Fact Sheets on Antiretroviral Drugs

<strong>Fact</strong> <strong>Sheets</strong> on Antiretroviral Drugs
� Saquinavir increases levels of Clarithromycin; Nelfinavir; §Sildenafil and
Terfenadine.
� Saquinavir decreases levels of Amprenavir and Efavirenz.
� Potential interactions with and anticonvulsants; statins; Methadone; oral
contraceptives; tricyclic antidepressants and oral anticoagulants.
Side Effects Frequency Severity
GI intolerance +++ +
Headache ++ +/-
Elevated transaminase + +/-
Fatigue + +/-
Rash + +/-
Thrombocytopaenia + +/-
Class Adverse Drug Reactions to Protease Inhibitors (PIs)
Hyperglycemia
New onset diabetes mellitus, diabetic ketoacidosis, and exacerbation of existing
diabetes mellitus, as well as hyperglycemia, insulin resistance or glucose tolerance
have all been reported in patients receiving protease inhibitors. Insulin resistance
occurs in up to 40% of patients treated with PIs, while hyperglycemia has been
reported in 3-17% of patients receiving PIs (median onset is 60 days after initiation of
therapy, ranging from 2-390 days); about 1% of these patients develop clinical
evidence of diabetes.
The reversibility of these events is currently unknown, due to limited data and
still limited follow up of patients. Some patients were able to continue the PI therapy
and initiated treatment with oral hypoglycemic agents or insulin.
An option for early diagnosis is to perform routine fasting blood glucose
measurements at regular intervals during treatment. Asking the patient to report
immediately the occurrence of suspect signs and symptoms as polydipsia, polyphagia
or polyuria can also be useful.
HIV-infected patients with pre-existing diabetes should be closely monitored
when PIs are prescribed.
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