Before you take INVIRASE
When you must not take it
Do not take INVIRASE if:
1. you have allergies to INVIRASE or any ingredients listed at the end of this leaflet
2. you have allergies to ritonavir
3. you have severe liver disease
4. if you were born with or have
any condition with abnormal electrocardiograms (ECG- electrical recording of the heart)
a salt imbalance in the blood, especially low concentrations of potassium (hypokalaemia) which are currently not corrected by treatment
a very slow heart rate
a weak heart (heart failure)
5. you are taking medicines that cause abnormal ECG changes
These medicines include:
certain heart medicines (amiodarone, bepridil, dofetilide, flecainide, hydroquinidine, ibutilide, lidocaine, propafenone, quinidine, sotalol)
medicines to treat depression (trazodone)
certain anti-infectives (e.g. erythromycin,)
terfenadine and astemizole; medicines used to treat allergic conditions (antihistamines)
cisapride, a medicine used to treat stomach reflux.
pimozide, a medicine used to treat psychoses
methadone, a medicine used to treat opioid dependence
6. you are taking certain other medicines
These medicines include:
ergotamine, dihydroergotamine ergonovine, methylergonovine , and methysergide; medicines used to treat migraine headaches
oral midazolam and triazolam; medicines to help you sleep at night or before surgery
simvastatin, lovastatin, atorvastatin, cerivastatin and fluvastatin; medicines used to lower cholesterol levels in the blood
rifampicin; a medicine used to prevent or treat tuberculosis
tipranavir; lopinavir/ritonavir combination,medicines used to treat people infected with HIV
7. the package is torn or shows signs of tampering
8. the expiry date (EXP) printed on the pack has passed
If you take it after the expiry date has passed, it may not work as well.
If you are not sure if you should be taking INVIRASE, talk to your doctor.
Do not give INVIRASE to children less than 12 years of age.
Safety and effectiveness in younger children have not been established.
Before you start to take it
Your doctor must know all about the following before you start to take INVIRASE.
1. if you are pregnant or plan to become pregnant
It is not known whether INVIRASE is harmful to an unborn baby when taken by a pregnant woman. If there is a need to take INVIRASE when you are pregnant your doctor will discuss the risks and benefits to you and the unborn baby.
2. if you are breast-feeding or plan to breast-feed
It is not known whether INVIRASE passes into breast milk. Your doctor will decide whether or not you should breast-feed.
3. if you are allergic to any other medicines, foods, dyes or preservatives
4. If you have a history of
arrhythmias, or abnormal heart rhythms
angina or heart disease caused by reduced blood flow in the blood vessels of the heart muscle
a disease of heart muscle
INVIRASE can change your heart's ECG. This is more common if you are female or elderly.
If you experience palpitations or any changes in your heart rate during treatment, you should tell your doctor immediately. Your doctor may wish to perform an ECG to measure your heart rhythm.
5. you have hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption (autosomal recessive disorder)
INVIRASE tablets contain lactose
6. if you have any other health problems including:
kidney disease
liver disease
haemophilia (a condition where patients have a tendency to bruise and bleed easily)
diabetes or high blood sugar levels
high cholesterol levels and high triglyceride levels, a blood fat
diarrhoea
If you have not told your doctor about any of the above, tell them before you take INVIRASE.
Taking other medicines
Tell your doctor if you are taking any other medicines including any that you have bought without a prescription from a pharmacy, supermarket or health food shop.
INVIRASE may be taken with a number of other medications that are commonly used in HIV infection.
There are some medicines that must not be taken with INVIRASE (see "Before you take INVIRASE" above). Other medicines may interfere with INVIRASE. These include:
itraconazole, ketoconazole, miconazole and fluconazole; medicines used to treat fungal infections
carbamazepine, phenobarbitone and phenytoin; medicines used to treat epilepsy
Felodipine, nifedipine, nicardipine, diltiazem, nimodipine, verapamil, amlodipine, nisoldipine, isradipine: calcium channel blockers used to treat heart conditions
certain heart or blood pressure medicines
midazolam (intravenous), medicine to help you sleep at night or before surgery
antibiotics such as clarithromycin, clindamycin, azithromycin, quinupristin/dalfopristin, rifabutin
omeprazole, esomeprazole, pantoprazole, lansoprazole, rabeprazole; medicines used to treat diseases related to the acid in the stomach
cimetidine, nizatidine; medicines used to treat diseases related to excess acid in the stomach
St John's wort (hypericum perforatum) which is a herbal product
garlic capsules
indinavir, delavirdine, didanosine and efavirenz; medicines used to treat people infected with HIV
sildenafil, tadalafil and vardenafil; medicines used to treat erectile dysfunction
cyclosporin, tacrolimus and rapamycin, medicines used to suppress the immune system
warfarin; a medicine to prevent blood clots
digoxin and disopyramide; medicines used to treat fast or irregular heart rate
quinine; a medicine use to treat night cramps and malaria
dapsone; an anti-infective agent used to treat TB and leprosy
alfentanil and fentanyl; strong pain killers usually used in anaesthesia
alprazolam, diazepam, clorazepate, flurazepam; medicines used to treat anxiety
nefazodone, tricyclic or tetracyclic antidepressants; medicines used to treat depression
ethinyloestradiol, an oestrogen-based oral contraceptive
dexamethasone, fluticasone and budesonide; medicines which reduce the activity of the immune system or treat asthma and hay fever.
Please consult your doctor if using intranasal or inhaled corticosteroid
These medicines may be affected by INVIRASE or may affect how well it works. You may need different amounts of your medicine, or you may need to take different medicines.
