Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
The manufacturer of Agenerase, GlaxoSmithKline, discontinued sale of Agenerase in October, 2007 due to decreased demand in the USA and the approval of fosamprenavir (Lexiva). Fosamprenavir is a drug that is converted to amprenavir in the body.
GENERIC NAME: amprenavir
BRAND NAME: Agenerase (Discontinued Brand)
DRUG CLASS AND MECHANISM: Amprenavir is an oral medication that is used for treating infections with the human immunodeficiency virus (HIV). It is in a class of drugs called protease inhibitors which, among others, includes indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir) and saquinavir (Invirase, Fortovase). During infection with HIV, the HIV virus multiplies within the body's cells. Viruses are released from the cells and spread throughout the body where they infect other cells. In this manner, HIV infection is perpetuated among new cells that the body produces continually. During the production of the viruses, new proteins are made. Some of the proteins are structural proteins, that, is, proteins that form the body of the virus. Other proteins are enzymes which manufacture DNA and other components for the new viruses. Protease is the enzyme that forms the new structural proteins and enzymes. Amprenavir blocks the activity of protease and results in the formation of defective viruses that are unable to infect the body's cells. As a result, the number of viruses in the body (the viral load) decreases. Nevertheless, amprenavir does not prevent the transmission of HIV among individuals, and it does not cure HIV infections or AIDS. Amprenavir was approved by the FDA in April 1999.
GENERIC AVAILABLE: No
PREPARATIONS: Capsule: 50 and 150 mg; Solution: 15 mg/ml
STORAGE: Capsules and oral solution should be stored at room temperature, 20 C to 25 C (68 F to 77 F).
PRESCRIBED FOR: Amprenavir is used in combination with other anti-HIV drugs for the treatment of HIV infection.
DOSING: The recommended dose is based on age, weight and the formulation. Individuals 4-12 years old or 13-16 years old and weighing less than 50 kg should receive 22.5 mg/kg twice daily or 17 mg/kg three times daily of the oral solution or 20 mg/kg twice daily or 15 mg/kg three times daily of the capsules.
Individuals 13- 16 years old who weigh 50 kg or more and individuals older than 16 years of age should receive 1400 mg twice daily of the oral solution or 1200 mg twice daily of the capsules.
The maximum daily dose is 2800 mg. Amprenavir capsules and solution are not interchangeable milligram for milligram. The oral solution should only be used when it is not possible to administer the capsules.
Amprenavir can be taken with or without food. However, foods high in fat may decrease the absorption of amprenavir and should be avoided.
DRUG INTERACTIONS: Amprenavir interacts with many drugs. Some of the important interactions are mentioned below. Patients should consult their doctor before combining any drugs with amprenavir.
Amprenavir should not be used together with amiodarone (Cordarone), quinidine (Quinaglute, Cardioquin), triazolam, ergot derivatives (for example, Ergostat), triazolam (Halcion), midazolam (Versed) and intravenous lidocaine (Xylocaine) because serious adverse effects could occur due to increased levels of these drug in the body.
Amprenavir also increases the concentrations in blood of rifabutin (Mycobutin) and sildenafil (Viagra). Therefore, the doses of rifabutin and sildenafil should be reduced.
Amprenavir may increase the blood concentration of lovastatin (Mevacor), simvastatin (Zocor), atorvastatin (Lipitor) and cerivastatin (Baycol). This may result in an increased occurrence of myopathy (muscle pain) or rhabdomyolysis (muscle breakdown).
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