Aluvia is a so-called "second-line" drug that would treat the growing number of Thai people who have developed a resistance to "first-line" drug therapies.
Abbott spokeswoman Jennifer Smoter said a compulsory license issued by Thailand to allow generic drugs was unnecessary because Abbott was offering Aluvia in Thailand at a reduced price of $1,000 per patient per year.
Brook Baker, a Northeastern University law professor and member of HealthGAP (Health Global Access Project) countered that generic drug makers in Thailand and India in all likelihood will be able to produce a generic alternative to Aluvia at far less than $1,000 if given the chance.
LPV is co-formulated with ritonavir in a heat-stable tablet (Aluvia
) and is the best option in patients without a refrigerator (other PIs require ritonavir boosting with a separate ritonavir capsule that ideally requires refrigeration, although ritonavir capsules are stable at room temperature for 30 days).
On admission she was found to have lactic acidosis (lactate 8.0 mmol/L; pH 7.2) as a complication of stavudine and was discharged on Aluvia
(lopinavir/ritonavir) and efavirenz.
For example, FBC is recommended at 1, 2, 3 and 6 months if the patient is receiving AZT; creatinine needs be monitored at months 3 and 6, and thereafter annually, if the patient is receiving TDF; and fasting cholesterol and triglycerides monitored at month 3 if the patient is receiving Aluvia (lopinavir/ritonavir; Abbott Laboratories), and then annually thereafter.
Prescriptions per month for drugs in each group before and after the new guidelines (mean n) Group 1, Group 1, Group 2, Group 3, Post-2010, Drug pre-2010 post-2010 post-2010 post-2010 combined mean Abacavir 1.00 0.92 0.00 3.08 1.33 Aluvia 6.00 11.04 16.29 10.00 12.44 Combivir 2.17 2.63 0.46 0.17 1.09 DDI 1.42 2.63 2.42 0.00 1.68 EFV 57.67 60.79 61.88 64.25 62.31 3TC 61.17 63.38 68.58 64.42 65.46 NVP 3.50 2.67 0.78 0.92 1.46 Reyataz 0.00 0.75 1.46 1.00 1.07 D4T 49.50 35.42 32.96 17.00 28.46 TDF 4.17 20.75 30.21 38.83 29.93 Truvada 2.50 6.46 8.00 13.17 9.21 AZT 7.92 8.71 8.50 6.00 7.74 DDI = didanosine; EFV = efavirenz; 3TC = lamivudine; NVP = nevirapine; D4T = stavudine; TDF = tenofovir; AZT = zidovudine.
For this reason ATV may be a preferable alternative to Aluvia in PI-naive older children in the private sector with adherence issues.
Aluvia tabs (LPV/r) refrigerated must be swallowed whole Kaletra[R] Oral Crushing the tabs reduces the Aluvia[R] solution absorption of the drugs should be Kaletra Solution and Capsules: refrigerated administer with food.
The registration and availability of the paediatric strength heat-stable LPV/r tablet (Aluvia
; 100 mg lopinavir/25 mg ritonavir) is still awaited, but it has been included.