Invirase (saquinavir)

How does it work?

Invirase capsules and tablets contain the active ingredient saquinavir, which is a type of medicine called a protease inhibitor. It is used in the treatment of HIV (human immunodeficiency virus) infection.

AIDS (acquired immune deficiency syndrome) is caused by infection with HIV. This virus invades cells of the immune system, particularly the white blood cells known as CD4 T-helper lymphocytes. These cells normally work to activate other cells in the immune system to fight infection. Since HIV kills CD4 T-helper cells, over time the body becomes less able to fight the virus or subsequent infections.

Once the virus has invaded a CD4 T-cell it multiplies, and new copies of the virus are released to infect more CD4 cells. Certain chemicals produced by HIV, called enzymes, play an important role in this multiplication. One of these enzymes, protease, has an essential involvement in assembling the new copies of the virus. Saquinavir works by stopping the protease enzyme from working. This means that new copies of the virus that are produced are faulty and cannot infect more CD4 cells.

There is no cure for HIV, but saquinavir is one of a number of medications that lowers the amount of virus in the body (viral load) and slows the progression of the disease from HIV to AIDS. Saquinavir is used together with another anti-HIV medicine called ritonavir . A low-dose of ritonavir increases the amount of saquinavir in the bood and is used to boost the effect of the saquinavir, rather than to have any effect on the virus itself. This combination is used in conjunction with other anti-HIV drugs that attack the HIV virus in different ways. This helps prevent the virus becoming resistant to the medicine.

What is it used for?

HIV infection.

Warning!

Invirase capsules and tablets should be taken with or after food. You should take your ritonavir at the same time.

The HIV virus is very good at becoming resistant to anti-HIV medicines. For this reason it is very important that you carefully follow your doctor's instructions for taking your anti-HIV medicines, in order to maintain effective levels of the medicines in your blood. If the blood levels drop, the virus will be given more chance to replicate and develop resistance to the drugs. Skipping even a few doses increases the risk of treatment failure, so you should try to ensure that you take all your doses at the correct time, and that you visit your doctor for repeat prescriptions before you run out of medicine.

Treatment of HIV infection with anti-HIV medicines such as this one does not reduce the risk of transmitting the virus to other people through sexual contact or blood contamination. You should continue to use condoms to prevent transmitting the virus to your sexual partner.

Combination antiretroviral therapy has been associated with a redistribution of body fat (lipodystrophy) in people with HIV. The long-term consequences of this are currently unknown, however your doctor may wish to monitor your body fat, and the levels of lipids (eg cholesterol) and sugar (glucose) in your blood, and may prescribe additional medicines for any lipid disorders that occur during treatment with this medicine. Contact your doctor if you notice any changes in your body fat during treatment with your HIV medicines.

Some people being treated with combination antiretroviral therapy may develop a bone condition called osteonecrosis. This condition is caused by loss of blood supply to a bone, causing death of the bone tissue. The risk of the condition is thought to be increased by corticosteroid use, alcohol consumption, severe immunosuppression, higher body mass index, advanced HIV disease and long-term use of antiretroviral medicines. If you notice any joint stiffness, aches and pains (especially of the hip, knee and shoulder) or difficulty in movement while using this medicine, you should tell your doctor so this can be investigated.

If you have any problems with your liver, in particular chronic hepatitis B or C, you will need to have regular blood tests to monitor your liver function while you are taking this medicine.

The safety and efficacy of this medicine in children under 16 years of age has not been established.

Use with caution in

Severely decreased kidney function.

Moderately decreased liver function.

Chronic hepatitis B.

Chronic hepatitis C.

Liver cirrhosis.

People with the blood clotting disorder haemophilia (this medicine may increase the risk of bleeding).

Diabetes.

Not to be used in

Severely decreased liver function.

Allergy to ritonavir.

Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Invirase capsules and tablets contain lactose).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine in pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any risks to the foetus. Seek medical advice from your doctor.

It is recommended that women infected with the HIV virus must not breastfeed their infants under any circumstances, in order to avoid transmission of the virus to the baby. Seek medical advice from your doctor.

Label warnings

Take this medication with or after food.

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