M

Non-nucleoside reverse transcri

[>tose inhibitors (NNRTIs)

Nevirapine (NVP)

Oral suspension: 10 mg/ml

Tablet: 200 mg

All ages

15 to 30 days: 5 mg/kg once daily for 2 weeks, then

120 mg/m2 twice daily for 2 weeks, then 200 mg/m2 twice daily

120 mg/m2 once daily for 2 weeks, then 120-200 mg/m2 twice daily

Maximum dose:

> 1 3 years: 200 mg once daily for first 2 weeks, then 200 mg/ twice daily

If rifampicin coadministration, avoid use

Store suspension at room temperature; must shake well

Can give with food

MUST WARN PARENTS ABOUT RASH. Do not escalate dose if rash occurs (if mild/moderate rash, hold drug; when rash cleared, restart dosing from beginning of dose escalation; if severe rash, discontinue drug) Drug interactions

Efavirenz (EFZ)

Syrup: 30 mg/ml (note: syrup requires higher doses than capsules, see dosing chart)

Capsules: 50 mg, 100 mg, 200 mg

Only for children over 3 years

Capsule (liquid) dose for > 3 years:

(300 mg = 10 ml) once daily 20 to 25 kg: 300 mg (360 mg = 12 ml) once daily

Capsules may be opened and added to food but have very peppery taste; however, can mix with sweet foods or jam to disguise taste

Can give with food (but avoid after high-fat meals which increase absorption by 50%).

Efavirenz (EFZ)

(continued)

Maximum dose:

>40 kg: 600 mg once daily

Best given at bedtime, especially first 2 weeks, to reduce central nervous system side-effects.

Drug interactions

Protease inhibitors (Pis)

Nelfinavir (NFV)

Powder for oral suspension (mix with liquid): 200 mg per level 5 ml teaspoon (50 mg per 1.25 ml scoop)

Tablet: 250 mg (tablets can be halved; can be crushed and added to food or dissolved in water)

All ages

However, extensive pharmacokinetic variability in infants, with requirement for very high doses in infants < 1 yr

< 1 yr: 40-50 mg/kg three times daily or 75 mg/kg twice daily

> 1 year to < 1 3 years: 55 to 65 mg/kg twice daily

Maximum dose:

> 13 yrs: 1250 mg twice daily

Powder is sweet, faintly bitter, but gritty and hard to dissolve; must be reconstituted immediately prior to administration in water, milk, formula, pudding, etc. - do not use acidic food or juice (increases bitter taste)

Because of difficulties with use of powder, crushed tablets preferred (even for infants) if appropriate dose can be given

Powder and tablets can be stored at room temperature

Nelfinavir

(continued)

Drug interactions (less than ritonavir-containing protease inhibitors)

Lopinavir/

ritonavir

(LPV/r)

Oral solution: 80 mg/ml lopinavir plus 20 mg/ml ritonavir

Capsules: 1 33.3 mg lopinavir plus 33.3 mg ritonavir

6 months of age or older

> 6 months to 13 years: 225 mg/m2 LPV/57.5 mg/m2 ritonavir twice daily or weight-based dosing: 7-15 kg: 12 mg/kg LPV 3 mg/kg ritonavir twice daily

15-40 kg: 10 mg/kg lopinavir 2-5 mg/kg ritonavir twice daily

Maximum dose:

> 40 kg: 400 mg LPV/100 mg ritonavir (3 capsules or 5 ml) twice daily

Preferably oral solution and capsules should be refrigerated; however, can store at room temperature up to 25°C (77°F) for 2 months

Liquid formulation has low volume but bitter taste

Capsules large

Should be taken with food

Drug interactions

* Body surface area calculation (m2): square root of (height in cm multiplied by weight in kg divided by 3600)

* Body surface area calculation (m2): square root of (height in cm multiplied by weight in kg divided by 3600)

Was this article helpful?

0 0

Post a comment