL ZPVS LJEOFZT CFGPSF ZPV TUBSU BOE XIJMF ZPV BSF UBLJOH 453*#*-% :PVS IFBMUIDBSF QSPWJEFS NBZ UFMM ZPV UP TUPQ UBLJOH 453*#*-% JG ZPV EFWFMPQ OFX PS XPSTF LJEOFZ QSPCMFNT t #POF QSPCMFNT DBO IBQQFO JO TPNF QFPQMF XIP UBLF 453*#*-% #POF QSPCMFNT JODMVEF CPOF QBJO TPGUFOJOH PS UIJOOJOH XIJDI NBZ MFBE UP GSBDUVSFT :PVS IFBMUIDBSF QSPWJEFS NBZ OFFE UP EP UFTUT UP DIFDL ZPVS CPOFT t Changes in body fat DBO IBQQFO JO QFPQMF XIP UBLF )*7 NFEJDJOF 5IFTF DIBOHFT NBZ JODMVEF JODSFBTFE BNPVOU PG GBU JO UIF VQQFS CBDL BOE OFDL iCVGGBMP IVNQw CSFBTU BOE BSPVOE UIF NJEEMF PG ZPVS CPEZ USVOL -PTT PG GBU GSPN UIF MFHT BSNT BOE GBDF NBZ BMTP IBQQFO 5IF FYBDU DBVTF BOE MPOH UFSN IFBMUI FGGFDUT PG UIFTF DPOEJUJPOT BSF OPU LOPXO t Changes in your immune system *NNVOF 3FDPOTUJUVUJPO 4ZOESPNF DBO IBQQFO XIFO ZPV TUBSU UBLJOH )*7 NFEJDJOFT :PVS JNNVOF TZTUFN NBZ HFU TUSPOHFS BOE CFHJO UP ý HIU JOGFDUJPOT UIBU IBWF CFFO IJEEFO JO ZPVS CPEZ GPS B MPOH UJNF 5FMM ZPVS IFBMUIDBSF QSPWJEFS SJHIU BXBZ JG ZPV TUBSU IBWJOH BOZ OFX TZNQUPNT BGUFS TUBSUJOH ZPVS )*7 NFEJDJOF
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Tell your healthcare provider about all your medical conditions, including: NFYJMFUJOF t *G ZPV IBWF PS IBE BOZ LJEOFZ CPOF PS MJWFS QSPCMFNT JODMVEJOH PYDBSCB[FQJOF 5SJMFQUBM®
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and herbal supplements: UIJPSJEB[JOF t 453*#*-% NBZ BGGFDU UIF XBZ PUIFS NFEJDJOFT XPSL BOE PUIFS WPSJDPOB[PMF 7GFOE®
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)PSNPOF CBTFE CJSUI DPOUSPM QJMMT QBUDIFT SJOHT TIPUT FUD Know the medicines you take. ,FFQ B MJTU PG BMM ZPVS NFEJDJOFT BOE TIPX JU UP ZPVS IFBMUIDBSF QSPWJEFS BOE QIBSNBDJTU XIFO ZPV HFU B "OUBDJE NFEJDJOFT UIBU DPOUBJOT BMVNJOVN NBHOFTJVN OFX NFEJDJOF %P OPU TUBSU BOZ OFX NFEJDJOFT XIJMF ZPV BSF UBLJOH IZESPYJEF PS DBMDJVN DBSCPOBUF 5BLF BOUBDJET BU MFBTU IPVST 453*#*-% XJUIPVU ý STU UBMLJOH XJUI ZPVS IFBMUIDBSF QSPWJEFS CFGPSF PS BGUFS ZPV UBLF 453*#*-% .FEJDJOFT UP USFBU EFQSFTTJPO PSHBO USBOTQMBOU SFKFDUJPO PS IJHI Keep STRIBILD and all medicines out of reach of children. CMPPE QSFTTVSF 5IJT #SJFG 4VNNBSZ TVNNBSJ[FT UIF NPTU JNQPSUBOU JOGPSNBUJPO BNJPEBSPOF $PSEBSPOF® 1BDFSPOF® BCPVU 453*#*-% *G ZPV XPVME MJLF NPSF JOGPSNBUJPO UBML XJUI ZPVS IFBMUIDBSF QSPWJEFS :PV DBO BMTP BTL ZPVS IFBMUIDBSF QSPWJEFS PS BUPSWBTUBUJO -JQJUPS® $BEVFU®
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IN THIS ISSUE
JULY/AUGUST 2013
6
2013 TREATMENT GUIDE
12 MEDICATION BY THE NUMBERS 9^V_ _^ Q\\ _V dXU 641 Q``b_fUT TbeWc ecUT d_ dbUQd 89F _b 89F bU\QdUT S_]`\YSQdY_^c
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OPPOSITE PAGE: TROY SMITH; THIS PAGE: MICHAEL SCHWARTZ
“IT IS THE ONLY DISEASE THAT I CAN THINK OF, IN MY LIFETIME, WHERE PEOPLE DIDN’T KNOW WHERE IT WAS COMING FROM. AIDS RODE INTO TOWN ON A MOTORCYCLE, AND THE AFFLICTION OF FEAR, STIGMA, AND HYSTERIA RODE IN THE SIDECAR,” REMEMBERS PAULA POUNDSTONE. ?^U _V @_e^Tcd_^Uºc \QdUcd WYWc gQc U]SUUY^W dXU c`bY^W RU^UÂd V_b dXU 194C 6_e^TQdY_^ _V 3XYSQW_ dXU =YTgUcdºc RYW WUcd `bYfQdU c_ebSU _V `XY\Q^dXb_`YS ce``_bd V_b 89F cUbfYSUc 1^T gXY\U dXU S_]UTYQ^ Yc^ºd ceb`bYcUT gUºbU cdY\\ RQdd\Y^W 89F cXUºc dXQ^[Ve\ V_b dXU `b_WbUcc dXQdºc RUU^ ]QTU ·9d SQ]U _^ c_ RYW Q^T RQT X_g S_e\T gU XQfU Uh`USdUT d_ gY^ dXQd RQdd\U Q^i UQb\YUb/¸ cXU cQic ·9 X_`U dXU bUcUQbSX Q^T `bUfU^dY_^ Uç_bdc S_^dY^eU Qc VQcd Qc dXUi SQ^¯gXU^ `U_`\U TYU Vb_] 194C Yd SQ^ ^UfUb cUU] VQcd U^_eWX Red bU]U]RUb gXUbU gU gUbU 9^ dUb]c _V dXU g_b\Tºc `bY_bYdYUc 9 SQ^ dU\\ i_e dXQd dXU ]_^Ui c`U^d _^ bUcUQbSX Q^T `bUfU^ dY_^ Yc Q W__T Y^fUcd]U^d ¸ 1TTYdY_^Q\\i <Qe`Ub XQc ^_d _^\i RUU^ Q V_bSU _V ^QdebU Y^ dXU ÂWXd d_ U^T 89F cXU XQc Q\c_ RUU^ Q^ e^gQfUbY^W QSdYfYcd V_b <72D UaeQ\Ydi cY^SU dXU RUWY^^Y^W _V XUb SQbUUb CXU S_V_e^TUT dXU DbeU 3_\_bc 6e^T Y^ " ( Q^ _bWQ^YjQdY_^ dXQd QTf_SQdUc UaeQ\Ydi V_b Q\\ Q^T QY]c d_ bQYcU QgQbU^Ucc _V <72D i_edX X_]U\Ucc^Ucc Qc gU\\ Qc RbY^W Q^ U^T d_ Yd ·I_e ÂWXd VUQb Q^T YW^_bQ^SU dXb_eWX UTeSQdY_^ Q^T QgQbU^Ucc ¸ cXU cQic _V dXU ]_dYfQdY_^ RUXY^T XUb QTf_SQSi ·8QfY^W ^UfUb RUU^ Q `Ubc_^ gX_ gQc QVbQYT d_ c`UQ[ e` 9 [^Ug 9 XQT d_ XU\` ]Q[U c_]U ^_YcU Q^T T_ gXQdUfUb 9 S_e\T d_ ]Q[U Q TYçUbU^SU ¸ DXQd TYçUbU^SU XQc Y^S\eTUT Q \_^W \Ycd _V 89F SXQbYdYUc Q^T _bWQ^YjQdY_^c gYdX gXYSX dXU cY^WUb XQc g_b[UT _fUb dXU iUQbc Y^S\eT Y^W $&&&$ dXU >U\c_^ =Q^TU\QµRQS[UT SQ] `QYW^ d_ XU\` bQYcU W\_RQ\ QgQbU^Ucc _V 89F Q^T 194C Q^T 2b_QTgQi 3QbUc 5aeYdi 6YWXdc 194C 9^ " ! <Qe`Ub Q^T <QTi 7QWQ RUSQ]U dXU VQSUc _V =13 3_c]UdYScº XYWX\i `eR\YSYjUT FYfQ 7\Q] SQ]`QYW^ RU^UÂdY^W dXU =13 194C 6e^T
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ย
HIV plus
11
2013 HIV COMPLETE
TREATMENT
GUIDE
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12
HIV plus
J U LY/A U G U S T 2 0 1 3
Everyone needs to know about the meds we take, so HIV Plus offers our most comprehensive look ever at the medications approved by the Food and Drug Administration for the treatment of HIV and opportunistic infections, as well as a state-by-state map of drug assistance programs, complementary therapies, and drug trials. Remember, before you take anything you should talk with your doctor about what meds youâ&#x20AC;&#x2122;re on, any drug allergies, whether you smoke, drink, or take other supplements or recreational drugs, if you breast-feed, or are pregnant or want to be. This info was culled from the National Institutes of Healthâ&#x20AC;&#x2122;s drug database, the FDA, and the individual pharmaceutical companies.
THE 2013 COMPLETE HIV TREATMENT GUIDE
JLIN?;M? CHBC<CNILM B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION 4R[R_VP ;NZR =Q[Ub
PREZISTA QN_b[NcV_ :Q^ccU^
REYATAZ NaNgN[NcV_ 2bYcd_\ =iUbc CaeYRR
APTIVUS aV]_N[NcV_ 2_UXbY^WUb 9^WU\XUY]
CRIXIVAN V[QV[NcV_ =UbS[
14
HIV plus
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
Two 400-mg capsules or one 800-mg tablet with one 100-mg Norvir capsule, once daily, with food
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300 mg, in capsule form, taken with 100 mg of Norvir, once daily, with food. For adults unable to tolerate Norvir, 400 mg of Reyataz with food is recommended. Take at the same time every day
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500 mg (two 250mg capsules or 5 milliliters of oral solution) with 200 mg (two 100-mg capsules/tablets or 2.5 milliliters of solution) of Norvir, twice daily. Capsules or solution may be taken with or without meals; tablets must be taken with meals
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800 mg, taken every eight hours, with water or another beverage, without food (one hour before or two hours after a meal) or with a light meal
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J U LY/A U G U S T 2 0 1 3
SIDE EFFECTS
JLIN?;M? CHBC<CNILM B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION MEDICATION 4R[R_VP ;NZR 4R[R_VP ;NZR =Q[Ub =Q[Ub
INVIRASE `N^bV[NcV_ ZR`fYNaR 8_ç]Q^^ <Q B_SXU
KALETRA Y\]V[NcV_ N[Q _Va\[NcV_ 1RR_dd <QR_bQd_bYUc
LEXIVA S\`NZ]_R[NcV_ FYYF 8UQ\dXSQbU
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
1,000 mg (five 200-mg capsules or two 500mg tablets), in combination with 100 mg of Norvir, twice daily, at least two hours after a meal
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800 mg, typically four tablets, once daily, or 400 mg, typically two tablets, twice daily. Swallow tablets whole; do not chew, break, or crush. An oral solution is available but should be taken with food
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For those used to protease inhibitors, 700 mg plus a 100-mg capsule of Norvir, twice daily. For those new to therapy, 1,400 mg of Lexiva twice daily, sometimes paired with Norvir, depending on the patient. Lexiva is available in tablets or oral solution; tablets can be taken with or without food, oral solution without food. Reduced dosage recommended for patients with liver impairment
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SIDE SIDE EFFECTS EFFECTS
J U LY/A U G U S T 2 0 1 3 HIV plus
15
The
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for me
Patient model. Pill shown is not actual size.
What is COMPLERA? ®
COMPLERA is a prescription HIV medicine that is used as a complete regimen to treat HIV-1 in adults who have never taken HIV medicines before and who have an amount of HIV in their blood (this is called “viral load”) that is no more than 100,000 copies/mL. COMPLERA contains 3 medicines – rilpivirine, emtricitabine and tenofovir disoproxil fumarate. It is not known if COMPLERA is safe and effective in children under the age of 18 years. COMPLERA® does not cure HIV-1 infection or AIDS. To control HIV-1 infection and decrease HIV-related illnesses you must keep taking COMPLERA. Avoid doing things that can spread HIV-1 to others: always practice safer sex and use condoms to lower the chance of sexual contact with body fluids; never reuse or share needles or other items that have body fluids on them, do not share personal items that may contain bodily fluids. Ask your healthcare provider if you have questions about how to reduce the risk of passing HIV-1 to others.
