Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Invirase.
Abnormal heart rhythm: Saquinavir may cause a problem with the electrical activity of the heart known as QT prolongation, which can affect the heart's rhythm. While you are taking Invirase, your doctor will monitor your heart rhythm regularly with a test called an electrocardiogram (ECG). You should not take Invirase if your ECG already shows that you have QT prolongation or if you are taking a medication that can cause QT prolongation.
Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, pimozide, moxifloxacin, Mefloquine, pentamidine, arsenic trioxide, tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with saquinavir. You are more at risk for this type of abnormal heart rhythm and its complications if you:
- are female
- are older than 65 years of age
- have a family history of sudden cardiac death
- have a history of heart disease or abnormal heart rhythms
- have a slow heart rate
- have congenital prolongation of the QT interval
- have Diabetes
- have had a Stroke
- have low potassium, magnesium, or calcium levels
- have nutritional deficiencies
If you have heart disease and abnormal heart rhythms, or people are taking certain medications (e.g., Verapamil, atazanavir), discuss with your doctor how Invirase may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invirase, and whether any special monitoring is needed.
Cholesterol: Invirase may increase cholesterol or triglyceride (another type of body fat) levels. Your doctor will regularly monitor your cholesterol levels while you are taking saquinavir.
Diabetes: Antiretroviral medications such as saquinavir may increase blood sugar levels. If you have diabetes, discuss with your doctor how Invirase may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invirase, and whether any special monitoring is required.
Fat redistribution: Over time, Invirase may change how fat is distributed on your body and may change your body shape. With long-term use, you may notice increased fat on the stomach, upper back and neck, chest, stomach area, and breasts. Fat may be reduced on your arms, legs, and face. The long-term effects of this are not known. Notify your doctor if you start developing any changes in your body's appearance.
Foods: Fatty foods and grapefruit juice increase the body's absorption of saquinavir.
Galactose intolerance: Saquinavir medications are prepared with lactose. If you have lactose or galactose intolerance you should not take these medications.
Hemophilia: People with hemophilia may have an increased risk of bleeding while taking Invirase. If you have hemophilia, discuss with your doctor how Invirase may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invirase, and whether any special monitoring is needed.
Immune reconstitution syndrome: Invirase may cause immune reconstitution syndrome, where signs and symptoms of inflammation from previous infections appear. These symptoms occur soon after starting anti-HIV medications and can vary. They are thought to occur as a result of the immune system improving and being able to fight infections that have been present without symptoms, such as pneumonia, herpes, or Tuberculosis. Report any new symptoms to your doctor immediately.
Liver function: Saquinavir can cause serious liver problems, including liver failure and rarely, death. If you are taking saquinavir, your doctor may request that you have regular liver function tests while you are taking Invirase. Invirase may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
People with severely impaired liver function should not take saquinavir.
Other medications: Saquinavir may interact with a number of medications, which may mean a change in how you take Invirase (See "What medications can interact with Invirase?"). Tell your doctor of all medications that you are taking. Certain medications should not be taken with saquinavir at all (see "Who should not take Invirase?"). Saquinavir should never be used on its own and should always be used in combination with ritonavir and other HIV medications.
Pancreatitis: Saquinavir can cause the pancreas to become inflamed. If you have a history of pancreatitis, gallstones, Alcoholism, or high triglycerides, you may be more at risk of experiencing this. If you have a history of pancreatitis, discuss with your doctor how Invirase may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invirase, and whether any special monitoring is needed.
Report signs of pancreatitis such as abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, or swollen abdomen to your doctor immediately.
Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Invirase, contact your doctor immediately.
Breast-feeding: It is not known if saquinavir passes into breast milk. Because HIV can be transmitted by breast milk, breast-feeding is not recommended for women who are HIV-positive.
Children: The safety and effectiveness of using Invirase have not been established for children younger than 16 years of age.
