|
 |
|
|
|
Issue #189: August 9, 1998
fastfax is available by fax in the 215 and 610 area codes at no cost, or by mail anywhere for $20.00 per year, by calling 215-545-6868, and by E-mail by contacting and type the message SUBSCRIBE in the message section. Sources for some articles in this issue include Associated Press and Reuters.WISDOM housing training canceled by Commission
Free water filters available to PWAs
Pregnant women excluded from protease trials
68 House members call for Medicaid for HIV+ people
Writer critiques fastfax Norvir report; Norvir Q&A
WISDOM housing training canceled by Commission
After four women from WISDOM (Women with Immune System Disorders Organizing and Meeting) arrived to give a scheduled sensitivity training for the Philadelphia Housing Authority's (PHA) Section 8 unit on August 31st, they were amazed to find it had been canceled the day before. And not by PHA or WISDOM.Rick Britt, co-chair of the Philadelphia EMA HIV Commission's Care Committee, calling from the HIV Commission Office, had canceled the training, according to PHA.
The training had been arranged by WISDOM after numerous complaints from its members at the way in which PHA staff had treated them. Linda Smith, a member of WISDOM and former president of We The People, had met with Manuela Costa, director of PHA's Section 8 Unit, to report on problems being experienced by women with AIDS in the Section 8 program, after which Costa asked WISDOM to conduct the training.
According to Pam Ladds, the director of WISDOM, after Smith's meeting, WISDOM agreed to two trainings, one on July 31st and one on August 7th.
The Section 8 issues had also been discussed at a recent meeting of the HIV Commission's Housing Committee, which Costa attended. This meeting was also attended by several WISDOM women who also had expressed a variety of concerns with PHA. Dale Grundy, co-chair of the HIV Commission, also participated in the meeting over speaker phone.
When the WISDOM women arrived and were told that their training had been canceled they asked why, and were informed of Britt's call. Ms. Costa also showed the women a letter she had received the same day, faxed from the Commission and signed by the Director Bernard Warren. The letter made suggestions as to how the training should be conducted, what the content should be and who should be giving it. In the letter, Warren "offer[ed] my assistance in obtaining the appropriately trained and experienced persons to offer such information." and listed himself and Grundy as contacts.
Ladds told fastfax, "Apparently, the Commission felt that WISDOM, with its 6 year history, its membership of HIV positive women and its extensive experience, wasn't competent to run a basic HIV/AIDS training. It would take the boys to get PHA up to speed." Ladds said it apparently didn't matter to the Commission that the trainings had been arranged independently between Ms. Costa and WISDOM and had nothing to do with the Commission. Ladds went on to say, "Although this event was billed as sensitivity training, that was the last thing demonstrated by the Commission."
Warren told fastfax that he had not been aware that WISDOM's arrangement with PHA was independent of the Commission's offer, and would apologize for the confusion.
Never known for their passivity, WISDOM women, upon the discovery of their training arrangement had been unilaterally canceled by the Commission, went to the Commission office to get the matter resolved.
WISDOM members Silverline Edwards, Linda Smith, Toni White and Pam Ladds waited for Bernard Warren, who was out of the office and apparently unreachable. According to Commission staff, he was expected back, so the WISDOM women waited.
When Grundy appeared in the office, he was asked about his part in the cancellation. His response was loud and belligerent, according to the women.
He said he "didn't care" what they wanted, he didn't have time to "deal" with them then. but he would when he returned "in 5 minutes," according to the women. When he returned, the WISDOM women declined to meet with him as they felt his attitude was inflammatory. He suggested WISDOM should schedule an appointment to meet with Warren in the future as "he wasn't coming in today," information directly at odds with that provided by the Commission staff.
Warren, in fact, did return to the office about two hours later.
Ladds then approached Karen Llanos to ask if she, as HIV Commission liaison to the Housing Committee, could shed any light on what had happened. Rick Britt, an unknown person to the WISDOM women who overheard the request, then demanded to know why his name was being mentioned.
WISDOM had discussed their concerns in the waiting area with Commission staff and Britt, who had been present but had not yet introduced himself . When asked why he had canceled a WISDOM training, he first denied it, then said it was PHA's fault that WISDOM had not been informed.
Britt told fastfax that "it was PHA's decision to 'postpone' the training until a more extensive event could be developed, and that it was their (PHA's) responsibility to inform WISDOM of the change."
