Post-exposure prophylaxis for HIV changed
Recommendations for HIV post-exposure prophylaxis (PEP) have been changed following last month's recall of nelfinavir (Viracept). Lopinavir/ritonavir (Kaletra) tablets should be substituted for nelfinavir in PEP starter packs.
In a letter cascaded to health care professionals across the UK, Sir
Liam Donaldson, the Department of Health’s chief medical officer,
says that prescribers need to be aware of the greater potential for drug
interactions between Kaletra and other medicines.
He explains that the Government’s expert advisory group on AIDS
(EAGA) had already been considering alternative regimens to nelfinavir
for PEP, since unboosted protease inhibitors were no longer recommended
as first-line treatment.
Until EAGA has completed its review and issued updated guidance, the
new regimen for PEP starter packs should be one Combivir tablet (300mg
zidovudine plus 150mg lamivudine) given twice daily plus two Kaletra
film-coated tablets (200mg lopinavir plus 50mg ritonavir) also given
twice daily.
Information on the stability and shelf life of Kaletra in PEP starter
packs can be found on the EAGA
webpages
All Viracept products
were recalled in June 2007 following contamination
with a genotoxic substance (PJ, 16 June, p694).
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