Details About Generic Salt ::  Amprenav

Main Medicine Class:: Antiviral   

am-PREN-ah-veer
Agenerase
Class: Antiviral

 

Drugs Class ::

 Action Inhibits HIV protease, the enzyme required to form functional proteins in HIV-infected patients.

Indications for Drugs ::

 Indications Treatment of HIV-1 infections in combination with other antiretroviral agents.

Drug Dose ::

 Route/Dosage

ADULTS AND CHILDREN 13 TO 16 YR: PO capsules 1200 mg bid in combination with other antiretroviral agents. CHILDREN 4 TO 12 YR OR 13 TO 16 YR WITH WEIGHT < 50 KG: PO capsules 20 mg/kg bid or 15 mg/kg tid (max 2400 mg daily) in combination with other antiretroviral agents. Oral solution 22.5 mg/kg (1.5 ml/kg) bid or 17 mg/kg (1.1 ml/kg) tid (max 2800 mg) in combination with other antiretroviral agents.

Contraindication ::

 Contraindications Concomitant therapies with bepridil, cisapride, dihydroergotamine, ergotamine, midazolam, and triazolam.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: HIV infected mothers should not breastfeed their infants. Children < 4 yr: Safety and efficacy not established. Elderly: Select dose with caution, reflecting greater frequency of decreased hepatic, renal, or cardiac function and comorbidity. Hepatic function impairment: Use with caution; decreased amprenavir clearance may occur.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CNS: Depression; paresthesia. GI: Nausea; vomiting; diarrhea; abdominal pain; taste disorders. HEMA: Acute hemolytic anemia. DERM: Rash; pruritus; Stevens-Johnson syndrome. META: Hyperglycemia; hypertriglyceridemia; hypercholesterolemia.

Drug Mode of Action ::  

 Action Inhibits HIV protease, the enzyme required to form functional proteins in HIV-infected patients.

Drug Interactions ::

 Interactions

Amiodarone, bepridil, cisapride, ergot derivatives, lidocaine (systemic), quinidine, rifabutin, sildenafil, tricyclic antidepressants: Amprenavir may elevate blood levels of these drugs, which may increase the risk of arrhythmias, hematologic abnormalities, seizures, or other potential serious adverse effects. Alprazolam, clorazepate, diazepam, flurazepam, midazolam, triazolam: Amprenavir may increase blood levels of these drugs, which may produce extreme sedation and respiratory depression. Antacids, carbamazepine, efavirenz, phenobarbital, phenytoin, rifabutin, rifampin: May decrease plasma levels of amprenavir, which may reduce antiviral activity. Cimetidine, delavirdine, erythromycin, itraconazole, ritonavir: May increase amprenavir plasma levels. Atorvastin, cerivastatin, carbamazepine, clozapine, dapsone, diltiazem, erythromycin, itraconazole, loratadine, lovastatin, nicardipine, nifedipine, nimodipine, pimozide, pravastatin, simvastatin: May have their plasma concentrations increased, which could increase activity or toxicity. Warfarin: Risk of bleeding may be increased.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Monitor for signs of hypersensitivity (eg, fever, rash, fatigue, nausea, vomiting, diarrhea, abdominal pain, malaise, lethargy, myalgia, arthralgia, edema, shortness of breath, paresthesia).
  • Discontinue use of medicine immediately if signs of hypersensitivity are present, and notify primary health care provider.
  • Assess contraindications as amprenavir is metabolized by cytochrome P450 CYP3A4 enzyme system and serious and life-threatening drug/drug interactions can potentially occur.
  • Monitor for adverse reactions including signs of Steven-Johnson syndrome, new-onset diabetes, increased bleeding in patients with hemophilia.
  • Monitor for elevation of liver function tests, increased creatine, phosphokinase or creatinine, elevated triglycerides or cholesterol, and hyperglycemia.
  • Monitor for blood glucose and triglyceride elevation, which may require adjustment in therapy for some patients such as those with diabetes
  • Administer with caution to patients with hepatic impairment. Dosage may need to be adjusted.

Drug Storage/Management ::

 Administration/Storage

  • Store at room temperature (25°C; 77°F).
  • Do not interchange capsules and oral solution on a mg per mg basis as amprenavir capsules and oral solution are not directly interchangeable.
  • Avoid a high-fat meal, as it will decrease absorption.
  • Do not take supplemental vitamin E because amprenavir capsules and solution contain large amounts of vitamin E.

Drug Notes ::

 Patient/Family Education

  • Advise patient to take medication exactly as prescribed.
  • Advise patient that if a dose is missed by > 4 hours, wait and take the next dose at the regularly scheduled time; however, if the dose is missed by < 4 hours, take the missed dose immediately.
  • Inform patient that amprenavir is not a cure for HIV infection and that he/she may continue to develop opportunistic infections and other complications associated with HIV disease.
  • Tell patients that there are currently no data demonstrating that therapy with amprenavir can reduce the risk of transmitting HIV to others through sexual contact.
  • The long-term effects of amprenavir are unknown at this time.
  • Advise patient to inform their primary health care provider if having a sulfa allergy. The potential for cross-sensitivity between drugs in the sulfonamide calls and amprenavir is unknown.
  • Advise patient to report to the health care provider if they plan to use any other prescription or nonprescription medication to avoid drug/drug interactions.
  • Instruct patients taking antacids or didanosine to take amprenavir ³ 1 hour before or after the antacid or didansoine use.
  • Advise patients receiving sidenafil that they may be at an increased risk of sildenafil-associated adverse events including hypotension, visual changes, and priapism. Patients should promptly report any of these symptoms.
  • Instruct patient receiving hormonal contraceptive to use alternate contraceptive measures during therapy with amprenavir.
  • Instruct patient to avoid high-fat meals.
  • Inform patients that redistribution or accumulation of body fat may occur in patients receiving protease inhibitors. The cause and long-term health effects of these conditions are unknown at this time.
  • Warn women with childbearing potential to inform the primary care giver if becoming pregnant.
  • Advise mothers not to breastfeed because of the risk of transmitting HIV.
  • Advise adult and pediatric patients not to take supplemental vitamin E.

Disclaimer ::

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