Ms. Costa, however, disputed this claim, saying that it was Britt who called and canceled. She told fastfax that she was embarrassed by the miscommunication and said that she wasn't aware that Britt and Ladds were from separate groups. She said the training scheduled for August 7th would go on as planned and that she would be scheduling several more, so that her entire staff could benefit from the experience.
Britt justified his action by saying that medical information was necessary for such a training and that he, as a "practitioner," was the person to teach it, according to the women from WISDOM. He was asked to elaborate on what he "practiced" but did not respond to the inquiry.
The discussion became extremely heated with raised voices from the WISDOM women, Britt and Grundy. Britt declared that this was why WISDOM was unfit to give a training. He also stated that as the issue of sensitivity training for PHA became apparent during a Housing Committee meeting, it was "Commission business," and therefore, it was the Commission's responsibility to provide the training. He felt it was irrelevant that the request for training had followed several phone calls from WISDOM women about Section 8 housing issues.
Britt also made a comment about the cost of the training, according to Linda Smith, a WISDOM member and long time AIDS advocate, which she questioned. WISDOM was providing training on a totally volunteer basis, as a service to PHA and people living with HIV/AIDS. At no point was money for the WISDOM training discussed. Britt claimed he was talking about the cost to PHA in terms of their time for what he considered an inadequate training. Ladds said that at this point the WISDOM women considered further discussion pointless, so they left after requesting a phone call from Mr Warren.
Smith, an African American woman living with AIDS who has served on the AIDS Consortium board of directors, as president of We The People, and on various clinical trial community advisory boards, expressed her anger at what she called the "disrespect" shown to WISDOM.
"Who are Rick Britt and Dale Grundy to decide whether WISDOM is capable of doing the work it is paid to do under city contracts?" Smith said. We have been around for six years increasing awareness about HIV/AIDS, and have been doing this kind of training for six years with great success. Since when does the Commission have a right to decide what we do and what we aren't going to be allowed to do?"
Smith said, "It is time for the ignorance to cease. Money doesn't play a part in WISDOM's work. It was appalling to me that Britt spoke in the way he did without knowing who any of us are." She went on to say, "He owes us an apology for the way he spoke. He was out of order. He doesn't know us from a can of paint."
Silverline Edwards, a peer counselor who has worked with WISDOM, ActionAIDS and We The People, an experienced trainer, a previous Commission member and also a woman with AIDS, said, "They know nothing about us and what we do. I truly wonder how in the world people like them keep getting away with doing things like this. People get put into those positions [as commission members] who obviously don't care about anything but their own petty self interests. This has got to stop. In the last 8 years this has gotten worse and worse."
Another long time AIDS activist, Toni White said, "I think the HIV Commission should be a lot more careful who they hire or appoint. I think that certain individuals that I came in contact with lack commitment, compassion and respect for women."
Bernard Warren, HIV Commission Director, admitted to fastfax that he signed a letter offering his and Grundy's services without adequate information. He said he was unaware that WISDOM was scheduled to do the training.
Ladds said that at no point did anyone approach WISDOM with questions or concerns about their ability to do such a training.
"As the HIV Commission is supposed to be a planning body and not a training organization, their involvement in a routine training would never have occurred to us," Ladds told fastfax. She went on to say, "We do trainings like this all the time. It has never been an issue before. We have never had to ask permission to do our job from a body that has no right to regulate us."
Rob Capone, interim executive director of We The People, and a member of the HIV Commission, expressed concerns that this incident is another example of how dysfunctional and prone to corruption and abuse the current system is. Capone told fastfax, "In my mind this was a blatant abuse of their (Britt and Grundy) positions as officers of the HIV Commission. There is absolutely no legitimate excuse for anyone representing the Commission to interfere with the work of any provider. They had no right to cancel that training."
WISDOM receives funding from the AIDS Activities Coordinating Office to conduct AIDS education services directed to women at risk of HIV infection. It has conducted AIDS education and sensitivity trainings on women's issues since forming as a caucus of We The People in 1991, and as an independent organization since 1992.
Capone echoed Ms. Ladds assertion that the Commission is not a training organization. "We (the HIV Commission) are not in the business of providing training to anyone. We are mandated to do the planning and priority setting for the region.
"While we do advocate for agencies that serve people living with HIV/AIDS to get sensitivity and other training, there are plenty of others already involved in the provision of that particular service."
Capone went on to say that "They (Britt and Grundy) have severely damaged what little credibility the Commission has at present with HIV+ women, and I think that they should consider stepping down from their positions as co-chairs. Quite frankly, I'm sick and tired of people using the system to pursue their own personal agendas."
