LEXIVA

Lexiva Generic Name & Formulations

Legal Class

General Description

Fosamprenavir (as calcium) 700mg; tabs; (prodrug of amprenavir).

Pharmacological Class

HIV-1 protease inhibitor.

How Supplied

Tabs—60; Susp—225mL

Manufacturer

GlaxoSmithKline

Generic Availability

Lexiva Indications

Indications

HIV-1 infection.

Lexiva Dosage and Administration

Adult

Oral susp: take without food; if emesis occurs within 30 minutes after dosing, re-dose. Therapy-naive: 1.4g twice daily; or fosamprenavir 1.4g + ritonavir 200mg once daily; or fosamprenavir 1.4g + ritonavir 100mg once daily; or fosamprenavir 700mg + ritonavir 100mg twice daily. Protease inhibitor-experienced: fosamprenavir 700mg + ritonavir 100mg twice daily. Hepatic impairment: see full labeling for dose adjustments.

Children

Protease inhibitor-naive (<4wks) or Protease inhibitor-experienced (<6mos): not recommended. Oral susp: take with food; if emesis occurs within 30 minutes after dosing, re-dose. Protease inhibitor-naive (≥4wks–18yrs) or Protease inhibitor-experienced (≥6mos): <11kg: fosamprenavir 45mg/kg + ritonavir 7mg/kg twice daily; 11–<15kg: fosamprenavir 30mg/kg + ritonavir 3mg/kg twice daily; 15–<20kg: fosamprenavir 23mg/kg + ritonavir 3mg/kg twice daily; ≥20kg: fosamprenavir 18mg/kg + ritonavir 3mg/kg twice daily. Alternatively, Protease inhibitor-naive (≥2yrs): fosamprenavir 30mg/kg twice daily. For all: do not exceed the adult dosage (see full labeling). Other dosing considerations: see full labeling.

Lexiva Contraindications

Contraindications

Concomitant alfuzosin, cisapride, lurasidone, pimozide, ergots, midazolam, triazolam, St. John's wort, rifampin, lovastatin, simvastatin, delavirdine, sildenafil (Revatio; when used for treating PAH). Concomitant flecainide, or propafenone with ritonavir-boosted fosamprenavir.

Lexiva Boxed Warnings

Not Applicable

Lexiva Warnings/Precautions

Warnings/Precautions

Sulfonamide allergy. Hepatic impairment: see full labeling. Do not exceed recommended dose. Discontinue if severe rash occurs. Monitor lipids, liver function, and for hyperglycemia, increase in body fat, immune reconstitution syndrome. Hemophilia: monitor for spontaneous bleeding. Interrupt or discontinue if nephrolithiasis occurs. Elderly. Pregnancy. Nursing mothers: not recommended.

Lexiva Pharmacokinetics

See Literature

Lexiva Interactions

Interactions

See Contraindications. Life-threatening arrhythmias possible with amiodarone, lidocaine (systemic), quinidine. Concomitant salmeterol, boceprevir, simeprevir, ketoconazole or itraconazole (doses >200mg/day), paritaprevir/ritonavir/ombitasvir/dasabuvir, or nevirapine without ritonavir: not recommended. Reduce rifabutin dose by at least ½ (or by 75% if with ritonavir) and monitor for neutropenia (do weekly CBCs). Potentiates atorvastatin (max atorvastatin 20mg/day), sildenafil, tadalafil, vardenafil; reduce doses of these. May potentiate fluticasone (consider alternative therapy), trazodone (reduce trazodone dose). Monitor with antiarrhythmics (eg, amiodarone), anticonvulsants (eg, phenytoin), H₂ blockers, immunosuppressants, tricyclics, warfarin, drugs that affect or are affected by CYP3A4 (eg, azole antifungals, certain benzodiazepines, calcium channel blockers, NNRTIs, protease inhibitors, statins, steroids). May antagonize, or be antagonized by combined hormonal contraceptives (use alternative non-hormonal methods), methadone, paroxetine. Concomitant dolutegravir (with ritonavir-boosted fosamprenavir): give dolutegravir 50mg twice daily; use alternative if known or suspected integrase inhibitor resistance. Concomitant bosentan, colchicine, quetiapine, maraviroc (adjust doses; see full labeling).

Lexiva Adverse Reactions

Adverse Reactions

Diarrhea, nausea, headache, rash (may be serious, eg, Stevens-Johnson), fatigue, vomiting and neutropenia (esp. children); hypertriglyceridemia, elevated liver enzymes, increase in body fat, immune reconstitution syndrome, hemolytic anemia.

Lexiva

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