IMPORTANT SAFETY INFORMATION What is the most important information you should know about COMPLERA? COMPLERA® can cause serious side effects: t Build-up of an acid in your blood (lactic acidosis), which is a serious medical emergency. Symptoms of lactic acidosis include feeling very weak or tired, unusual (not normal) muscle pain, trouble breathing, stomach pain with nausea or vomiting, feeling cold, especially in your arms and legs, feeling dizzy or lightheaded, and/or a fast or irregular heartbeat. t Serious liver problems. The liver may become large (hepatomegaly) and fatty (steatosis). Symptoms of liver problems include your skin or the white part of your eyes turns yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements (stools), loss of appetite for several days or longer, nausea, and/or stomach pain. t You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time. In some cases, these serious conditions have led to death. Call your healthcare provider right away if you have any symptoms of these conditions. t Worsening of hepatitis B (HBV) infection. If you also have HBV and stop taking COMPLERA, your hepatitis may suddenly get worse. Do not stop taking COMPLERA without first talking to your healthcare provider, as they will need to monitor your health. COMPLERA is not approved for the treatment of HBV.
Who should not take COMPLERA? Do not take COMPLERA if you have ever taken other anti-HIV medicines. COMPLERA may change the effect of other medicines and may cause serious side effects. Your healthcare provider may change your other medicines or change their doses. Do not take COMPLERA if you also take these medicines: t anti-seizure medicines: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal), phenobarbital (Luminal), phenytoin (Dilantin, Dilantin-125, Phenytek) t anti-tuberculosis medicines: rifabutin (Mycobutin), rifampin (Rifater, Rifamate, Rimactane, Rifadin) and rifapentine (Priftin) t proton pump inhibitors for stomach or intestinal problems: esomeprazole (Nexium, Vimovo), lansoprazole (Prevacid), dexlansoprazole (Dexilant), omeprazole (Prilosec), pantoprazole sodium (Protonix), rabeprazole (Aciphex) t more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate t St. John’s wort (Hypericum perforatum) If you are taking COMPLERA you should not take other HIV medicines or other medicines containing tenofovir (Viread, Truvada, Stribild or Atripla); other medicines containing emtricitabine or lamivudine (Emtriva, Combivir, Epivir, Epivir-HBV, Epzicom, Trizivir, Atripla, Stribild or Truvada); rilpivirine (Edurant) or adefovir (Hepsera). In addition, tell your healthcare provider if you are taking the following medications because they may interfere with how COMPLERA works and may cause side effects: t certain antacid medicines containing aluminum, magnesium hydroxide, or calcium carbonate (examples: Rolaids, TUMS). These medicines must be taken at least 2 hours before or 4 hours after COMPLERA. t medicines to block stomach acid including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine HCL (Zantac). These medicines must be taken at least 12 hours before or 4 hours after COMPLERA. t any of these medicines: clarithromycin (Biaxin); erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral) methadone (Dolophine); posaconazole (Noxifil), telithromycin (Ketek) or voriconazole (Vfend). t medicines that are eliminated by the kidneys like acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene IV, Vitrasert), valacyclovir (Valtrex) and valganciclovir (Valcyte).
COMPLERA.
A complete HIV treatment in only 1 pill a day. COMPLERA is for adults who have never taken HIV-1 medicines before and have no more than 100,000 copies/mL of virus in their blood.
Ask your healthcare provider if itâ&#x20AC;&#x2122;s the one for you.
These are not all the medicines that may cause problems if you take COMPLERA. Tell your healthcare provider about all prescription and nonprescription medicines, vitamins, or herbal supplements you are taking or plan to take.
The most common side effects reported with COMPLERA are trouble sleeping (insomnia), abnormal dreams, headache, dizziness, diarrhea, nausea, rash, tiredness, and depression. Some side effects also reported include vomiting, stomach pain or discomfort, skin discoloration (small spots or freckles) and pain.
Before taking COMPLERA, tell your healthcare provider if you: liver problems, including hepatitis B or C virus infection, or have abnormal liver tests t Have kidney problems t Have ever had a mental health problem t Have bone problems t Are pregnant or planning to become pregnant. It is not known if COMPLERA can harm your unborn child t Are breastfeeding: Women with HIV should not breastfeed because they can pass HIV through their milk to the baby. Also, COMPLERA may pass through breast milk and could cause harm to the baby
This is not a complete list of side effects. Tell your healthcare provider or pharmacist if you notice any side effects while taking COMPLERA, and call your healthcare provider for medical advice about side effects.
t Have
COMPLERA can cause additional serious side effects: t New or worsening kidney problems, including kidney failure. If you have had kidney problems, or take other medicines that may cause kidney problems, your healthcare provider may need to do regular blood tests. t Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: feeling sad or hopeless, feeling anxious or restless, have thoughts of hurting yourself (suicide) or have tried to hurt yourself. t Changes in liver enzymes: People who have had hepatitis B or C, or who have had changes in their liver function tests in the past may have an increased risk for liver problems while taking COMPLERA. Some people without prior liver disease may also be at risk. Your healthcare provider may need to check your liver enzymes before and during treatment with COMPLERA. t Bone problems can happen in some people who take COMPLERA. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do additional tests to check your bones. t Changes in body fat can happen in people taking HIV medicine. t Changes in your immune system. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new symptoms after starting COMPLERA.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088. Additional Information about taking COMPLERA: t Always take COMPLERA exactly as your healthcare provider tells you to take it. t Take COMPLERA with a meal. Taking COMPLERA with a meal is important to help
get the right amount of medicine in your body. (A protein drink does not replace a meal). Stay under the care of your healthcare provider during treatment with COMPLERA and see your healthcare provider regularly. Please see Brief Summary of full Prescribing Information with important warnings on the following pages.
Learn more at www.COMPLERA.com
Brief Summary of full Prescribing Information
t
®
COMPLERA (kom-PLEH-rah) (emtricitabine, rilpivirine, tenofovir disoproxil fumarate) tablets Brief summary of full Prescribing Information. For more information, please see the full Prescribing Information including Patient Information. What is COMPLERA? t
COMPLERA is a prescription HIV (Human Immunodeficiency Virus) medicine that is used to treat HIV-1 in adults – who have never taken HIV medicines before, and – who have an amount of HIV in their blood (this is called ‘viral load’) that is no more than 100,000 copies/mL. Your healthcare provider will measure your viral load.
(HIV is the virus that causes AIDS (Acquired Immunodeficiency Syndrome)). t
COMPLERA contains 3 medicines – rilpivirine, emtricitabine, tenofovir disoproxil fumarate – combined in one tablet. It is a complete regimen to treat HIV-1 infection and should not be used with other HIV medicines.
t
It is not known if COMPLERA is safe and effective in children under the age of 18 years old.
t
COMPLERA does not cure HIV infection or AIDS. You must stay on continuous therapy to control HIV infection and decrease HIV-related illnesses.
t
Ask your healthcare provider if you have any questions about how to prevent passing HIV to other people. Do not share or re-use needles or other injection equipment, and do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal fluids or blood.
Who should not take COMPLERA? Do not take COMPLERA if: t your HIV infection has been previously treated with HIV medicines. t
you are taking any of the following medicines: – anti-seizure medicines: carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol-XR, Teril, Epitol); oxcarbazepine (Trileptal); phenobarbital (Luminal); phenytoin (Dilantin, Dilantin-125, Phenytek) – anti-tuberculosis (anti-TB) medicines: rifabutin (Mycobutin); rifampin (Rifater, Rifamate, Rimactane, Rifadin); rifapentine (Priftin) – proton pump inhibitor (PPI) medicine for certain stomach or intestinal problems: esomeprazole (Nexium, Vimovo); lansoprazole (Prevacid); dexlansoprazole (Dexilant); omeprazole (Prilosec, Zegerid); pantoprazole sodium (Protonix); rabeprazole (Aciphex) – more than 1 dose of the steroid medicine dexamethasone or dexamethasone sodium phosphate – St. John’s wort (Hypericum perforatum)
t
If you take COMPLERA, you should not take: – Other medicines that contain tenofovir (Atripla, Stribild, Truvada, Viread)
What is the most important information I should know about COMPLERA? COMPLERA can cause serious side effects, including: t Build-up of lactic acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take COMPLERA or similar (nucleoside analogs) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get any of the following symptoms which could be signs of lactic acidosis: – feel very weak or tired – have unusual (not normal) muscle pain – have trouble breathing – have stomach pain with nausea (feeling sick to your stomach) or vomiting – feel cold, especially in your arms and legs
– Other medicines that contain emtricitabine or lamivudine (Combivir, Emtriva, Epivir or Epivir-HBV, Epzicom, Trizivir, Atripla, Truvada, Stribild) – rilpivirine (Edurant) – adefovir (Hepsera) What should I tell my healthcare provider before taking COMPLERA? Before you take COMPLERA, tell your healthcare provider if you: t have or had liver problems, including hepatitis B or C virus infection, kidney problems, mental health problem or bone problems t
– feel dizzy or lightheaded Severe liver problems. Severe liver problems can happen in people who take COMPLERA. In some cases, these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Call your healthcare provider right away if you get any of the following symptoms of liver problems:
t
– your skin or the white part of your eyes turns yellow (jaundice) – dark “tea-colored” urine – light-colored bowel movements (stools)
are breast-feeding or plan to breast-feed. You should not breastfeed if you have HIV because of the risk of passing HIV to your baby. Do not breastfeed if you are taking COMPLERA. At least two of the medicines contained in COMPLERA can be passed to your baby in your breast milk. We do not know whether this could harm your baby. Talk to your healthcare provider about the best way to feed your baby.
– loss of appetite for several days or longer
Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
– nausea
t
– stomach pain t
are pregnant or plan to become pregnant. It is not known if COMPLERA can harm your unborn child. Pregnancy Registry. There is a pregnancy registry for women who take antiviral medicines during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.
– have a fast or irregular heartbeat t
Worsening of Hepatitis B infection. If you have hepatitis B virus (HBV) infection and take COMPLERA, your HBV may get worse (flare-up) if you stop taking COMPLERA. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. COMPLERA is not approved for the treatment of HBV, so you must discuss your HBV with your healthcare provider. – Do not let your COMPLERA run out. Refill your prescription or talk to your healthcare provider before your COMPLERA is all gone. – Do not stop taking COMPLERA without first talking to your healthcare provider. – If you stop taking COMPLERA, your healthcare provider will need to check your health often and do blood tests regularly to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking COMPLERA.
You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking COMPLERA for a long time.
COMPLERA may affect the way other medicines work, and other medicines may affect how COMPLERA works, and may cause serious side effects. If you take certain medicines with COMPLERA, the amount of COMPLERA in your body may be too low and it may not work to help control your HIV infection. The HIV virus in your body may become resistant to COMPLERA or other HIV medicines that are like it.
Especially tell your healthcare provider if you take: t an antacid medicine that contains aluminum, magnesium hydroxide, or calcium carbonate. If you take an antacid during treatment with COMPLERA, take the antacid at least 2 hours before or at least 4 hours after you take COMPLERA. t
t
a medicine to block the acid in your stomach, including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine hydrochloride (Zantac). If you take one of these medicines during treatment with COMPLERA, take the acid blocker at least 12 hours before or at least 4 hours after you take COMPLERA. any of these medicines (if taken by mouth or injection): – clarithromycin (Biaxin) – erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone)
trouble sleeping (insomnia)
t
abnormal dreams
t
headache
t
dizziness
t
diarrhea
t
nausea
t
rash
t
tiredness
t
depression
Additional common side effects include:
– fluconazole (Diflucan)
t
vomiting
– itraconazole (Sporanox)
t
stomach pain or discomfort
– ketoconazole (Nizoral)
t
skin discoloration (small spots or freckles)
– methadone (Dolophine)
t
pain
– posaconazole (Noxafil) – telithromycin (Ketek) – voriconazole (Vfend) t
The most common side effects of COMPLERA include: t
medicines that are eliminated by the kidney, including acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene IV, Vitrasert), valacyclovir (Valtrex), and valganciclovir (Valcyte)
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of COMPLERA. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088).
What are the possible side effects of COMPLERA?
How should I take COMPLERA?
COMPLERA can cause serious side effects, including: t See “What is the most important information I should know about COMPLERA?”
t
Stay under the care of your healthcare provider during treatment with COMPLERA.
t
Take COMPLERA exactly as your healthcare provider tells you to take it.
t
Always take COMPLERA with a meal. Taking COMPLERA with a meal is important to help get the right amount of medicine in your body. A protein drink does not replace a meal.
t
Do not change your dose or stop taking COMPLERA without first talking with your healthcare provider. See your healthcare provider regularly while taking COMPLERA.
t
If you miss a dose of COMPLERA within 12 hours of the time you usually take it, take your dose of COMPLERA with a meal as soon as possible. Then, take your next dose of COMPLERA at the regularly scheduled time. If you miss a dose of COMPLERA by more than 12 hours of the time you usually take it, wait and then take the next dose of COMPLERA at the regularly scheduled time.
t
Do not take more than your prescribed dose to make up for a missed dose.
t
t
New or worse kidney problems, including kidney failure, can happen in some people who take COMPLERA. Your healthcare provider should do blood tests to check your kidneys before starting treatment with COMPLERA. If you have had kidney problems in the past or need to take another medicine that can cause kidney problems, your healthcare provider may need to do blood tests to check your kidneys during your treatment with COMPLERA. Depression or mood changes. Tell your healthcare provider right away if you have any of the following symptoms: – feeling sad or hopeless – feeling anxious or restless – have thoughts of hurting yourself (suicide) or have tried to hurt yourself
t
Change in liver enzymes. People with a history of hepatitis B or C virus infection or who have certain liver enzyme changes may have an increased risk of developing new or worsening liver problems during treatment with COMPLERA. Liver problems can also happen during treatment with COMPLERA in people without a history of liver disease. Your healthcare provider may need to do tests to check your liver enzymes before and during treatment with COMPLERA.
t
Bone problems can happen in some people who take COMPLERA. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do additional tests to check your bones.
t
Changes in body fat can happen in people taking HIV medicine. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the main part of your body (trunk). Loss of fat from the legs, arms and face may also happen. The cause and long term health effect of these conditions are not known.
t
Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new symptoms after starting your HIV medicine.