Warren did say that WISDOM would receive an apology. However, he said, he perceived as a "threat" Ladds' adamant request to make sure that Grundy and Britt not attend the scheduled WISDOM training on August 7th.
"Our main concern now," Ladds said, "is to get on with the training. It is really a shame that this happened and we are concerned that yet another organization thinks the AIDS industry is incapable of working its way out of a paper bag. We must all appear like idiots."
Free water filters available to PWAs
Philadelphia Community Health Alternatives and ActionAIDS are offering a limited supply of free water filters for low-income people living with HIV infection in southeastern Pennsylvania.The filters are being provided under a grant from The Philadelphia AIDS Consortium. Residents of New Jersey are not eligible for the program.
Applicants must prove their HIV status and provide proof of income. Eligibility is limited to individuals whose income is three times the federal poverty level or less. Only one filter is available per household.
Applications are only available from the two organizations. Once an application is completed, it is submitted to ActionAIDS for processing, and if approved, the applicant will receive a voucher entitling them to pick up a filter at PCHA.
PCHA is located at 1201 Chestnut Street, on the 3rd Floor. ActionAIDS is at 1216 Arch Street on the 6th Floor. Applicants do not need to be clients of either agency.
Pregnant women excluded from protease trials
The National Institutes of Health have "temporarily" stopped recruiting pregnant women into studies of protease inhibitors, citing "an unexpected number" of premature births among women who took the drugs while pregnant.Of 10 U.S. babies studied so far, three were premature and one died in utero. A similar Swiss study found that nine out of 30 babies were premature. The Swiss study also found an equal risk between mothers who took a protease combination and mothers who just took two older AIDS drugs. That means that taking more drugs in total might be the explanation for the premature births, according to researchers.
It has become standard procedure for HIV-infected pregnant women to take combination drug cocktails, but their use in pregnancy is only now being studied.
In a late-breaker abstract presented during the 12th World AIDS Conference in Geneva last month, Dr. Patrizio Lorenzi and colleagues described the safety of combination antiretroviral therapies in women and their offspring. Data were collected from October 1996 to April 1998 on subjects treated with two reverse transcriptase inhibitors and a protease inhibitor.
Dr. Lorenzi's team found that "...one or more adverse events occurred in 21/37 women and in 17/30 babies." Nine women developed grade 1 anemia and six women developed grade 2 anemia or higher. Other complications included leukopenia, thrombocytopenia, elevated liver enzymes, hypertension and insulin -dependent diabetes.
Among the neonates, prematurity, which occurred in 11 neonates, was the most common adverse effect. Two infants experienced intracerebral hemorrhage that was not life-threatening, and one neonate was born with a major malformation.
Other adverse events in the neonates included anemia, hyperbilirubinemia, transient hepatitis and cryptorchidia.
NIH officials stressed that the safety concerns are very preliminary, and there is no reason for pregnant women taking drug cocktails containing protease inhibitors to stop. They stated, however, that "doctors should carefully monitor HIV-infected women who have higher risks of premature birth."
NIH's Betsy Smith, who monitors the safety findings, said, "Our view is the great majority of women on these drugs do very well [but] with increased risk factors that might lead to prematurity, we should be cautious."
68 House members call for Medicaid for HIV+ people
U.S. House Democratic Leader Richard Gephardt (D MO), Rep. Nancy Pelosi (D CA) and 66 of their colleagues have sent a letter to Health and Human Services Secretary Donna Shalala, urging her to expand Medicaid to low-income people who are HIV-positive but have not yet developed symptoms of HIV disease."It is unconscionable to deny people living with HIV the drugs we know can help keep them well simply because they have no health insurance or are not yet sick enough to qualify for Medicaid," said Gephardt. "In light of what the latest research is telling us, I join my colleagues in the fervent hope that the Administration will quickly take the necessary steps to fill this unjustifiable gap in our current Medicaid policy."
Under current Medicaid regulations, people with HIV infection must become sick and disabled before they can receive benefits. Yet waiting for the disease to progress to this point runs counter to recommendations developed by the U.S. Department of Health and Human Services and a distinguished panel of medical experts. They have advised early treatment with protease inhibitors -- before symptoms develop -- for many people in the early stages of HIV disease.
While this does not guarantee that fatal complications will be averted or delayed, there is evidence to suggest it can keep people with HIV healthier for a longer time. It is also believed that earlier treatment may help ultimately reduce the cost of HIV care, as people remain healthier longer and have less need for more expensive medical interventions.
