Indications: HIV infection in combination with other antiretroviral drugs

Cautions: concomitant use with drugs that prolong QT or PR interval cardiac conduction disorders, structural heart disease, patients at high risk of cardiovascular disease (especially if 10-year cardiovascular risk greater than 20%), pancreatitis, monitor liver function before and during treatment.

Contra-indications: acute porphyria

Hepatic impairment: avoid oral solution due to propylene glycol content (manufacturer advises avoid capsules and tablets in severe impairment ) should be used with caution in patients with chronic hepatitis B or C (increased risk of hepatic side effects.

Renal impairment: avoid oral solution due to propylene glycol content (use tablets with caution in severe impairment).

Pregnancy: avoid oral solution due to high propylene glycol content (use tablets only if potential benefit outweighs risk (toxicity in animal studies)).

Side Effects: Most common : gastro-intestinal disturbances (including diarrhoea, nausea, vomiting, abdominal pain, flatulence), anorexia, hepatic dysfunction, pancreatitis; blood disorders including anaemia, neutropenia, and thrombocytopenia; sleep disturbances, fatigue, headache, dizziness, paraesthesia, myalgia, myositis, rhabdomyolysis; taste disturbances; rash, pruritus, Stevens-Johnson syndrome, hypersensitivity reactions including anaphylaxis, see also notes above for lipodystrophy and metabolic effects (Lipodystrophy Syndrome), and Osteonecrosis. also colitis, weight changes, hypertension, anxiety, neuropathy, sexual dysfunction, amenorrhoea, menorrhagia, arthralgia, night sweats. less commonly gastro-intestinal ulcer, rectal bleeding, dry mouth, stomatitis, myocardial infarction, AV block, cerebrovascular accident, deep vein thrombosis, abnormal dreams, convulsions, tremor, nephritis, haematuria, visual disturbances, tinnitus, alopecia.

Dose: 2 tablets twice daily alternatively, in adults with a HIV strain that has less than 3 mutations to protease inhibitors, 4 tablets may be taken once daily.