This Brief Summary summarizes the most important information about COMPLERA. If you would like more information, talk with your healthcare provider. You can also ask your healthcare provider or pharmacist for information about COMPLERA that is written for health professionals, or call 1-800-445-3235 or go to www.COMPLERA.com Issued: January 2013
COMPLERA, the COMPLERA Logo, EMTRIVA, GILEAD, the GILEAD Logo, GSI, HEPSERA, STRIBILD, TRUVADA, VIREAD, and VISTIDE are trademarks of Gilead Sciences, Inc., or its related companies. ATRIPLA is a trademark of Bristol-Myers Squibb & Gilead Sciences, LLC. All other marks referenced herein are the property of their respective owners. ©2013 Gilead Sciences, Inc. All rights reserved. CPAC0023 03/13
THE 2013 COMPLETE HIV TREATMENT GUIDE
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TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
600 mg (six 100mg tablets), twice daily, with a meal. Swallow tablets whole with water; do not chew, break, or crush. Also available in capsules or oral solution. Reduced dosage recommended for people taking other protease inhibitors
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1,250 mg (five 250-mg tablets or two 625-mg tablets), twice daily, or 750 milligrams (three 250-mg tablets) three times daily. Each dose should be taken with a meal. An oral powder is also available
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SIDE EFFECTS
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TRADITIONAL DOSAGE
SELZENTRY
300 mg twice daily, or 150 mg twice daily if given with potent CYP3A inhibitors, or 600 mg twice daily if given with potent CYP3A inducers
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SIDE EFFECTS
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TRADITIONAL DOSAGE
Injection of 90 mg in the upper arm, upper leg, or stomach twice daily
WHAT IT DOES
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DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
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SIDE EFFECTS
=_cd cUbY_ec* Y^ZUSdY_^ cYdU Y^VUSdY_^c _b bUQS dY_^c ceSX Qc YdSXY^W cgU\\Y^W bUT^Ucc `QY^ _b dU^TUb^Ucc XQbTU^UT c[Y^ Re]`c Qd dXU cYdU _V Y^ZUSdY_^+ Q\\UbWYS bUQSdY_^cยถQ\c_ `QdYU^dc dQ[Y^W 6ejU_^ ]Qi TUfU\_` RQSdUbYQ\ `^Ue]_^YQ ]_bU _VdU^ dXQ^ _dXUbc Q\dX_eWX Yd Yc e^S\UQb YV dXU TbeW Yc dXU SQecU ?dXUb* `QY^ Q^T ^e]R^Ucc Y^ VUUd _b \UWc \_cc _V c\UU` TU`bUccY_^ TUSbUQcUT Q``UdYdU cY^ec `b_R\U]c U^\QbWUT \i]`X ^_TUc gUYWXd TUSbUQcU gUQ[^Ucc _b \_cc _V cdbU^WdX ]ecS\U `QY^ S_^cdY`QdY_^ Q^T `Q^SbUQc `b_R\U]c
CHN?AL;M? CHBC<CNILM B?FJ <FI=E ;H BCP'?H;<FCHA ?HTSG? ISENTRESS _NYaRT_NcV_
One 400-mg tablet, twice daily
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=_cd cUbY_ec* cUfUbU c[Y^ bUQSdY_^c Q^T Q\\UbWYS bUQSdY_^c \YfUb `b_R\U]c SXQ^WUc Y^ i_eb Y]]e^U cicdU] ?dXUb* XUQTQSXU db_eR\U c\UU`Y^W ^QecUQ dYbUT^Ucc+ \Ucc S_]]_^ cYTU UรงUSdc Y^S\eTU gUQ[^Ucc cd_]QSX `QY^ TYjjY^Ucc TU`bUccY_^ Q^T ceYSYTQ\ dX_eWXdc Q^T QSdY_^c
Getting HIV treatment information has never been easier. % '! "' ( & "#* ) #" +#(% !# ) * ' ($ '# ' '% '! "' " #%! ' #" #") " "' $ %! + ," % " ' #" % &#(% &
Get instant access to the
Treatment Guide Mobile App Point your mobile browser to www.hivplusmag.com/treatmentguide iPHONE PHOTO COURTESY OF APPLE INC.
THE 2013 COMPLETE HIV TREATMENT GUIDE
HO=F?IMC>? L?P?LM? NL;HM=LCJN;M? CHBC<CNILM "HLNC# B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION 4R[R_VP ;NZR =Q[Ub
TRUVADA
RZa_VPVaNOV[R N[Q aR[\S\cV_ QV`\]_\eVY SbZN_NaR 7Y\UQT CSYU^SUc
COMBIVIR
YNZVcbQV[R N[Q gVQ\cbQV[R FYYF 8UQ\dXSQbU 2bQ^T ^Q]U DUfQ @XQb]QSUedYSQ\c 7U^UbYS
EMTRIVA
RZa_VPVaNOV[R
7Y\UQT CSYU^SUc
EPIVIR
YNZVcbQV[R \_ A0 FYYF 8UQ\dXSQbU
22
HIV plus
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
One tablet, containing 200 mg of emtricitabine and 300 mg of tenofovir disoproxil fumarate, once daily
DbefQTQ S_^dQY^c dg_ >BD9c gXYSX QSd _^ bUfUbcU dbQ^ cSbY`dQcU Q ceRcdQ^SU 89F ^UUTc V_b bU`\YSQdY_^ 4_ ^_d dQ[U DbefQTQ YV i_e dQ[U 1dbY`\Q 3_]RYfYb 5]dbYfQ 5`YfYb _b 5`YfYb 82F 5`jYS_] DbYjYfYb _b FYbUQT gXYSX XQfU dXU cQ]U _b cY]Y\Qb QSdYfU Y^WbUTYU^dc I_e ]Qi ^UUT d_ QTZecd T_cQWU YV Q\c_ dQ[Y^W FYTUh BUiQdQj _b ;Q\UdbQ 4_ ^_d dQ[U gYdX 8U`cUbQ 9V i_e XQfU XQT [YT^Ui `b_R\U]c _b dQ[U _dXUb TbeWc dXQd SQ^ SQecU [YT^Ui `b_R\U]c i_eb T_Sd_b cX_e\T T_ bUWe\Qb R\__T dUcdc d_ SXUS[ i_eb [YT^Uic 9^ " !" dXU 641 Q``b_fUT DbefQTQ V_b ecU Y^ 89F `bUfU^ dY_^ Q]_^W 89F ^UWQdYfU `U_`\U gX_ QbU Qd XYWX bYc[ _V QSaeYbY^W dXU fYbec DXU 641ºc e`TQdUT \QRU\Y^W _^ dXU TbeW ^_dUc dXQd `Ubc_^c ecY^W dXU TbeW `bUfU^dQdYfU\i ^UUT d_ RU S_^Âb]UT Qc 89F ^UWQdYfU UfUbi dXbUU ]_^dXc Q^T ecU dXU TbeW Qc `bUcSbYRUT Y^ S_]RY^QdY_^ gYdX cQVUb cUh `bQSdYSUc Q^T S_e^cU\Y^W
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T cUbY_ec \YfUb `b_R\U]c ÃQbU e`c _V XU`QdYdYc 2 fYbec Y^VUS dY_^ [YT^Ui `b_R\U]c dXY^^Y^W R_^Uc SXQ^WUc Y^ R_Ti VQd ci]`d_]c _V Y^ÃQ]]QdY_^ Vb_] `bUfY_ec Y^VUS dY_^c ?dXUb* TYQbbXUQ TYjjY^Ucc ^QecUQ f_]YdY^W XUQTQSXU VQdYWeU QR^_b]Q\ TbUQ]c c\UU`Y^W `b_R\U]c bQcX TU`bUccY_^ cX_bd^Ucc _V RbUQdX `QY^ VQddi \YfUb cd_]QSX `QY^ gUQ[ ^Ucc Y^TYWUcdY_^ Y^dUcdY^Q\ WQc XYWX f_\e]U _V ebY^U UhSUccYfU dXYbcd c[Y^ TYcS_\_bQdY_^ 9^ `QdYU^dc ecY^W Dbe fQTQ V_b `bUfU^dY_^ dXU ]_cd S_] ]_^ cYTU UçUSdc XQfU RUU^ XUQTQSXU QRT_]Y^Q\ `QY^ Q^T gUYWXd \_cc
One tablet, containing 150 mg of lamivudine and 300 mg zidovudine (both NRTIs), twice daily
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=_cd cUbY_ec* \_g gXYdU Q^T bUT R\__T SU\\ S_e^dc cUbY_ec Q\\UbWYS bUQSdY_^c ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T \YfUb d_hYSYdi _b g_bcU^Y^W _V \YfUb TYcUQcU `Q^SbUQdYdYc ]ecS\U TYc_bTUbc Q^T Y^ÃQ]]QdY_^ SXQ^W Uc Y^ R_Ti VQd SXQ^WUc Y^ dXU Y]]e^U cicdU] ?dXUb* XUQTQSXU ^QecUQ VQdYWeU TYQbbXUQ S_eWX cdeçi ^_cU WU^UbQ\ VUU\Y^W _V TYcS_]V_bd
One 200-mg capsule or 240 mg of oral solution, once daily
4_ ^_d ecU gYdX _dXUb TbeWc S_^dQY^Y^W U]dbYSYdQRY^U ceSX Qc 1dbY`\Q 3_]`\UbQ DbefQTQ _b CdbYRY\T
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T \YfUb `b_R\U]c Y^S\eTY^W ÃQbU e` _V XU`QdYdYc 2 QVdUb TYcS_^ dY^eQdY_^ ?dXUb* XUQTQSXU TYQbbXUQ ^QecUQ VQdYWeU TYjjY^Ucc TU`bUc cY_^ Y^c_]^YQ QR^_b]Q\ TbUQ]c bQcX QRT_]Y^Q\ `QY^ QcdXU^YQ Y^SbUQcUT S_eWX bXY^YdYc
300 mg daily, in one or two doses, in tablets or oral solution
4_ ^_d dQ[U gYdX 5]dbYfQ 3_]RYfYb 5`jYS_] DbYjYfYb 1dbY`\Q DbefQTQ CdbYRY\T _b 3_]`\UbQ 5`YfYb Yc ^_d bUS_] ]U^TUT V_b ecU Y^ S_]RY^QdY_^ gYdX jQ\SYdQRY^U 9V i_e XQfU XU`QdYdYc 3 dXUbU Yc Q SXQ^SU _V cUfUbU \YfUb TUS_]`_cYdY_^ YV i_e QbU dQ[Y^W S_]RY^QdY_^ Q^dYbUdb_fYbQ\ dXUbQ`i Q^T Y^dUbVUb_^ Q\VQ TbeWc V_b XU` 3