"Powerful new drugs have given people with HIV renewed hope in fighting this disease. It is imperative that our government health care programs catch up with the recommendations of government health care experts," Pelosi said.
New research released at the just completed 12th World AIDS Conference in Geneva provides further evidence that treatment of HIV infection early in the course of disease is both medically beneficial and cost effective. A cost effectiveness study from the University of California, San Francisco, reports that, "expansion of the U.S. Medicaid system to provide wider access to combination antiretroviral therapy would prevent thousands of deaths and AIDS diagnoses, leading to 14,500 more years of life for persons with HIV disease over five years." The study found that cost neutrality was within reach and that "the program is affordable from a federal perspective."
"While government researchers issue hopeful statements about the benefits of early therapy and news reports herald a new age for people with AIDS, Medicaid trails the science," Pelosi said.
"We must act now to expand access to these very important drugs for low income uninsured people with HIV."
A surprising cosigner to the letter to Sec. Shalala is Rep. Tom Coburn of Oklahoma, who has gained publicity for seeking to mandate HIV testing nationally as well as require reporting of the names of all people with HIV infection in the country.
New Philadelphia congressman Robert Brady also signed the letter. He was the only Philadelphia area representative to support the request.
Writer critiques fastfax Norvir report
The following letter was received last week by fastfax, regarding our report on the withdrawal by Abbott Laboratories of Norvir capsules from the market because of manufacturing problems, and the recommendation that Norvir users switch to the liquid formulation. Readers are encouraged to submit their comments on fastfax to wtp@critpath.org or by writing fastfax, 425 S. Broad St., Phila., PA 19147.To the editor of fastfax:
While I usually am impressed with fastfax, I must comment on the article about the impending Norvir shortage. There is no denying that this is a major problem for People living with AIDS. However, to frame the article the way you did does nothing to help people with the disease. Reading that article, you get the distinct impression that not only do you hold Abbott labs responsible for something that they clearly could never have wanted to happen, but you make people think that the options available for people who take Norvir are completely unacceptable.
All this accomplishes is to all but encourage people to skip doses or stop taking their meds altogether. While I absolutely encourage you not to sugarcoat the seriousness of the problem, I can not believe you wouldn't go further to offer viable temporary solutions for your readers. Rather, you just dismissed the alternatives out of hand. I hope you realize how much influence your newsletter has. People living with HIV and AIDS need real solutions they can work with, not useless bitching and blaming.
Again, overall I think fastfax is a wonderful resource. I hope this was just an aberration and not something that we will be seeing more of in the future.
Petr Pronsati
Our response:
We appreciate Petr's comments, and will take them into account in future articles to make sure we consider all of the implications of our reports and the way people from differing perspectives may look at an issue.We're not sure we can agree with Petr's perception that the problem facing Abbott is "something that they clearly could never have wanted to happen." Obviously, we have no way of knowing what they wanted, but we have a responsibility to question what they should have expected. The following comment was posted by activist Jim Corti (corti@earthlink.net) on the AIDSACT newsgroup on the Internet:
"Abbott simply has a major problem. They put their product on the market in the quickest possible time/method, and that, frankly, can be admired as well as have rocks thrown at it. I admire the speed they went to market, getting out a drug that seems to work for the community; and the community voted with their prescriptions, selection and tolerance of Norvir. Took some tweaking but it is what it is. There is every chance in the world that they did not have the best real estate, glass, white tile and stainless steel in order, that would guarantee the non-interrupted long term manufacture of Norvir. They needed to get there fast to protect their position versus Crix and Saquinavir, and they did. Somewhere in there, were the needs of the community, but, they were sure as hell secondary to Abbott's needs.
"Now, the production of Norvir has fallen apart. There are a bunch of ways to look at this. Have they tried a new manufacturing program with new precursors or techniques, either for speed of manufacture or lower costs? Something changed, structurally, chemically, mechanically, environmentally. To say that they don't know what happened doesn't ring well with me. Someone knows what happened, and how to get out of the mess. My bet is that there were financial considerations serving as the genesis for this mess. Going back to clarythro, and through their history, they never, ever have been the fountain of generosity. Maybe there are new people on board that see it differently, I doubt it. They are in a pickle, obviously. I surely hope they are putting the needs of the community, that is somewhat dependent on their compound, first.
