BNF for Children 2011-2012

312 5.3.1 HIV infection BNFC 2011–2012Ziagen c (ViiV) ATablets, yellow, f/c, scored, abacavir (as sulphate)300 mg, net price 60-tab pack = £208.95. Counselling,hypersensitivity reactionsOral solution, sugar-free, banana and strawberryflavoured, abacavir (as sulphate) 20 mg/mL, net price240-mL = £55.72. Counselling, hypersensitivity reactionsExcipients include propylene glycolWith lamivudineFor cautions, contra-indications and side-effects seeunder individual drugsKivexa c (ViiV) ATablets, orange, f/c, abacavir (as sulphate) 600 mg,lamivudine 300 mg, net price 30-tab pack = £352.25.Counselling, hypersensitivity reactionsDoseHIV infection in combination with other antiretroviraldrugs. By mouthChild 12–18 years and body-weight over 40 kg 1tablet once dailySide-effects see notes above; also pancreatitis (lesscommon in children, see also under Cautions), liverfailure, anaphylactic reactions, peripheral neuropathy(switch to another antiretroviral if peripheral neuropathydevelops), diabetes mellitus, hypoglycaemia,acute renal failure, rhabdomyolysis, dry eyes, retinaland optic nerve changes, dry mouth, parotid glandenlargement, sialadenitis, alopecia, hyperuricaemia(suspend if raised significantly)Licensed use tablets not licensed for use in childrenunder 3 months; EC capsules not licensed for use inchildren under 6 yearsIndication and doseHIV infection in combination with other antiretroviraldrugs. By mouthNeonate 14–28 days 50–100 mg/m 2 twice dailyChild 1–8 months 50–100 mg/m 2 twice dailyChild 8 months–18 years 180–240 mg/m 2 oncedaily; usual dose 200 mg/m 2 once daily; max.400 mg daily5 InfectionsWith lamivudine and zidovudineNote use only if child is stabilised (for 6–8 weeks) on theindividual components in the same proportions. For cautions,contra-indications and side-effects see under individualdrugsTrizivir c (ViiV) ATablets, blue-green, f/c, abacavir (as sulphate)300 mg, lamivudine 150 mg, zidovudine 300 mg, netprice 60-tab pack = £509.06. Counselling, hypersensitivityreactionsDoseHIV infection. By mouthChild body-weight over 30 kg 1 tablet twice dailyDIDANOSINE(ddI, DDI)Cautions see notes above; also history of pancreatitis(preferably avoid, otherwise extreme caution, see alsobelow); peripheral neuropathy or hyperuricaemia (seeunder Side-effects); ophthalmological examination(including visual acuity, colour vision, and dilatedfundus examination) recommended annually or ifvisual changes occur; interactions: Appendix 1(didanosine)Pancreatitis If symptoms of pancreatitis develop or if serumlipase is raised and pancreatitis is confirmed, discontinuetreatment. Whenever possible avoid concomitant treatmentwith other drugs known to cause pancreatic toxicity (e.g.intravenous pentamidine isetionate); monitor closely if concomitanttherapy unavoidable. Since significant elevations oftriglycerides cause pancreatitis monitor closely if triglycerideselevatedHepatic impairment see notes aboveRenal impairment reduce dose if estimated glomerularfiltration rate less than 60 mL/minute/1.73 m 2 ;consult product literaturePregnancy manufacturer advises use only if potentialbenefit outweighs riskBreast-feeding see p. 310Videx c (Bristol-Myers Squibb) ATablets, with calcium and magnesium antacids,didanosine 25 mg, net price 60-tab pack = £25.06.Label: 23, counselling, administration, see belowExcipients include aspartame equivalent to phenylalanine 36.5 mg pertablet (section 9.4.1)Note Antacids in formulation may affect absorption of otherdrugs—see interactions: Appendix 1 (antacids)Administration to ensure sufficient antacid, each dose to betaken as at least 2 tablets (child under 1 year 1 tablet) chewedthoroughly, crushed or dispersed in water; clear apple juice maybe added for flavouring; tablets to be taken 2 hours after lopinavirwith ritonavir capsules and oral solution or atazanavir with ritonavirVidex c EC capsules, enclosing e/c granules, didanosine125 mg, net price 30-cap pack = £48.18;200 mg, 30-cap pack = £77.09; 250 mg, 30-cap pack =£96.37; 400 mg, 30-cap pack = £154.19. Label: 25,counselling, administration, see belowAdministration capsules should be swallowed whole and taken atleast 2 hours before or 2 hours after foodEMTRICITABINE(FTC)Cautions see notes above; also on discontinuation,monitor patients with hepatitis B (risk of exacerbationof hepatitis); interactions: Appendix 1 (emtricitabine)Hepatic impairment see notes above and CautionsaboveRenal impairment reduce dose or increase dosageinterval if estimated glomerular filtration rate lessthan 50 mL/minute/1.73 m 2 ; consult product literaturePregnancy manufacturer advises use only if essential—noinformation availableBreast-feeding see p. 310Side-effects see notes above; also abnormal dreams,pruritus, and hyperpigmentationIndication and doseSee preparations