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T cUfUbU \YfUb `b_R\U]c SXQ^WUc Y^ dXU Y]]e^U cicdU] SXQ^WUc Y^ R_Ti VQd ?dXUb* XUQTQSXU ^QecUQ ]Q\QYcU Q^T VQdYWeU ^QcQ\ `b_R\U]c TYQbbXUQ Q^T S_eWX
J U LY/A U G U S T 2 0 1 3
SIDE EFFECTS
HO=F?IMC>? L?P?LM? NL;HM=LCJN;M? CHBC<CNILM "HLNC# B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION 4R[R_VP ;NZR =Q[Ub
EPZICOM
NONPNcV_ `bYSNaR N[Q YNZVcbQV[R FYYF 8UQ\dXSQbU
RETROVIR
gVQ\cbQV[R \_ .GA
FYYF 8UQ\dXSQbU+ WU^UbYS fUbcY_^c Q\c_ QfQY\QR\U
TRIZIVIR
NONPNcV_ `bYSNaR YNZVcbQV[R N[Q gVQ\cbQV[R
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
One tablet, containing 600 mg of abacavir sulfate and 300 mg of lamivudine (both NRTIs), once daily
4_ ^_d dQ[U YV i_e XQfU [YT^Ui `b_R\U]c _b QbU `b_^U d_ XUQbd TYcUQcU EcU gYdX SQedY_^ YV i_e Q\bUQTi dQ[U 1dbY`\Q 3_]RYfYb 5]dbYfQ 5`YfYb DbYjYfYb DbefQTQ JYQWU^ ]UdXQT_^U _b ]UTYSY^Uc ecUT d_ dbUQd XU`QdY dYc 9V i_e XQfU XU`QdYdYc 2 T_ ^_d be^ _ed _V 5`jYS_] _b cd_` dQ[Y^W Yd gYdX_ed dQ\[Y^W d_ i_eb XUQ\dX SQbU `b_ fYTUb I_eb `b_fYTUb cX_e\T ]_^Yd_b i_eb XUQ\dX Q^T T_ bUWe\Qb R\__T dUcdc d_ SXUS[ i_eb \YfUb YV i_e cd_` dQ[Y^W 5`jYS_] 4_ ^_d dQ[U YV i_e XQfU ]_TUbQdU d_ cUfUbU \YfUb `b_R\U]c
=_cd cUbY_ec* cUfUbU Q\\UbWYS bUQS dY_^c ReY\Te` _V QSYT Y^ dXU R\__T \YfUb `b_R\U]c ?dXUb* Y^c_]^YQ TU`bUccY_^ XUQTQSXU dYbUT^Ucc TYjjY^Ucc ^QecUQ TYQbbXUQ bQcX Q^T VUfUb
600 mg a day, taken in divided doses, in tablets, capsule, or syrup. Can also be given as an intravenous infusion, one mg per kilogram of body weight, over one hour, five or six times daily
4_ ^_d dQ[U gYdX _dXUb ]UTYSY^Uc dXQd S_^dQY^ dXU cQ]U QSdYfU Y^WbUTYU^dc Y^S\eTY^W 3_]RYfYb Q^T DbYjYfYb >_d bUS_]]U^TUT V_b ecU gYdX dXU Q^dYXU`QdYdYc TbeWc 3_`UWec BURUd_\ BYRQDQR _b BYRQc`XUbU EcU gYdX SQedY_^ YV dQ[Y^W WQ^SYS\_fYb _b Y^dUbVUb_^ Q\VQ 4_ ^_d ecU BUdb_fYb gYdX cdQfeTY^U _b T_h_beRYSY^ BUdb_fYb SQ^ Q\c_ RU ecUT d_ `bUfU^d dbQ^c]YccY_^ _V 89F Vb_] Q ]_dXUb d_ XUb e^R_b^ SXY\T
=_cd cUbY_ec* ^Uedb_`U^YQ Q^T Q^U]YQ \_g gXYdU Q^T bUT R\__T SU\\ S_e^dc ]i_`QdXi Q^T ]i_cYdYc ]ecS\U TYc_bTUbc Q^T Y^ÃQ]]Q dY_^ ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T cUfUbU \YfUb `b_R\U]c SXQ^W Uc Y^ dXU Y]]e^U cicdU] SXQ^WUc Y^ R_Ti VQd ?dXUb* XUQTQSXU ]Q\QYcU ^QecUQ Q^_bUhYQ Q^T f_]YdY^W
One tablet (300 mg of abacavir sulfate, 150 mg of lamivudine, and 300 mg of zidovudine, all NRTIs), twice daily
4_ ^_d dQ[U YV i_e XQfU SUbdQY^ \YfUb `b_R\U]c _b gUYWX \Ucc dXQ^ ) `_e^Tc DQ[U gYdX SQedY_^ YV i_e XQfU Q `QbdYSe\Qb WU^U fQbYQdY_^ SQ\\UT 8<1 2 %' ! XU`QdYdYc 2 [YT^Ui _b XUQbd `b_R\U]c \_g R\__T SU\\ S_e^dc XYWX R\__T `bUccebU XYWX SX_\UcdUb_\ _b TYQRUdUc EcU gYdX SQedY_^ YV i_e dQ[U 2QSdbY] CU`dbQ 3id_fU^U 48@7 Y^dUbVUb_^ Q\VQ 1TbYQ]iSY^ 3_`UWic BURUd_\ FYbQ j_\U R_^U ]Qbb_g ce``bUccYfU ]UTYSY^Uc _b Sid_d_hYS ]UTYSY^Uc 1dbY`\Q 3_]RYfYb 3_]`\UbQ 5]dbYfQ 5`Y fYb _b 5`YfYb 82F 5`jYS_] BUdb_fYb DbefQTQ JUbYd _b JYQWU^
=_cd cUbY_ec* cUfUbU _b VQdQ\ Q\\Ub WYS bUQSdY_^c XUQbd QddQS[ ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T \YfUb TYc_b TUbc R\__T `b_R\U]c ]ecS\U gUQ[ ^Ucc SXQ^WUc Y^ R_Ti VQd SXQ^WUc Y^ Y]]e^U cicdU] ?dXUb* ^QecUQ f_]YdY^W XUQTQSXU gUQ[^Ucc _b dYbUT^Ucc TYQbbXUQ VUfUb Q^T _b SXY\\c TU`bUccY_^ ]ecS\U Q^T Z_Y^d `QY^ c[Y^ bQcXUc S_\T ci]`d_]c ^Ubf_ec^Ucc Q^T UQb ^_cU Q^T dXb_Qd Y^VUSdY_^c
Depends on weight. For individuals weighing 132 pounds or more, the recommended dose is 400 mg in enteric-coated capsules, once daily. For adults weighing less than 132 pounds, the recommended dose is 250 mg, once daily. Take the drug on an empty stomach, and swallow the capsules whole; do not chew, break, crush, or dissolve. A powder form to be mixed with water is available for children
4_ ^_d dQ[U YV i_e dQ[U <_`ebY^ _b Ji\_`bY] gXYSX QbU ecUT d_ dbUQd W_ed Q^T [YT^Ui cd_^Uc _b dXU Q^dYXU`Q dYdYc TbeWc 3_`UWec BURUd_\ BYRQ DQR _b BYRQc`XUbU EcU gYdX SQedY_^ YV dQ[Y^W ]UdXQT_^U _b WQ^SYS\_fYb _b Q^i TbeWc dXQd ]Qi SQecU d_hYSYdi d_ dXU `Q^SbUQc _b ^Ubf_ec cicdU] 9V i_e QbU Q\c_ dQ[Y^W FYbUQT dXU T_cU _V FYTUh 53 cX_e\T RU bUTeSUT Q^T Yd cX_e\T RU dQ[U^ _^ Q^ U]`di cd_]QSX _b gYdX Q \YWXd ]UQ\
=_cd cUbY_ec* `Q^SbUQdYdYc ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T \YfUb TYc _bTUbc fYcY_^ `b_R\U]c SXQ^WUc Y^ Y]]e^U cicdU] SXQ^WUc Y^ R_Ti VQd `UbY`XUbQ\ ^Ueb_`QdXi ?dXUb* TYQbbXUQ ^QecUQ f_]YdY^W XUQT QSXU cd_]QSX `QY^ c[Y^ bQcX
FYYF 8UQ\dXSQbU
VIDEX EC QVQN[\`V[R 2bYcd_\ =iUbc CaeYRR
SIDE EFFECTS
J U LY/A U G U S T 2 0 1 3 HIV plus
23
THE 2013 COMPLETE HIV TREATMENT GUIDE
HO=F?IMC>? L?P?LM? NL;HM=LCJN;M? CHBC<CNILM "HLNC# B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION 4R[R_VP ;NZR =Q[Ub
VIREAD
aR[\S\cV_ QV`\]_\eVY SbZN_NaR 7Y\UQT CSYU^SUc
ZERIT
`aNcbQV[R \_ Q!A
2bYcd_\ =iUbc CaeYRR
ZIAGEN
NONPNcV_
7\Qh_C]YdX;\Y^U
24
HIV plus
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
One 300mg tablet, once daily. Adults who are unable to swallow tablets whole may take 7 scoops of Viread oral powder. Patients with kidney problems may be prescribed a lower dose
4_ ^_d dQ[U FYbUQT YV i_e QbU dQ[Y^W _dXUb ]UTYSY^Uc dXQd S_^dQY^ dU^_V_fYb 1dbY`\Q 3_]`\UbQ DbefQTQ _b CdbYRY\T _b QTUV_fYb 8U`cUbQ 4_cQWUc ]Qi ^UUT d_ RU SXQ^WUT YV i_e QbU dQ[Y^W FYTUh 53 BUiQdQj _b ;Q\UdbQ
For patients weighing 132 pounds or more, 40 mg, in capsules or oral solution, twice daily; for patients weighing less than 132 pounds, 30 mg twice daily
4_ ^_d dQ[U gYdX BUdb_fYb jYT_feTY^U _b Q^i jYT_feTY^U S_^dQY^Y^W `b_TeSdc ceSX Qc 3_]RYfYb _b DbYjYfYb 4_ ^_d dQ[U gYdX XiTb_hiebUQ gXYSX Yc ]Qb[UdUT e^TUb RbQ^T ^Q]Uc 4b_hYQ Q^T 8iTbUQ EcU gYdX SQedY_^ gYdX FYTUh 53 1TbYQ]iSY^ BeRUh 3_`UWec BURUd_\ BYRQc`XUbU FYbQj_\U B_VUb_^ 1 Q^T 9^db_^ 1 EcU gYdX SQedY_^ YV i_e XQfU \YfUb `Q^SbUQc _b [YT^Ui `b_R\U]c `UbY`XUbQ\ ^Ue b_`QdXi _b WQ\\cd_^Uc 6_b `QdYU^dc gYdX bU^Q\ Y]`QYb]U^d _b e^TUbW_Y^W XU]_TYQ\icYc T_cY^W QTZecd]U^dc ]Qi RU ^UUTUT 4_ ^_d TbY^[ Q\S_X_\ gXY\U _^ dXU TbeW
=_cd cUbY_ec* ReY\Te` _V Q^ QSYT Y^ dXU R\__T cUbY_ec \YfUb `b_R\U]c `Q^SbUQdYdYc SXQ^WUc Y^ R_Ti VQd SXQ^WUc Y^ Y]]e^U cicdU] `UbY`XUbQ\ ^Ueb_`QdXi ?dXUb* XUQTQSXU TYQbbXUQ bQcX ^QecUQ f_]YdY^W
600 mg in tablets daily, administered as either 300 mg twice daily or 600 mg once daily. Also available as an oral solution. Patients with mild liver impairment should take 200 mg twice daily
4_ ^_d dQ[U YV i_e XQfU ]_TUbQdU d_ cUfUbU \YfUb Y]`QYb ]U^d 4_ ^_d RbUQcd VUUT gXY\U dQ[Y^W dXU TbeW 9V i_e XQfU Q cUfUbU Q\\UbWYS bUQSdY_^ T_ ^_d bUce]U dQ[Y^W JYQWU^ _b Q^i _dXUb QRQSQfYb S_^dQY^Y^W TbeW 5`jYS_] DbYjYfYb BYc[ _V Q\\UbWYS bUQSdY_^ Yc XYWXUb YV i_e XQfU Q WU^U fQbYQdY_^ SQ\\UT 8<1 2 %' !