Your doctor or pharmacist has a complete list of medicines to be careful with or avoid while taking INVIRASE.
If you have not told your doctor about any of the above, tell them before you start taking INVIRASE.
How to take INVIRASE
How much to take
Take INVIRASE only when prescribed by your doctor. Your doctor will tell you how many INVIRASE film-coated tablets to take each day.
INVIRASE should be taken only in combination with ritonavir (Norvir®), a medicine used to treat HIV.
The recommended dose of INVIRASE is two 500 mg film-coated tablets of INVIRASE two times a day (a total of four INVIRASE tablets per day), with one 100 mg capsule of ritonavir (Norvir®) two times a day (a total of two Norvir® capsules).
Both medicines should be taken at the same time.
How to take it
Film-coated tablets should be swallowed whole with a glass of water.
When to take it
Take INVIRASE within two hours after a meal to ensure maximum absorption and effectiveness.
Taking INVIRASE with a meal that is high in calories, fat and protein increases your body's ability to absorb the medicine and in turn increases its effectiveness.
Taking your medicine at the same time each day will have the best effect on the HIV infection. It will also help you remember to take the medicine.
How long to take INVIRASE
INVIRASE helps control your HIV infection but does not cure it. Therefore INVIRASE must be taken every day. Continue taking INVIRASE for as long as your doctor prescribes.
If you forget to take INVIRASE
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to. Otherwise, take it as soon as you remember together with some food and then go back to taking it as you would normally.
If you are not sure whether to skip the dose, talk to your doctor or pharmacist.
Do not take a double a dose to make up for one you have missed.
In case of an overdose
If you think that you or anyone else may have taken too much INVIRASE, immediately telephone your doctor or Poisons Information Centre (telephone 13 11 26) or go to Accident and Emergency at your nearest hospital. Do this even if there are no signs of discomfort or poisoning.
Keep telephone numbers for these places handy.
If you are not sure what to do, contact your doctor or pharmacist.
You may need urgent medical attention.
While you are taking INVIRASE
Things you must do
Tell all doctors, dentists and pharmacists who are treating you that you are taking INVIRASE.
Do not take any other medicines whether they require a prescription or not without first telling your doctor.
Continue to use safe sexual practices while taking INVIRASE. INVIRASE has not been shown to decrease the chance of giving HIV to your partner.
If you are using an oestrogen-based oral contraceptive, you should also use an additional type of contraception.
If you become pregnant while taking INVIRASE, tell your doctor.
Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed.
Otherwise, your doctor may think that it was not effective and change your treatment unnecessarily.
Tell your doctor if you feel that INVIRASE is not helping your condition.
Be sure to keep all of your appointments with your doctor so that your progress can be checked.
Your doctor may want to take regular blood samples to measure your blood glucose levels or liver enzymes.
Things you must not do
Do not stop taking INVIRASE or change the dose without first checking with your doctor. Do not let yourself run out of medicine over the weekend or on holidays.
Do not give INVIRASE to anyone else even if their symptoms seem similar to yours.
Things to be careful of
Be careful driving or operating machinery until you know how INVIRASE affects you.
INVIRASE generally does not cause problems with your ability to drive a car or operate machinery. However, as with many medicines, INVIRASE may cause dizziness in some people. Make sure you know how you react to INVIRASE before you drive a car or operate machinery.
Side Effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking INVIRASE.
INVIRASE helps most people with HIV infection but it may have unwanted side effects in some people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Frequently it is difficult to tell whether side effects are the result of taking INVIRASE, effects of the HIV disease or side effects of other medicines you may be taking. For this reason it is very important to inform your doctor of any change in your condition. Your doctor may want to change your dose or advise you to stop taking INVIRASE.
Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
diarrhoea
constipation
stomach discomfort/pain, distention, wind
vomiting,
feeling sick
dizziness, headache
tiredness, weakness
generally feeling unwell
skin problems such as itching and rash
hair loss
dry mouth/lip
heartburn, indigestion or belching after eating
tingling, numbness, weakness of the arms or legs
inability to sleep or increased need for sleep
increased or decreased appetite
taste disturbance or loss of taste
decreased libido
shortness of breath, difficulty breathing, chest tightness or rapid deep breathing
muscle spasms, fits or seizures
allergic reaction- shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin
being short of breath when exercising,
looking pale
yellowing of skin or eyes
increased bruising or bleeding
These are the more common side effects of INVIRASE. For the most part these have been mild.
There are some side effects that may occur with the protease inhibitor class of drug. As mentioned earlier, INVIRASE belongs to this class of drugs, and may cause the following side effects:
diabetes (excessive thirst, increased appetite with weight loss, feeling tired, drowsy, weak, depressed, irritable and generally unwell, and passing large amounts of urine)
body fat distribution changes including loss of fat from the limbs and increased fat around the stomach, breast enlargement could also occur in women
metabolic abnormalities such as hypertriglyceridemia (increased blood levels of triglycerides); insulin resistance (diminished effectiveness of insulin in lowering the levels of blood sugar); hypercholesterolemia (increased blood levels of cholesterol); and hyperlactatemia (increased levels of lactic acid in the blood)
This is not a complete list of all possible side effects. Others may occur in some people and there may be some side effects not yet known.
Tell your doctor if you notice anything else that is making you feel unwell, even if it is not on this list.
Ask your doctor or pharmacist if you don't understand anything in this list.
Do not be alarmed by this list of possible side effects. You may not experience any of them.
