Saquinavir
(Hard Gel Capsule/Tablet)

Please read this factsheet together with the patient information leaflet carefully before taking your medicine. If you have any questions or are unsure about anything, ask your doctor or pharmacist.

Saquinavir hard gel capsule/tablet is also known as Invirase. It belongs to a class of drugs called Protease Inhibitors. These are used in the treatment of HIV infection, usually in combination with other anti-HIV drugs. If you would like more information about how these drugs work in the body, a leaflet is available. Please ask your doctor or the pharmacist for details.

Before taking Saquinavir
Tell your doctor about:

* All other drugs that you are taking, including any that you buy over the counter in your
community pharmacy, herbal medicines and recreational drugs;
* If you suffer from chronic diarrhoea or malabsorption;
* Previous allergy to any medicines;
* If you have ever had any liver disease;
* If you are pregnant or thinking about becoming pregnant;

Taking your Saquinavir

* Saquinavir hard gel (HG) is available as a green and yellow capsule, containing 200mg of saquinavir or as an oval light orange tablet (with SQV500 marking on one side) containing 500mg saquinavir;
* Saquinavir is generally only prescribed with ritonavir. Ritonavir boosts the amount of saquinavir in the body, making it more effective;
* The most commonly prescribed dose is 5 capsules or 2 tablets (1000mg) twice each day, taken with 1 capsule (100mg) ritonavir twice a day;
* Saquinavir should be taken at the same time as ritonavir, within two hours of a meal, to ensure enough saquinavir is being absorbed into the body;
* The doses of saquinavir should be divided equally throughout the day: for twice daily regimens, try to take the doses as close as possible to twelve hours apart and for once daily regimens as close as possible to 24 hours apart, at the same times each day;
* Saquinavir works best if there is a constant amount in your bloodstream. It is therefore very important to take the capsules regularly. If you forget to take a dose, take it as soon as you remember, but do not double up the next dose;

Do not run out of saquinavir. If you are going on holiday and need additional supplies, tell your doctor. When receiving a supply from pharmacy, ensure that you have an adequate supply to last until your next appointment.

Other drugs and saquinavir/ ritonavir
Saquinavir / ritonavir are metabolised (processed in the body) by the liver. Some other drugs are metabolised in the same way. This is why it is important to tell your doctor about all the medicines that you take even if you only take them occasionally, including herbal and recreational drugs. Examples of some drugs that are metabolised in the same way as saquinavir / ritonavir and should NOT be taken are rifampicin, simvastatin, phenytoin and St. Johns Wort.

Other examples of drugs that are metabolised in the same way as saquinavir / ritonavir include warfarin, methadone, drugs for erectile dysfunction (e.g. Viagra®), NNRTIs and other protease inhibitors. Your doctor may alter your doses if you are taking one of these drugs.

Saquinavir / ritonavir can stop hormonal contraceptives from working effectively, so you must use an alternative form of contraception, e.g. barrier methods. If you are taking the chewable tablet form of didanosine (ddI) or antacids (for indigestion) in combination with saquinavir / ritonavir you should take the two drugs at least one hour apart.

Side Effects
Saquinavir like all other medications has some side effects. The most important ones are:

* diarrhoea;
* abdominal discomfort;
* nausea and vomiting;
* dyspepsia;

Combination regimes containing protease inhibitors have been associated with redistribution of body fat in some patients. They are also associated with metabolic abnormalities such as raised cholesterol, increased risk of diabetes and heart disease. Your clinic doctor will monitor you for all of these.

If you experience any of these side effects or any other new symptoms after you start saquinavir, tell your doctor who will advise you what to do. If you decide to stop taking saquinavir, it is important to tell your doctor so that he or she can discuss other treatment options with you.

Admission to hospital
If you are admitted to hospital please bring all your medicines with you. This is especially important for anti-HIV drugs, as they have to be taken regularly. Thomas Macaulay Ward operates a self medication programme. Some patients are able to self administer their own medicines to enable them to stick to the routine they have been used to at home.

Storing your saquinavir
Saquinavir HG and tablets should be stored at room temperature.