=_cd cUbY_ec* cUfUbU Q\\UbWYS bUQSdY_^ ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T gYdX \YfUb U^\QbWU]U^d SXQ^WUc Y^ R_Ti VQd SXQ^WUc Y^ Y]]e^U cicdU] Y^SbUQcUT bYc[ _V XUQbd QddQS[ Uc`USYQ\\i YV i_e XQfU _dXUb bYc[ VQSd_bc ceSX Qc c]_[Y^W XYcd_bi _V XUQbd db_eR\U TYQRUdUc XYWX R\__T `bUccebU _b XYWX SX_\UcdUb_\ ?dXUb* ^QecUQ f_]YdY^W dYbUT^Ucc XUQTQSXU TYQbbXUQ db_eR\U c\UU`Y^W VUfUb Q^T SXY\\c Q^T \_cc _V Q``UdYdU
Â&#x17E; J U LY/A U G U S T 2 0 1 3
FYbUQT Yc Q\c_ ecUT d_ dbUQd XU`QdYdYc 2
SIDE EFFECTS
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T cUfUbU \YfUb `b_R \U]c SXQ^WUc Y^ R_Ti VQd SXQ^WUc Y^ dXU Y]]e^U cicdU] R_^U `QY^ c_VdU^Y^W _b dXY^^Y^W ?dXUb* ^QecUQ bQcX TYQbbXUQ XUQTQSXU `QY^ TU`bUccY_^ gUQ[^Ucc
HIHHO=F?IMC>? L?P?LM? NL;HM=LCJN;M? CHBC<CNILM "HHLNC# B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION 4R[R_VP ;NZR =Q[Ub
EDURANT
_VY]VcV_V[R :Q^ccU^
INTELENCE Ra_NcV_V[R
:Q^ccU^
RESCRIPTOR
QRYNcV_QV[R
FYYF 8UQ\dXSQbU
SUSTIVA
RSNcV_R[g
2bYcd_\ =iUbc CaeYRR
VIRAMUNE [RcV_N]V[R
2_UXbY^WUb 9^WU\XUY]
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
One 25-mg tablet, once daily, with a meal
>>BD9c QddQS[ dXU cQ]U U^ji]U >BD9c T_ Y^ Q TYçUbU^d gQi 4_ ^_d dQ[U 5TebQ^d gYdX Q^dYcUYjebU TbeWc \Y[U DUWbUd_\ DbY\U`dQ\ Q^T 4Y\Q^dY^+ Q^dYRQSdUbYQ\c =iS_RedY^ BYVQTY^ BY]QSdQ^U _b @bYVdY^+ `b_d_^ `e]` Y^XYRYd_bc ceSX Qc >UhYe] FY]_f_ @bUfQSYT @bY\_cUS @b_d_^Yh Q^T 1SY`XUh+ ]_bU dXQ^ _^U T_cU _V TUhQ]UdXQ c_^U+ _b CQY^d :_X^ºc g_bd EcU gYdX SQedY_^ gYdX Q^dYVe^WQ\c dQ[U^ _bQ\\i Q^dYRY_dYSc \Y[U 2YQhY^ Q^T UbidXb_]iSY^ Q^T ]UdXQT_^U DQ[U Q^dQSYTc _b 8" R\_S[Ubc Qd \UQcd !" X_ebc RUV_bU _b V_eb X_ebc QVdUb 5TebQ^d
=_cd cUbY_ec* TU`bUccY_^ _b ]__T SXQ^WUc Y^S\eTY^W ceY SYTQ\ dX_eWXdc+ SXQ^WUc Y^ R_Ti VQd+ SXQ^WUc Y^ Y]]e^U cicdU] ?dXUb* Y^c_]^YQ XUQTQSXU bQcX
200 mg (one 200-mg tablet or two 100-mg tablets), twice daily
4_ ^_d dQ[U gYdX dXU Q^dY 89F TbeWc 1SdYfec <UhYfQ BUiQdQj Ve\\ T_cU >_bfYb FYbQ]e^U CecdYfQ _b BUcSbY`d_b+ U`Y\U`ci Q^T cUYjebU ]UTYSY^Uc DUWbUd_\ 3QbRQdb_\ <e]Y^Q\ 4Y\Q^dY^ _b @XU^idU[+ XUbRQ\ `b_TeSdc S_^dQY^Y^W CQY^d :_X^ºc g_bd+ _b dXU Q^dYRQSdUbYQ\ TbeWc =iS_RedY^ BYVQTY^ BYVQdUb BYVQ]QdU _b @bYVdY^ 1\gQic dQ[U QVdUb Q ]UQ\ Q^T cgQ\\_g dXU `Y\\ gYdX Q Ve\\ W\Qcc _V gQdUb+ T_ ^_d SXUg
=_cd cUbY_ec* cUfUbU c[Y^ bQcX _b Q\\UbWYS bUQSdY_^ ?dXUb* SXQ^WUc Y^ R_Ti cXQ`U _b R_Ti VQd SXQ^WUc Y^ Y]]e^U cicdU] dY^W\Y^W _b `QY^ Y^ dXU XQ^Tc _b VUUd ^e]R^Ucc
400 mg (two or four tablets) three times daily
GXU^ dQ[Y^W BUcSbY`d_b T_ ^_d dQ[U FUbcUT 8Q\SY_^ HQ^Qh 4 8 5 $% 9^ZUSdY_^ 5bW_]Qb =YWbQ^Q\ GYWbQY^U 3QVUbW_d ?bQ` @b_`e\ cYT 8Yc]Q^Q\ CU\TQ^U bYVQ]`Y^ `XU^_RQbRYdQ\ 4Y\Q^dY^ DUWbUdb_\ CQY^d :_X^ºc g_bd =UfQS_b _b J_S_b DQ\[ d_ i_eb T_Sd_b RUV_bU dQ[ Y^W FYQWbQ <Y`Yd_b 2QiS_\ _b <UcS_\ 9V dQ[Y^W FYTUh _b Q^dQSYTc dQ[U Q^ X_eb RUV_bU _b Q^ X_eb QVdUb dQ[Y^W BUcSbY`d_b 4_cUc _V `b_dUQcU Y^XYRYd_bc 1WU^UbQcU 3bYhYfQ^ 9^fYbQcU 6_bd_fQcU ;Q\UdbQ >_bfYb Q^T FYbQSU`d ]Qi ^UUT d_ RU QTZecdUT DQ\[ gYdX i_eb T_Sd_b YV i_e XQfU \YfUb _b [YT^Ui TYcUQcU
=_cd cUbY_ec* cUfUbU c[Y^ bQcX QSS_]`Q^YUT Ri R\YcdUbc VUfUb Z_Y^d _b ]ecS\U `QY^ bUT^Ucc _b cgU\\Y^W _V dXU UiUc _b c_bUc Y^ dXU ]_edX ?dXUb* XUQTQSXU ^QecUQ TYQbbXUQ Q^T dYbUT^Ucc
600 mg (three capsules at once or one tablet), taken daily
4_ ^_d dQ[U 1dbY`\Q FQcS_b @b_`e\cYT FUbcUT ?bQ` 8Q\SY_^ _b UbW_d ]UTYSQdY_^c ceSX Qc GYWbQY^U Q^T 3QVUbW_d DXU V_\\_gY^W ]UTYSY^Uc ]Qi ^UUT d_ RU bU`\QSUT gYdX Q^_dXUb gXU^ i_e QbU dQ[Y^W CecdYfQ* 6_bd_fQcU 9^fYbQcU 2YQhY^ 3QbRQdb_\ DUWbUd_\ >_hQÂ\ C`_bQ^_h Q^T BUiQdQj YV dXYc Yc ^_d dXU Âbcd dY]U i_e XQfU RUU^ dbUQdUT V_b 89F DXU V_\\_gY^W TbeWc ]Qi bUaeYbU Q SXQ^WU Y^ dXU T_cU _V UYdXUb Cec dYfQ _b dXU _dXUb ]UTYSY^U* 3QbTYjU] DYQjQS 3_fUbQ 8C 9c_`dY^ CB <Y`Yd_b @bQfQSX_\ J_S_b 3bYhYfQ^ ;Q\UdbQ ]UdXQT_^U =iS_RedY^ BUiQdQj BYVQTY^ BYVQ]QdU BYVQdUb CU\jU^dbi FVU^T 7U^WbQV >U_bQ\ CQ^TY]]e^U @b_WbQV BQ`Q]e^U GU\\RedbY^ J_\_Vd Q^T JifQ^ 9V i_e QbU dQ[Y^W CecdYfQ Q^T BUiQdQj i_e cX_e\T Q\c_ RU dQ[Y^W >_bfYb DU\\ i_eb T_Sd_b YV i_e XQfU XQT XU`QdYdYc _b _dXUb \YfUb `b_R\U]c ]U^ dQ\ Y\\^Ucc _b cUYjebUc DQ[U CecdYfQ _^ Q^ U]`di cd_]QSX `bUVUbQR\i Qd RUTdY]U gYdX gQdUb
=_cd cUbY_ec* cUfUbU \YfUb `b_R\U]c bQcXUc Q^T c[Y^ bUQSdY_^c ?dXUb* SXQ^WUc Y^ dXU Y]]e^U cicdU] SXQ^WUc Y^ R_Ti VQd TYjjY^Ucc ^QecUQ XUQTQSXU Y^c_]^YQ dYbUT^Ucc
One 200-mg tablet daily for first 14 days, then one 200mg twice daily; also available in oral suspension
4_ ^_d dQ[U CQY^d :_X^ºc g_bd CecdYfQ 1dbY`\Q ;Q\UdbQ <UhYfQ BUiQdQj >Yj_bQ\ C`_bQ^_h BYVQTY^ BYVQ]QdU BYVQdUb _b RYbdX S_^ db_\ `Y\\c DU\\ T_Sd_b YV dQ[Y^W 2YQhY^ 4YÃeSQ^ 3bYhYfQ^ ]UdXQT_^U FYbQSU`d =iS_RedY^ 3_e]QTY^ :Q^d_fU^ _b 9^fYbQcU 4YcS_^dY^eU Y]]UTYQdU\i YV i_e TUfU\_` cYW^c _V XU`QdYdYc cUfUbU c[Y^ bUQSdY_^c _b bQcX gYdX cicdU]YS ci]`d_]c
=_cd cUbY_ec* cUfUbU `ciSXY QdbYS `b_R\U]c Y^S\eTY^W ceY SYTQ\ dX_eWXdc+ \YfUb TYc_bTUbc+ cUfUbU bQcX ?dXUb* TYjjY^Ucc ^QecUQ f_]YdY^W TYQbbXUQ bQcX c\UU` TYcdebRQ^SUc Tb_gcY^Ucc db_eR\U S_^SU^ dbQdY^W _b e^eceQ\ TbUQ]c
SIDE EFFECTS
J U LY/A U G U S T 2 0 1 3 HIV plus
25
=IG<CH;NCIH >LOAM B?FJ JL?P?HN L?JFC=;NCIH I@ BCP MEDICATION 4R[R_VP ;NZR =Q[Ub
STRIBILD RYcVaRT_NcV_ P\OVPV`aNa RZa_VPVaNOV[R aR[\S\cV_ QV`\]_\eVY SbZN_NaR 7Y\UQT CSYU^SUc
ATRIPLA RSNcV_R[g RZa_VPVaNOV[R N[Q aR[\S\cV_ QV`\]_\eVY SbZN_NaR 2bYcd_\ =iUbc CaeYRR 7Y\UQT CSYU^SUc
COMPLERA RZa_VPVaNOV[R _VY]VcV_V[R N[Q aR[\S\cV_ QV`\]_\eVY SbZN_NaR 7Y\UQT CSYU^SUc
TRADITIONAL DOSAGE
DRUG INTERACTIONS, PRECAUTIONS, & RECOMMENDATIONS
One tablet, once daily, with a meal (150 mg of elvitegravir, 150 mg of cobicistat, 200 mg of emtricitabine, and 300 mg of tenofovir disoproxil fumarate)
CdbYRY\T Yc ^_d Q``b_fUT V_b dbUQd]U^d _V `QdYU^dc gX_ XQfU XU`QdYdYc 2 Qc CdbYRY\T SQ^ UhQSUbRQdU dXU TYcUQcU Q^T SQecU ÃQbU e`c CdbYRY\T cX_e\T ^_d RU ecUT V_b `QdYU^dc gYdX Q^ UcdY]QdUT SbUQdY^Y^U S\UQbQ^SU RU\_g ' ]< `Ub ]Y^edU 4_ ^_d ecU gYdX _dXUb Q^dY 89F TbeWc S_^dQY^Y^W U]dbYSYdQRY^U _b dU^_V_fYb TYc_`b_hY\ Ve]QbQdU Y^S\eTY^W 1dbY`\Q 3_]`\UbQ 5]dbYfQ DbefQTQ _b FYbUQT+ T_ ^_d ecU gYdX TbeWc S_^dQY^Y^W \Q]YfeTY^U _b gYdX TbeWc _b bUWY]U^c S_^dQY^Y^W bYd_^QfYb ceSX Qc 3_]RYfYb 5`YfYb 5`YfYb 82F 5`jYS_] _b DbYjYfYb 4_ ^_d QT]Y^YcdUb Y^ S_]RY^QdY_^ gYdX 8U`cUbQ 4_ ^_d ecU gYdX cY\TU^QÂ\ gXU^ RbQ^TUT Qc BUfQdY_ dX_eWX cY\TU^QÂ\ gXU^ T_cUT Qc FYQWbQ ]Qi RU cQVU c_ S_^ce\d i_eb T_Sd_b 4_ ^_d ecU gYdX Q\Vej_cY^ bYVQ]`Y^ SYcQ`bYTU `Y]_jYTU _b dXU XUbRQ\ bU]UTi CQY^d :_X^ºc g_bd 4_ ^_d dQ[U CdbYRY\T gYdX UbW_d TUbYfQdYfUc ceSX Qc TYXiTb_UbW_dQ]Y^U UbW_dQ]Y^U _b ]UdXi\UbW_^_fY^U 8=7 3_1 BUTeSdQcU Y^XYRYd_bc ceSX Qc \_fQcdQdY^ Q^T cY]fQcdQdY^ _b gYdX cUTQdYfU Xi`^_dYSc
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T+ cUfUbU \YfUb _b [YT^Ui `b_R\U]c gXYSX S_e\T \UQT d_ `_dU^dYQ\\i VQdQ\ bU^Q\ VQY\ebU+ dXY^^Y^W R_^Uc Q^T SXQ^WUc Y^ dXU Y]]e^U cicdU] ?dXUb* ^QecUQ Q^T TYQbbXUQ
One tablet, once daily, on an empty stomach, preferably at bedtime (containing 600 mg of efavirenz, 200 mg of emtricitabine, and 300 mg of tenofovir disoproxil fumarate). If you are also taking Rifadin, add 200 mg of efavirenz
5VQfYbU^j Yc Q ^_^^eS\U_cYTU bUfUbcU dbQ^cSbY`dQcU Y^XYRY d_b >>BD9 dXU _dXUb S_]`_^U^dc QbU ^eS\U_cYTU bUfUbcU dbQ^cSbY`dQcU Y^XYRYd_bc >BD9c + dXU TYçUbU^d di`Uc _V TbeWc QddQS[ 89F Qd TYçUbU^d cdQWUc Y^ Ydc bU`\YSQdY_^ `b_SUcc 4_ ^_d dQ[U 1dbY`\Q gYdX Q^dY 89F TbeWc 3_]RYfYb 3_]`\UbQ 5]dbYfQ 5`YfYb _b 5`YfYb 82F 5`jYS_] DbYjYfYb DbefQTQ FYbUQT _b CdbYRY\T gXYSX XQfU dXU cQ]U _b cY]Y\Qb QSdYfU Y^WbUTYU^dc DQ[U gYdX CecdYfQ _^\i YV i_eb T_Sd_b bUS_] ]U^Tc 9V i_e QbU dQ[Y^W ;Q\UdbQ T_cQWU _V dXQd TbeW ]Qi ^UUT d_ RU QTZecdUT 4_ ^_d dQ[U gYdX FYSdbU\Yc FQcS_b @b_`e\cYT FUbcUT ?bQ` 8Q\SY_^ UbW_d ]UTYSQdY_^c ceSX Qc GYWbQY^U Q^T 3QVUbW_d FVU^T 8U`cUbQ _b dXU XUbRQ\ bU]UTi CQY^d :_X^ºc g_bd EcU gYdX SQedY_^ gYdX 6_bd_fQcU 9^fYbQcU FYTUh BUiQdQj 3bYhYfQ^ CU\jU^dbi 2YQhY^ >_hQÂ\ C`_bQ^_h SQ\SY e] SXQ^^U\ R\_S[Ubc ceSX Qc TY\dYQjU] Q^T fUbQ`Q]Y\ gXYSX XQfU fQbY_ec RbQ^T ^Q]Uc Y]]e^_ce``bUccQ^d TbeWc ceSX Qc SiS\_c`_bY^U dQSb_\Y]ec Q^T cYb_\Y]ec c_\T e^TUb fQbY_ec RbQ^T ^Q]Uc ]UdXQT_^U =iS_RedY^ BYVQTY^ BY]QSdQ^U <Y`Yd_b @bQfQSX_\ J_S_b J_\_Vd _b cUYjebU ]UTc ceSX Qc `XU^id_Y^ SQbRQ]QjU`Y^U Q^T `XU^_RQbRYdQ\ 9V i_e XQfU XU`QdYdYc 2 Q^T cd_` dQ[Y^W 1dbY`\Q i_e ]Qi Uh`UbYU^SU Q ÃQbU e` _V dXU TYcUQcU 4_ ^_d dQ[U YV i_e XQfU cUfUbU [YT^Ui Y]`QYb]U^d