The same community that supports them financially. Abbott created the product, they are party to having insured that the demand would continued; now, it is up to Abbot to spare nothing to insure Norvir is back on line without any mis-steps, reluctance or hesitation on their part. And, a little, maybe a lot, of transparency into how and why this incident has happened, wouldn't hurt."
Questions and Answers from Abbott on Norvir
The following information is posted by Abbott on its web page [http://www.norvir.com] about the Norvir crisis:Abbott Laboratories is experiencing manufacturing difficulties with our HIV protease inhibitor, Norvir (ritonavir) capsules, which will result in a shortage. We have encountered an undesired formation of a Norvir crystalline structure that affects how the capsule form of Norvir dissolves.
It is our plan to supply Norvir oral solution (liquid) until we can resume Norvir capsule production and distribution. Norvir capsules currently in distribution are not affected by this issue. When used in accordance with prescribing information, product on the market is safe and effective.
The active ingredients in Norvir liquid and Norvir capsules are identical, as is their activity against HIV. Changing to Norvir liquid should not affect your anti-retroviral regimen.
Each Norvir capsule contains 100 mg of active drug, and each mL of Norvir liquid contains 80 mg of active drug. For your convenience, Norvir liquid comes with a dosing cup that provides markings indicating the amount of liquid to be taken for the two most common doses. It is important to measure the correct dose of Norvir; therefore, the dosing cup has been specially designed to provide the right dose of Norvir liquid. This cup should be used to measure a dose. Please be advised that when measuring a dose, the cup should be placed on a flat surface at eye level, and the cup filled with Norvir liquid to the line showing the appropriate dose.
You should wash the dosing cup with soap and warm water as soon as possible. The dosing cup is not dishwasher safe.
The following conversion equation may be helpful:
6 - Norvir capsules (100 mg each) = 7.5 mL of Norvir liquid (1 1/2 teaspoons)
4 - Norvir capsules (100 mg each) = 5 mL of Norvir liquid (1 teaspoon)
Patients may improve the taste of Norvir liquid by mixing with chocolate milk, Ensure, or Advera within one hour of dosing.
To ensure continued stability of Norvir liquid, it should not be refrigerated and should be stored at room temperature (below 77F/25C) and used within 30 days of dispensing. It is important that you shake the liquid well before each use. Your health care providers have been informed of the dosing and handling for Norvir liquid.
People will receive Norvir liquid when their pharmacy runs out of Norvir capsules. After finishing your prescription for Norvir capsules, you should begin taking Norvir liquid at your next scheduled dose. It is critical for you to take your medication at the prescribed dose and time recommended by your physician. If you have questions about the liquid, contact your physician immediately.
Norvir is indicated in adults in combination with other anti-retroviral agents or as monotherapy for the treatment of HIV infection. Norvir has also been cleared by the FDA for use in children between the ages of 2 and 16 based on safety and pharmacokinetic data.
Norvir is not a cure for HIV infection. People treated with Norvir may continue to acquire illness associated with advanced HIV infection, including opportunistic infections. Norvir may not be right for everyone, including people with liver disease, hepatitis, or hemophilia. Elevated blood sugar levels have been reported in patients taking protease inhibitors. Allergic reactions ranging from mild to severe have been reported. Common adverse reactions include fatigue, vomiting, diarrhea, loss of appetite, abdominal pain, taste disturbance, tingling sensation or numbness in the hands, feet, or around the lips, headache and dizziness. Norvir should not be used with certain medications including some non-sedating antihistamines, sedative hypnotics, antiarrhythmics, or ergot alkaloid preparations. Talk to your doctor or pharmacist.
We deeply regret this inconvenience and appreciate your understanding and patience as we work to solve the problem. Abbott is committed to doing everything it can to allow patients to continue Norvir therapy without interruption, and to resuming timely delivery of Norvir capsules.
If you have questions or concerns, please ask your doctor or call us at 1-800-637-2400.
Q. What steps has Abbott taken to address the problem?
Abbott is doing everything it can to solve the problem in order to resume production of Norvir capsules as soon as possible. Additionally, Abbott is increasing its production of Norvir oral solution (liquid) in an effort to provide continued Norvir therapy.
Q. When will the problem be fixed? When will capsules be available?
Abbott's Norvir capsule inventory is expected to be available through mid-August. At this time, we do not have a date for when production of capsules will resume. Norvir capsules currently in distribution are not affected by this issue. Norvir capsule production remains the utmost priority for Abbott Laboratories.
