Stomach pain, nausea, vomiting, heartburn, loss of appetite, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
As your immune system gets stronger, it can begin to fight off infections you already had, possibly causing disease symptoms to come back. You could also have symptoms if your immune system becomes overactive. This reaction may happen at any time (soon after starting HIV treatment or many months later). Get medical help right away if you have any serious symptoms, including: unexplained weight loss, severe tiredness, muscle aches/weakness that doesn't go away, headaches that are severe or don't go away, joint pain, numbness/tingling of the hands/feet/arms/legs, vision changes, signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, non-healing skin sores), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), signs of a certain nerve problem known as Guillain-Barre syndrome (such as trouble breathing/swallowing/moving your eyes, drooping face, paralysis, trouble speaking).
Seek immediate medical attention if any of these rare but serious side effects occur: symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating), easy bruising/bleeding, persistent nausea/vomiting, stomach/abdominal pain, yellowing eyes/skin, dark urine, signs of kidney problems (such as change in the amount of urine).
Cirixivan may cause kidney stones. Tell your doctor right away if you have symptoms such as side or mid-back pain, pink/bloody urine, or pain with urination.
This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.
Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of treatment with your doctor, as well as the possible use of exercise to reduce this side effect.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
The in vitro activity of Cirixivan was assessed in cell lines of lymphoblastic and monocytic origin and in peripheral blood lymphocytes. HIV-1 variants used to infect the different cell types include laboratory-adapted variants, primary clinical isolates and clinical isolates resistant to nucleoside analogue and nonnucleoside inhibitors of the HIV-1 reverse transcriptase. The IC95 (95% inhibitory concentration) of Cirixivan in these test systems was in the range of 25 to 100 nM. In drug combination studies with the nucleoside analogues zidovudine and didanosine, Cirixivan showed synergistic activity in cell culture. The relationship between in vitro susceptibility of HIV-1 to Cirixivan and inhibition of HIV-1 replication in humans has not been established.
Nephrolithiasis and renal dysfunction
Cirixivan is associated with risk of renal calculus formation, affecting
10% of recipients, and can also be associated with nephropathy in the absence of overt calculus formation. Cirixivan-induced renal calculi (which are radiolucent) generally respond to hydration, diuresis, and urinary acidification. Cirixivan is also associated with “retinoid” side effects, including dry lips and skin (
30%), and hair and nail changes including paronychia (
5%). There have now been >30 reports of renal calculi in atazanavir recipients, although clinical risk factors are not yet known. Atazanavir and lopinavir/ritonavir may also be associated with increased risk of chronic kidney disease .
How should I take Cirixivan?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Cirixivan works best if you take it on an empty stomach, at least 1 hour before or 2 hours after a meal.
You may also take Cirixivan with a light meal such as dry toast with jelly, or corn flakes with skim milk and sugar. Avoid eating a high-fat meal.
Cirixivan is usually taken every 8 hours around the clock. Take the medicine at the same times each day.
Take Cirixivan with a full glass (8 ounces) of water, skim milk, juice, coffee, or tea. Drink at least 6 glasses of water each day to prevent kidney stones while you are taking Cirixivan.
Use Cirixivan regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
While using Cirixivan, you will need frequent blood tests.
HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.
Store at room temperature away from moisture and heat. Keep the capsules in their original container, along with the packet or canister of moisture-absorbing preservative. Keep the bottle tightly closed when not in use.
Cirixivan sulfate was approved by the FDA on March 13, 1996, for use in combination with other antiretroviral agents or as monotherapy for the treatment of HIV infection. Evidence suggests that use of a three-drug regimen that includes Cirixivan and two nucleoside reverse transcriptase inhibitors (NRTIs) can increase CD4 cell counts and decrease plasma HIV-1 RNA levels in pediatric patients who previously received long-term therapy with NRTIs, especially if the three-drug regimen includes NRTIs not used in previous regimens.
Cirixivan sulfate is also used in conjunction with other antiretroviral agents for postexposure prophylaxis of HIV infection in healthcare workers and others who have had occupational exposure to HIV.
How is this medicine (Cirixivan) best taken?
Use Cirixivan as ordered by your doctor. Read all information given to you. Follow all instructions closely.
- Take with water, juice, skim milk, coffee, tea, or a light snack. Take 1 hour before or 2 hours after meals.
- If taking Cirixivan with ritonavir, you may take it with food.
- Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
- Do not take didanosine within 1 hour of Cirixivan.
- Keep taking Cirixivan as you have been told by your doctor or other health care provider, even if you feel well.
- It is important that you do not miss or skip a dose of Cirixivan during treatment.
What do I do if I miss a dose?
- Take a missed dose as soon as you think about it.
- If it has been 2 hours or more since the missed dose, skip the missed dose and go back to the normal time.
- Do not take 2 doses at the same time or extra doses.
- If you are not sure what to do if you miss a dose, call your doctor.