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T cUfUbU \YfUb _b [YT^Ui `b_R\U]c cUbY_ec `ciSXY QdbYS `b_R\U]c dXY^^Y^W R_^Uc Q fYdQ]Y^ 4 ce``\U]U^d ]Qi RU Y^TYSQdUT V_b dXU \QddUb ?dXUb* TYjjY^Ucc XUQTQSXU Y^c_]^YQ Tb_gcY^Ucc db_eR\U S_^SU^dbQd Y^W e^eceQ\ TbUQ]c VQdYWeU e`cUd cd_]QSX ^QecUQ f_]Yd Y^W WQc TYQbbXUQ
One tablet, once daily, with a meal (200 mg of emtricitabine, 25 mg of rilpivirine, and 300 mg of tenofovir disoproxil fumarate)
BY\`YfYbY^U Yc Q^ >>BD9 dXU _dXUb S_]`_^U^dc >BD9c 3_] `\UbQ Yc _^\i V_b `QdYU^dc gX_ XQfU ^_d `bUfY_ec\i dQ[U^ Q^dY bUdb_fYbQ\ TbeWc Q^T XQfU Q fYbQ\ \_QT _V ! S_`YUc `Ub ]Y\\Y\YdUb _V R\__T _b \Ucc 4_ ^_d dQ[U gYdX ]UTYSY^Uc dXQd S_^dQY^ \Q]YfeTY^U 5`YfYb 5`YfYb 82F 5`jYS_] 3_]RYfYb Q^T DbYjYfYb _dXUb 89F Q^dYbUdb_fYbQ\ ]UTYSQdY_^c TbeWc d_ dbUQd cUYjebUc _b deRUbSe\_cYc `b_d_^ `e]` Y^XYRYd_bc ceSX Qc ;Q`YTUh _b 4UhY\Q^d 8Uc`UbQ CQY^d :_X^ºc g_bd _b ]_bU dXQ^ _^U T_cU _V TUhQ]UdXQc_^U EcU SQedY_^ gXU^ dQ[Y^W Q^dQSYTc Q^dYVe^WQ\ ]UTYSQdY_^c 8" bUSU`d_b Q^dQW_^Ycdc Q^dYRY_dYSc _b ]UdXQT_^U
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ dXU R\__T cUfUbU \YfUb `b_R\U]c XU`QdYdYc 2 fYbec Y^VUS dY_^ ÃQbU e`c TU`bUccY_^ R_^U dXY^^Y^W Q^T SXQ^WUc Y^ dXU Y]]e^U cicdU] ?dXUb* Y^c_] ^YQ XUQTQSXU bQcXUc TYQb bXUQ ^QecUQ VQdYWeU TYjjY^Ucc TU`bUccY_^ QR^_b]Q\ TbUQ]c f_]YdY^W cd_]QSX _b _dXUb `QY^ Q^T c[Y^ TYcS_\_bQdY_^
SIDE EFFECTS
J U LY/A U G U S T 2 0 1 3 HIV plus
31
IJJILNOHCMNC= CH@?=NCIHM ;H> INB?L >LOAM MEDICATION TRADITIONAL DOSAGE
EGRIFTA
" ]W Y^ZUSdUT ceRSedQ^U_ec\i Zecd RU\_g dXU c[Y^ _^SU TQY\i
8U\`c bUTeSU 89F bU\QdUT UhSUcc RU\\i VQd Ri U^S_ebQWY^W dXU R_Ti d_ `b_TeSU ^QdebQ\ Wb_gdX X_b ]_^Uc dXQd bUTeSU VQd
4_ ^_d dQ[U YV i_e XQfU _b XQT YcceUc Y^f_\fY^W i_eb `YdeYdQbi W\Q^T YV i_e XQfU QSdYfU SQ^SUb _b YV i_e QbU `bUW^Q^d _b RbUQcd VUUTY^W
=_cd cUbY_ec* cUfUbU Q\\UbWYS bUQS dY_^ _b ÃeYT bUdU^dY_^ Y^ZUSdY_^ cYdU bUQSdY_^c _b Y^SbUQcU Y^ W\eS_cU Y^d_\UbQ^SU TYQRUdUc ?dXUb* @QY^ cgU\\Y^W ]ecS\U c_bU^Ucc dY^W\Y^W ^e]R^Ucc Q^T `bYS[Y^W ^QecUQ f_]YdY^W bQcX YdSXY^W
$ ]W dg_ _b V_eb dQR\Udc dXbUU dY]Uc TQY\i
DbUQdc Q^T XU\`c `bUfU^d bUSebbU^SU _V @^Ue]_SicdYc `^Ue]_^YQ Y^ 89F `_cYdYfU `QdYU^dc+ Q\c_ ecUT _^ _dXUb RQSdUbYQ\ Y^VUSdY_^c
DQ[U Qd dXU cQ]U dY]U UfUbi TQi Dbi ^_d d_ ]Ycc Q T_cU
=_cd cUbY_ec* c[Y^ bQcX Z_Y^d _b ]ecS\U QSXUc c_bU dXb_Qd _b VUfUb e^eceQ\ R\UUTY^W _b RbeYcY^W ?dXUb* TYjjY^Ucc ^QecUQ f_]YdY^W TYQbbXUQ \_cc _V Q``UdYdU VQdYWeU XUQTQSXU
?^U & ]W dQR\Ud UfUbi '" X_ebc _b " ]W _V _bQ\ c_\e dY_^ _^SU TQY\i
DbUQdc XU`QdYdYc 2
4_ ^_d dQ[U @UWQcic 9V ecY^W _bQ\ c_\edY_^ S\_cU R_dd\U Q^T S\UQ^ T_cY^W Se` Y]]UTYQdU\i QVdUb T_cY^W [UU` Se` Tbi RUdgUU^ ecUc Q^T T_ ^_d ecU V_b Q^idXY^W U\cU
=_cd cUbY_ec* ReY\Te` _V \QSdYS QSYT Y^ R_Ti cUfUbU \YfUb `b_R\U]c ]ecS\U `QY^ _b gUQ[^Ucc ^UbfU `b_R\U]c ÃQbU e` _V XU`QdYdYc 2 QVdUb TYcS_^ dY^eQdY_^ ?dXUb* TYQbbXUQ QRT_]Y ^Q\ `QY^ _b cgU\\Y^W S_eWX XUQTQSXU TYjjY^Ucc c_bU dXb_Qd VUfUb
Dg_ $% ]W dQR \Udc dgYSU TQY\i V_b "! TQic dXU^ dg_ dQR\Udc _^SU TQY\i
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34
HIV plus
J U LY/A U G U S T 2 0 1 3
MEDICATION
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DOSAGE
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J U LY/A U G U S T 2 0 1 3 HIV plus
35
MEDICATION DOSAGE
WHAT IT DOES
WHAT TO KNOW
SIDE EFFECTS
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HIV plus
J U LY/A U G U S T 2 0 1 3
THE 2013 COMPLETE HIV TREATMENT GUIDE
CHP?MNCA;NCIH;F G?>C=;NCIHM The medications used to treat HIV and all its complications went through extensive investigations and clinical trials before being approved for general use. Doctors are now working on vaccines and cures for HIV, utilizing everything from bone marrow transplants to injections of disease-killing cells. But there are even more promising advances coming from medical, university, and pharmaceutical organizations. Some of these new medications, which are not yet approved for use outside clinical trials, may soon be coming to a pharmacy near you.
NAME & MAKER
WHAT IT DOES
BMS-806 #SJTUPM .ZFST 4RVJCC
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J U LY/A U G U S T 2 0 1 3 ย HIV plus
37
THE 2013 COMPLETE HIV TREATMENT GUIDE // INVESTIGATIONAL MEDICATIONS NAME & MAKER
AMD070 (FO[ZNF
IBALIZUMAB 5BJ.FE APRICITABINE "WFYB -UE
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38
WHAT IT DOES
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HIV plus
ย J U LY/A U G U S T 2 0 1 3
YOUâ&#x20AC;&#x2122;VE COME A LONG WAY MANAGING YOUR HIV.
NOW, ON TO HIV-RELATED EXCESS ABDOMINAL FAT.
www.egrifta.com
Indication: EGRIFTA® (tesamorelin for injection) is a daily injectable prescription medicine to reduce the excess abdominal fat in HIV-infected patients with lipodystrophy. Limitations of use: r 5IF JNQBDU BOE TBGFUZ PG EGRIFTA® on cardiovascular health has not been studied r EGRIFTA® is not indicated for weight-loss management r *U T OPU LOPXO XIFUIFS UBLJOH EGRIFTA® helps improve compliance with antiretroviral medications r EGRIFTA® is not recommended to be used in children Important Risk Information Do not use EGRIFTA® if you: r )BWF QJUVJUBSZ HMBOE UVNPS QJUVJUBSZ HMBOE TVSHFSZ PS PUIFS QSPCMFNT SFMBUFE to your pituitary gland r )BWF BDUJWF DBODFS FJUIFS OFXMZ EJBHOPTFE PS SFDVSSFOU PS BSF SFDFJWJOH treatment for cancer r "SF BMMFSHJD UP UFTBNPSFMJO PS BOZ PG UIF JOHSFEJFOUT JO EGRIFTA® JODMVEJOH mannitol or sterile water r "SF QSFHOBOU PS CFDPNF QSFHOBOU Before using EGRIFTA®, tell your healthcare provider if you: r )BWF PS IBWF IBE DBODFS r )BWF EJBCFUFT r "SF CSFBTUGFFEJOH PS QMBO UP CSFBTUGFFE r )BWF LJEOFZ PS MJWFS QSPCMFNT r )BWF BOZ PUIFS NFEJDBM DPOEJUJPO r 5BLF QSFTDSJQUJPO PS OPO QSFTDSJQUJPO NFEJDJOFT WJUBNJOT PS IFSCBM TVQQMFNFOUT EGRIFTA® may cause serious side effects, including: r 4FSJPVT BMMFSHJD SFBDUJPO 4UPQ VTJOH EGRIFTA® and get emergency help right away JG ZPV IBWF BOZ PG UIF GPMMPXJOH TZNQUPNT SBTI PWFS ZPVS CPEZ IJWFT TXFMMJOH PG ZPVS GBDF PS UISPBU TIPSUOFTT PG CSFBUI PS USPVCMF CSFBUIJOH GBTU IFBSUCFBU GFFMJOH of faintness or fainting r 4XFMMJOH áVJE SFUFOUJPO EGRIFTA® can cause swelling in some parts of your body. $BMM ZPVS IFBMUIDBSF QSPWJEFS JG ZPV IBWF BO JODSFBTF JO KPJOU QBJO PS QBJO PS numbness in your hands or wrist (carpal tunnel syndrome) r *ODSFBTF JO HMVDPTF CMPPE TVHBS JOUPMFSBODF BOE EJBCFUFT :PVS IFBMUIDBSF provider will measure your blood sugar periodically r *OKFDUJPO TJUF SFBDUJPOT TVDI BT SFEOFTT JUDIJOH QBJO JSSJUBUJPO CMFFEJOH SBTI BOE TXFMMJOH $IBOHF SPUBUF ZPVS JOKFDUJPO TJUF UP IFMQ MPXFS ZPVS SJTL GPS injection-site reactions The most common side effects of EGRIFTA® include: r KPJOU QBJO r OVNCOFTT BOE QSJDLJOH r QBJO JO MFHT BOE BSNT r OBVTFB r TXFMMJOH JO ZPVS MFHT r WPNJUJOH r NVTDMF TPSFOFTT r SBTI r UJOHMJOH r JUDIJOH EGRIFTA® XJMM /05 DVSF )*7 PS MPXFS ZPVS DIBODF PG QBTTJOH )*7 UP PUIFST You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Actual patient living with HIV since 2000
You can receive valuable information about ways to discuss this condition and EGRIFTA® with your doctor when you sign up at egrifta.com/info or call the AXIS Center2/13 at 877-714-AXIS (2947) 111122-102311
Please see Consumer Brief Summary of EGRIFTA® on following page.