Q. Can customers be assured that Norvir oral solution (liquid) is not affected by this problem?
We are continuing thorough testing on all Norvir to ensure that all product released meets quality assurance standards.
Q. How does the liquid formulation differ from the capsules?
Norvir oral solution (liquid) and Norvir capsules are identical in their activity against HIV. Each Norvir capsule contains 100 mg of active drug, and each mL of Norvir liquid contains 80 mg of active drug.
For patient convenience, Norvir liquid comes with a dosing cup that provides markings indicating the amount of liquid to be taken for the two most common doses. It is important to measure the correct dose of Norvir; therefore, the dosing cup has been specially designed to provide the right dose of Norvir liquid. This cup should be used to measure a dose. When measuring a dose, the cup should be placed on a flat surface at eye level. Fill the cup with Norvir liquid to the line showing the appropriate dose. You should wash the dosing cup with soap and warm water as soon as possible. The dosing cup is not dishwasher safe.
After finishing your prescription for Norvir capsules, you should begin taking Norvir liquid at your next scheduled dose. Additionally, Norvir liquid should not be refrigerated. It should be stored at room temperature (below 77F/25C) and used within 30 days of dispensing. It is important that you shake the liquid well before each use.
The following conversion equation may be helpful:
6 - Norvir capsules (100 mg each) = 7.5 mL of Norvir liquid or 1 1/2 teaspoons
4 - Norvir capsules (100 mg each) = 5 mL of Norvir liquid or 1 teaspoon
Q. Is there a cost difference between Norvir capsules and Norvir oral solution (liquid)?
Our price for the two formulations is approximately the same.
Q. Am I at greater risk for resistance with the Norvir oral solution (liquid) formulation vs. capsules?
No. Norvir oral solution (liquid) and Norvir capsules are identical in their activity against HIV. With HIV therapies, patient compliance is an essential component in preventing drug resistance. It is critical for you to take your medication at the prescribed dose and time recommended by your health care provider. If you have questions about the liquid, contact your physician immediately.
Q. What should I do if I have questions about Norvir oral solution (liquid)?
You should immediately contact your physician if you have questions about Norvir oral solution (liquid).
Q. What if I want to stop therapy and wait to resume protease inhibitor therapy when the capsules are ready?
Interruption or discontinuation of treatment is not recommended unless advised by a physician. Decisions about treatment should be discussed with a physician and must be individualized to your needs.
Q. What if I am combining Norvir with another protease inhibitor?
Norvir oral solution (liquid) and Norvir capsules are identical in their anti-HIV activity. Changing to Norvir liquid should not affect your anti-retroviral regimen.
Q. Can customers be assured that you have adequate Norvir oral solution (liquid) for patients to continue therapy?
Abbott is increasing production of Norvir oral solution (liquid) in an effort to provide continued Norvir therapy for patients.
Q. Am I at greater risk for resistance with the Norvir oral solution (liquid) formulation capsules?
No. Norvir oral solution (liquid) and Norvir capsules are identical in their activity against HIV. With HIV therapies, patient compliance is an essential component in preventing drug resistance. It is critical for patients to take their medications at the prescribed dose and time recommended by the patient's health care provider. If you have questions about the liquid, contact your physician immediately or call 1-800-637-2400.
Q. Are there any issues if I want to switch to an alternative protease inhibitor until Norvir capsules are available?
A decision to switch therapies should be made in consultation with one's physician. Decisions about treatment should be discussed with a physician and must be individualized to a patient's needs. Do not stop taking your protease inhibitor without first consulting your health care provider.
Q. Do I need a new prescription?
Your pharmacist and physician should be aware of this situation. When your prescription is refilled next, your pharmacist may need to call your physician to secure approval for the switch from Norvir capsules to liquid. No special action should be required on your part.
Q. Will this formulation switch require me to see my physician?
The change from Norvir capsules to liquid should not require a physician visit. The pharmacist may need to call the physician to secure approval for the switch from Norvir capsules to liquid.
Q. Should I stop taking my current supply of Norvir capsules?
No. Norvir capsules currently in distribution are not affected by this issue. It is important that you continue to take Norvir at the prescribed dose and time recommended by your health care provider.
Q. Are there any special requirements (like food) for this liquid formulation?
It is recommended that Norvir be taken with meals if possible. The taste of Norvir liquid may be improved by mixing with chocolate milk, Ensure, or Advera within one hour of dosing.
To obtain a weekly email version of fastfax, contact with the message: "subscribe" or fill in the box on the fastfax index page.