Consumer Brief Summary for EGRIFTAÂŽ (tesamorelin for injection) EGRIFTAÂŽ (eh-GRIF-tuh) (tesamorelin for injection) for subcutaneous use Read the Patient Information that comes with EGRIFTAÂŽ CFGPSF ZPV TUBSU UP UBLF JU BOE FBDI UJNF ZPV HFU B SFĂ MM 5IFSF NBZ CF OFX JOGPSNBUJPO 5IJT MFBĂĄFU EPFT OPU UBLF UIF QMBDF PG UBMLJOH UP ZPVS IFBMUIDBSF QSPWJEFS BCPVU ZPVS NFEJDBM DPOEJUJPO PS your treatment. What is EGRIFTAÂŽ? t EGRIFTAÂŽ is an injectable prescription medicine to reduce the excess in abdominal
fat in HIV-infected patients with lipodystrophy. EGRIFTAÂŽ contains a growth hormonereleasing factor (GRF) t 5IF JNQBDU BOE TBGFUZ PG EGRIFTAÂŽ on cardiovascular health has not been studied t EGRIFTAÂŽ is not indicated for weight-loss management t IU JT OPU LOPXO XIFUIFS UBLJOH EGRIFTAÂŽ helps improve compliance with antiretroviral medications t *U JT OPU LOPXO JG EGRIFTAÂŽ is safe and effective in children. EGRIFTAÂŽ is not recommended to be used in children Who should not use EGRIFTAÂŽ? Do not use EGRIFTAÂŽ if you: t I BWF QJUVJUBSZ HMBOE UVNPS QJUVJUBSZ HMBOE TVSHFSZ PS PUIFS QSPCMFNT SFMBUFE UP ZPVS pituitary gland t have or have had a history of active cancer (either newly diagnosed or recurrent) t are allergic to tesamorelin or any of the ingredients in EGRIFTAÂŽ 4FF UIF FOE PG UIJT MFBĂĄFU GPS B DPNQMFUF MJTU PG JOHSFEJFOUT JO EGRIFTAÂŽ t BSF QSFHOBOU PS CFDPNF QSFHOBOU *G ZPV CFDPNF QSFHOBOU TUPQ VTJOH EGRIFTAÂŽ and UBML XJUI ZPVS IFBMUIDBSF QSPWJEFS 4FF i8IBU TIPVME * UFMM NZ IFBMUIDBSF QSPWJEFS before using EGRIFTAÂŽ?â&#x20AC;? What should I tell my healthcare provider before using EGRIFTAÂŽ? Before using EGRIFTAÂŽ UFMM ZPVS IFBMUIDBSF QSPWJEFS JG ZPV t have or have had cancer t have diabetes t BSF CSFBTUGFFEJOH PS QMBO UP CSFBTUGFFE *U JT OPU LOPXO JG EGRIFTAÂŽ passes into your CSFBTU NJML 5IF $FOUFST GPS %JTFBTF $POUSPM BOE 1SFWFOUJPO $%$ SFDPNNFOET UIBU )*7 JOGFDUFE NPUIFST OPU CSFBTUGFFE UP BWPJE UIF SJTL PG QBTTJOH )*7 JOGFDUJPO UP ZPVS CBCZ 5BML XJUI ZPVS IFBMUIDBSF QSPWJEFS BCPVU UIF CFTU XBZ UP GFFE ZPVS CBCZ JG ZPV BSF UBLJOH EGRIFTAÂŽ t IBWF LJEOFZ PS MJWFS QSPCMFNT t have any other medical condition 5FMM ZPVS IFBMUIDBSF QSPWJEFS BCPVU BMM UIF NFEJDJOFT ZPV UBLF JODMVEJOH QSFTDSJQUJPO BOE OPOQSFTDSJQUJPO NFEJDJOFT WJUBNJOT BOE IFSCBM TVQQMFNFOUT EGRIFTAÂŽ may affect UIF XBZ PUIFS NFEJDJOFT XPSL BOE PUIFS NFEJDJOFT NBZ BGGFDU IPX EGRIFTAÂŽ XPSLT ,OPX UIF NFEJDJOFT ZPV UBLF ,FFQ B MJTU XJUI ZPV UP TIPX ZPVS IFBMUIDBSF QSPWJEFS BOE pharmacist when you get a new medicine. How should I use EGRIFTAÂŽ? t Read the detailed â&#x20AC;&#x153;Instructions for Useâ&#x20AC;? that comes with EGRIFTAÂŽ before you start using EGRIFTAÂŽ :PVS IFBMUIDBSF QSPWJEFS XJMM TIPX ZPV IPX UP JOKFDU EGRIFTAÂŽ t Use EGRIFTAÂŽ exactly as prescribed by your healthcare provider t Inject EGRIFTAÂŽ VOEFS UIF TLJO TVCDVUBOFPVTMZ PG ZPVS TUPNBDI BSFB BCEPNFO
t Change (rotate) the injection site on your stomach area (abdomen) with each dose. Do not inject EGRIFTAÂŽ JOUP TDBS UJTTVF CSVJTFT PS ZPVS OBWFM t %P OPU TIBSF OFFEMFT PS TZSJOHFT XJUI PUIFS QFPQMF 4IBSJOH PG OFFEMFT DBO SFTVMU JO UIF USBOTNJTTJPO PG JOGFDUJPVT EJTFBTFT TVDI BT )*7 What are the possible side effects of EGRIFTAÂŽ? EGRIFTAÂŽ may cause serious side effects including: t 4FSJPVT BMMFSHJD SFBDUJPO 4PNF QFPQMF UBLJOH EGRIFTAÂŽ may have an allergic reaction. 4UPQ VTJOH EGRIFTAÂŽ and get emergency help right away if you have any of the following symptoms: â&#x20AC;&#x201C; a rash over your body
â&#x20AC;&#x201C; hives â&#x20AC;&#x201C; swelling of your face or throat â&#x20AC;&#x201C; shortness of breath or trouble breathing â&#x20AC;&#x201C; fast heartbeat â&#x20AC;&#x201C; feeling of faintness or fainting t 4XFMMJOH ĂĄVJE SFUFOUJPO EGRIFTAÂŽ can cause swelling in some parts of your CPEZ $BMM ZPVS IFBMUIDBSF QSPWJEFS JG ZPV IBWF BO JODSFBTF JO KPJOU QBJO PS QBJO PS numbness in your hands or wrist (carpal tunnel syndrome) t *ODSFBTF JO HMVDPTF CMPPE TVHBS JOUPMFSBODF BOE EJBCFUFT :PVS IFBMUIDBSF QSPWJEFS
will measure your blood sugar periodically t *OKFDUJPO TJUF SFBDUJPOT $IBOHF SPUBUF ZPVS JOKFDUJPO TJUF UP IFMQ MPXFS ZPVS SJTL GPS
injection-site reactions. Call your healthcare provider for medical advice if you have the following symptoms around the area of the injection site: â&#x20AC;&#x201C; bleeding â&#x20AC;&#x201C; redness â&#x20AC;&#x201C; rash â&#x20AC;&#x201C; itching â&#x20AC;&#x201C; swelling â&#x20AC;&#x201C; pain â&#x20AC;&#x201C; irritation The most common side effects of EGRIFTAÂŽ include: â&#x20AC;&#x201C; joint pain â&#x20AC;&#x201C; nausea â&#x20AC;&#x201C; vomiting â&#x20AC;&#x201C; pain in legs and arms â&#x20AC;&#x201C; rash â&#x20AC;&#x201C; swelling in your legs â&#x20AC;&#x201C; itching â&#x20AC;&#x201C; muscle soreness m UJOHMJOH OVNCOFTT BOE QSJDLJOH 5FMM ZPVS IFBMUIDBSF QSPWJEFS JG ZPV IBWF BOZ TJEF FGGFDU UIBU CPUIFST ZPV PS UIBU EPFT not go away. 5IFTF BSF OPU BMM UIF QPTTJCMF TJEF FGGFDUT PG EGRIFTAÂŽ 'PS NPSF JOGPSNBUJPO BTL ZPVS healthcare provider or pharmacist. $BMM ZPVS IFBMUIDBSF QSPWJEFS GPS NFEJDBM BEWJDF BCPVU TJEF FGGFDUT 5P SFQPSU TJEF FGGFDUT DPOUBDU &.% 4FSPOP UPMM GSFF BU FYU :PV NBZ SFQPSU TJEF FGGFDUT UP UIF '%" BU '%" Keep EGRIFTAÂŽ and all medicines out of the reach of children. General information about the safe and effective use of EGRIFTAÂŽ: .FEJDJOFT BSF TPNFUJNFT QSFTDSJCFE GPS QVSQPTFT PUIFS UIBO UIPTF MJTUFE JO B 1BUJFOU *OGPSNBUJPO MFBĂĄFU %P OPU VTF EGRIFTAÂŽ for a condition for which it was not prescribed. Do not give EGRIFTAÂŽ UP PUIFS QFPQMF FWFO JG UIFZ IBWF UIF TBNF TZNQUPNT ZPV IBWF It may harm them. Do not share your EGRIFTAÂŽ TZSJOHF XJUI BOPUIFS QFSTPO FWFO JG UIF OFFEMF JT DIBOHFE Do not share your EGRIFTAÂŽ needles with another person. 5IJT 1BUJFOU *OGPSNBUJPO MFBĂĄFU TVNNBSJ[FT UIF NPTU JNQPSUBOU JOGPSNBUJPO BCPVU EGRIFTAÂŽ *G ZPV XPVME MJLF NPSF JOGPSNBUJPO UBML XJUI ZPVS IFBMUIDBSF QSPWJEFS :PV DBO BTL ZPVS IFBMUIDBSF QSPWJEFS PS QIBSNBDJTU GPS JOGPSNBUJPO BCPVU EGRIFTAÂŽ that is written for healthcare professionals. For more information about EGRIFTAÂŽ HP UP XXX EGRIFTA.com or contact the "9*4 $FOUFS UPMM GSFF BU What are the ingredients in EGRIFTAÂŽ? Active ingredient: tesamorelin *OBDUJWF JOHSFEJFOUT NBOOJUPM BOE 4UFSJMF 8BUFS GPS *OKFDUJPO
EMD Serono, Inc. is a subsidiary of Merck KGaA, Darmstadt, Germany
ÂĽ &.% 4FSPOP *OD "MM SJHIUT SFTFSWFE &(3*'5" JT B SFHJTUFSFE USBEFNBSL PG 5IFSBUFDIOPMPHJFT *OD
THE 2013 COMPLETE HIV TREATMENT GUIDE
=IGJF?G?HN;LS ;H> ;FN?LH;NCP? G?>C=CH? The use of whatโ s called complementary and alternative medicine (CAM) is popular in the U.S., where yoga and massage have become mainstream activities. In fact, according to a study published in the journal AIDS Care, 60% of HIV-positive people have tried some form of CAM, most in addition to their antiretrovirals. While some CAMs have demonstrated bene๏ฌ ts, others are unproven and sometimes dangerous. TREATMENT
WORTH IT?
ACUPUNCTURE
I5C
CHINESE BITTER MELON
=1I25
WHAT IT DOES
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MASSAGE
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MULTIVITAMINS
I5C
?^U cdeTi V_e^T dXQd ]e\dYfYdQ]Y^c bUTeSUT 89F `_cYdYfU g_]U^ยบc bYc[ _V 194C Q^T TUQdX Ri #
PRAYER
=1I25
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REFLEXOLOGY
=1I25
1 cdeTi Y^ DXQY\Q^T V_e^T dXQd V__d bUร Uh_\_Wi bUTeSUT `QY^ Q^T VQdYWeU Y^ X_c`YdQ\YjUT 194C `QdYU^dc
REIKI
>?
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SELENIUM
I5C
1 cdeTi Y^ dXU 1bSXYfUc _V 9^dUb^Q\ =UTYSY^U V_e^T dXQd cU\U^Ye] Y^SbUQcUT XUQ\dXi 34$ SU\\c Q^T bUTeSUT dXU Q]_e^d _V 89F Y^ dXU R\__T
SPIRULINA
I5C
DXU XUQ\dX RU^Uร dc _V c`Ybe\Y^Q Q\c_ [^_g^ Qc R\eU WbUU^ Q\WQU XQfU RUU^ d_edUT V_b iUQbc RUSQecU Yd ^QdebQ\\i Y^S\eTUc ^e]Ub_ec fYdQ]Y^c ?^U cdeTi Y^ dXU :_eb^Q\ _V 1SaeYbUT 9]]e^U 4Uร SYU^Si Ci^Tb_]Uc V_e^T dXQd dXU Q\WQU ce``\U]U^d Y^XYRYdUT 89F bU`\YSQdY_^ Y^ dXU R\__T 1 `Ub[* 9dยบc c_\T Y^ Q `_gTUb dXQd SQ^ UQcY\i RU QTTUT d_ c]__dXYUc
VITAMIN A
=1I25
DXU G8? bUS_]]U^Tc fYdQ]Y^ 1 UfUbi V_eb d_ cYh ]_^dXc V_b Q\\ i_e^W SXY\TbU^ Qd XYWX bYc[ _V TUร SYU^Si Red ^_ cdeTi Y^ dXU E C XQc cX_g^ Yd RU^Uร SYQ\ d_ 89F QTe\dc
YOGA
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>e]Ub_ec cdeTYUc cX_g Yd XQc Q `_cYdYfU `XicY_\_WYSQ\ UรงUSd Q^T XU\`c Q\\UfYQdU ci]`d_]c _V 89F
ZINC
I5C
JY^S TUร SYU^Si _SSebc Y^ _fUb % _V 89F QTe\dc+ cdeTYUc cX_g dXQd jY^S TU\Qic Y]]e^_\_WYSQ\ VQY\ebU Q^T TUSbUQcUc TYQbbXUQ
never take these supplements without doctorโ s approval: sutherlandia, saint-johnโ s-wort, grapefruit, african potato, vitamin c, and garlic.
J U LY/A U G U S T 2 0 1 3 ย HIV plus
41
; MN;N?'<S'MN;N? AOC>? NI NB? ;C>M >LOA ;MMCMN;H=? JLIAL;G ";>;J# Don’t have deep pockets? The federally created, state-managed AIDS Drug Assistance Program (ADAP) can help people pay for their HIV medications. The programs provide prescription medication to uninsured or underinsured people with HIV or AIDS. The requirements vary by state, but typically you have to be a resident, have HIV, and earn less than a certain amount per year, calculated as a percentage of the federal poverty level. Below is a guide to ADAP income requirements, whether there is a waiting list to join, how many people are on it as of April (if available), and contact information. Each state’s Maximum Qualifying Income (MQI) to be in ADAP is shown as a percentage of the federal poverty level as well as the dollar amount for a one-person household (in the 48 contiguous states the federal poverty level for one person is $11,490; add $4,020 per family member). ALABAMA GURcYdU* adph.org/aids @X_^U* (334) 206-5364 =A9* 250% or $28,725; GQYdY^W <Ycd* Yes, 27
IDAHO
ALASKA
ILLINOIS
GURcYdU* bit.ly/AKadap
(907) 263-2050 =A9* 300% or $43,050; GQYdY^W <Ycd* No
GURcYdU* bit.ly/illinoisADAP @X_^U* (217) 524-5983 =A9* 300% or $34,470; GQYdY^W <Ycd* No
ARIZONA
INDIANA
GURcYdU* bit.ly/AZadap @X_^U* (800) 334-1540 =A9* 300% or $34,470; GQYdY^W <Ycd* No
GURcYdU* bit.ly/indianaADAP @X_^U* (866) 588-4948 =A9* 300% or $34,470; GQYdY^W <Ycd* No
ARKANSAS GURcYdU* bit.ly/ARadap @X_^U* (501) 661-2408 =A9* 200% or $22,980; GQYdY^W <Ycd* Yes
IOWA
CALIFORNIA GURcYdU* bit.ly/CAadap @X_^U* (916) 449-5900 =A9* less than $50,000; GQYdY^W <Ycd* No
KANSAS
COLORADO GURcYdU* bit.ly/COadap @X_^U* (303) 692-2748 =A9* 400% or $45,960; GQYdY^W <Ycd* No
KENTUCKY GURcYdU* bit.ly/kentuckyADAP @X_^U* (866) 510-0005 =A9* 300% or $34,470; GQYdY^W <Ycd* No
CONNECTICUT GURcYdU* bit.ly/CTadap @X_^U* (800) 233-2503 =A9* 400% or $45,960; GQYdY^W <Ycd* No
LOUISIANA GURcYdU* hiv.dhh.louisiana.gov @X_^U* (504) 568-7474 =A9* 300% or $34,470; GQYdY^W <Ycd* Yes
DELAWARE GURcYdU* bit.ly/DEadap @X_^U* (302) 744-1050 =A9* 500% or $57,450; GQYdY^W <Ycd* No
MAINE
DISTRICT OF COLUMBIA GURcYdU* bit.ly/DCadap @X_^U* (202) 671-4900 =A9* 500% or $57,450; GQYdY^W <Ycd* No
MARYLAND GURcYdU* bit.ly/MDadap @X_^U* (800) 205-6308 =A9* 500% or $57,450; GQYdY^W <Ycd* No
FLORIDA
MASSACHUSETTS GURcYdU* bit.ly/MAadap @X_^U* (800) 228-2714 =A9* 500% or $57,450; GQYdY^W <Ycd* No
GURcYdU* floridaADAP.org @X_^U* (800) 352-2437 =A9* 400% or $45,960; GQYdY^W <Ycd* Yes, 22 GEORGIA
GURcYdU* bit.ly/georgiaADAP @X_^U* (404) 657-3100 =A9* 300% or $34,470; GQYdY^W <Ycd* No HAWAII
GURcYdU* bit.ly/hawaiiADAP @X_^U* (808) 733-9360 =A9* 400% or $52,920; GQYdY^W <Ycd* No
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HIV plus
J U LY/A U G U S T 2 0 1 3
GURcYdU* safesex.idaho.gov @X_^U* (208) 334-6527 =A9* 200% or $22,980; GQYdY^W <Ycd* Yes, 14
GURcYdU* bit.ly/iowaADAP @X_^U* (515) 281-4775 =A9* 200% or $22,980; GQYdY^W <Ycd* No GURcYdU* bit.ly/kansasADAP @X_^U* (785) 368-8218 =A9* 300% or $34,470; GQYdY^W <Ycd* No
GURcYdU* bit.ly/MEadap @X_^U* (207) 287-3747 =A9* $55,850, add $3,960 per dependent; GQYdY^W <Ycd* No
MICHIGAN GURcYdU* michigan.gov/dap @X_^U* (888) 826-6565 =A9* 450% or $51,705; GQYdY^W <Ycd* No MINNESOTA GURcYdU* bit.ly/minnesotaADAP @X_^U* (800) 657-3761 =A9* 300% or $34,470; GQYdY^W <Ycd* No
THE 2013 COMPLETE HIV TREATMENT GUIDE MISSISSIPPI GURcYdU* bit.ly/mississippiADAP @X_^U* (601) 362-4356 =A9* 400% or $45,960; GQYdY^W <Ycd* No
PENNSYLVANIA
MISSOURI GURcYdU* bit.ly/missouriADAP @X_^U* (573) 751-6439 =A9* 300% or $34,470; GQYdY^W <Ycd* No
RHODE ISLAND GURcYdU* bit.ly/RIadap @X_^U* (401) 222-2320 =A9* 400% or $45,960; GQYdY^W <Ycd* No
MONTANA GURcYdU* bit.ly/montanaADAP @X_^U* (406) 444-4744 =A9* 330% or $37,917; GQYdY^W <Ycd* No
SOUTH CAROLINA GURcYdU* scdhec.gov/adap @X_^U* (803) 831-7806 =A9* 300% or $34,470; GQYdY^W <Ycd* No
NEBRASKA GURcYdU* bit.ly/NEadap @X_^U* (402) 559-4673 =A9* 200% or $22,980; GQYdY^W <Ycd* No
SOUTH DAKOTA GURcYdU* bit.ly/SDadap @X_^U* (605) 773-3737 =A9* 300% or $34,470; GQYdY^W <Ycd* No
NEVADA
TENNESSEE GURcYdU* bit.ly/TNadap @X_^U* (615) 532-2392 =A9* 300% or $34,470; GQYdY^W <Ycd* No
GURcYdU* bit.ly/nevadaADAP @X_^U* (775) 684-3499 =A9* 400% or $45,960; GQYdY^W <Ycd* No
GURcYdU* bit.ly/PennADAP @X_^U* (800) 922-9384 =A9* 337% or $38,721; GQYdY^W <Ycd* No
NEW HAMPSHIRE GURcYdU* bit.ly/NHadap @X_^U* (603) 271-4502 =A9* 500% or $57,450; GQYdY^W <Ycd* No
TEXAS
NEW JERSEY GURcYdU* bit.ly/newjerseyADAP @X_^U* (877) 613-4533 =A9* 500% or $57,450; GQYdY^W <Ycd* No
UTAH
NEW MEXICO GURcYdU* bit.ly/newmexicoADAP @X_^U* (505) 827-2433 =A9* 400% or $45,960; GQYdY^W <Ycd* No
VERMONT
NEW YORK GURcYdU* bit.ly/newyorkADAP @X_^U* (800) 542-2437 =A9* 435% or $49,981; GQYdY^W <Ycd* No
VIRGINIA
NORTH CAROLINA GURcYdU* bit.ly/NCadap @X_^U* (877) 466-2232 =A9* 300% or $34,470; GQYdY^W <Ycd* No
WASHINGTON GURcYdU* bit.ly/WAadap @X_^U* (360) 236-3426 =A9* 300% or $34,470; GQYdY^W <Ycd* No
NORTH DAKOTA GURcYdU* ndhealth.gov/HIV @X_^U* (701) 328-1059 =A9* 300% or $34,470; GQYdY^W <Ycd* No
WEST VIRGINIA GURcYdU* bit.ly/WestVAADAP @X_^U* (304) 232-6822 =A9* 400% or $45,960; GQYdY^W <Ycd* No
OHIO
GURcYdU* bit.ly/OHadap @X_^U* (866) 777-4775 =A9* 300% or $34,470; GQYdY^W <Ycd* No
WISCONSIN GURcYdU* bit.ly/WIadap @X_^U* (800) 991-5532 =A9* 300% or $34,470; GQYdY^W <Ycd* No
OKLAHOMA GURcYdU* bit.ly/OKADAP @X_^U* (405) 271-4636 =A9* 200% or $22,980; GQYdY^W <Ycd* No
WYOMING GURcYdU* bit.ly/WYadap @X_^U* (307) 777-5856 =A9* $38,300-$45,500, based on county; GQYdY^W <Ycd* No
GURcYdU* bit.ly/texasADAP @X_^U* (800) 255-1090 =A9* 200% or $22,980; GQYdY^W <Ycd* No GURcYdU* bit.ly/utahADAP @X_^U* (801) 538-6197 =A9* 250% or $28,725; GQYdY^W <Ycd* No GURcYdU* bit.ly/vermontADAP @X_^U* (802) 951-4005 =A9* 500% or $57,540; GQYdY^W <Ycd* No GURcYdU* bit.ly/virginiaADAP @X_^U* (866) 392-1309 =A9* 400% or $45,960; GQYdY^W <Ycd* No
OREGON
GURcYdU* bit.ly/oregonADAP @X_^U* (800) 805-2313 =A9* 200% or $22,980; GQYdY^W <Ycd* No
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J U LY/A U G U S T 2 0 1 3 ย HIV plus
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A H C N H ? G O >I= L ? G ; L = ? H >O;
The famed HIV-positive photographer has shot celebrities, dignitaries, and everyday people. Now heâ&#x20AC;&#x2122;s back with a family history project and a new campaign to change how we deal with the chronic condition By Diane Anderson-Minshall
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From left: Cramer with model Helena Christensen; Cramerโ s greatgrandparents Alonzo Cramer and Martha Collins and their two children circa 1890; Edsel M. Cramer, a noted artist who took many of the images in Cramerโ s upcoming book, was also commissioned by luminaries like President George H.W. Bush.
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J U LY/A U G U S T 2 0 1 3 ย HIV plus
47
MEDICATION
ETOPOPHOS Ud_`_cYTU 2bYcd_\ =iUbc CaeYRR
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HEPSERA QTUV_fYb TY`Yf_hY\
DOSAGE
WHAT IT DOES
WHAT TO KNOW
SIDE EFFECTS
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48
HIV plus
J U LY/A U G U S T 2 0 1 3
HIV/AIDS is not the same epidemic it was 30 years ago. But it’s far from over. Here in the U.S., someone is infected with HIV every 9 1/2 minutes.1
HIV ends with
US
Ending HIV is not magic. All of us have the basic tools to end the epidemic:
Break the silence - Talk to family, friends, church, your community and coworkers.
Be a role model - Get tested regularly as part of your overall health and well-being and encourage others to follow your lead.
If you’re HIV-, take steps to stay negative. If you’re HIV+, protect yourself and others - Talk to your doctor about how early and effective treatment may help protect your immune system and vital organs.
Get involved - With all of us fighting stigma and discrimination, we will turn the tide.
1) Every 9 1/2 Minutes, Someone In The United States Is Infected with HIV. (2009). Accessed January 12, 2012 from http://communitydispatch.com/CDC_Health_Advisory _Notices__amp__Announcements_48/HIV_in_US1032 6.shtml
To view and share the video, Go to NMAC.org. To find an HIV test site, visit hivtest.org. For treatment information go to treathivnow.com. Gilead Sciences, Inc. All rights reserved. UN11989 2/12.