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Lesson The Importance of Adhering to Your Treatment Regimen
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Which are the easiest drug combinations? (A look at fewer pills and once-a-day dosing)

Companies have responded to the demand for HIV drugs that require fewer pills, taken fewer times a day. Many newer drugs were developed with simplicity in mind, and many older drugs have been redeveloped to allow for easier dosing. It's also becoming more common to see two or more different drugs combined into a single tablet or capsule.

Drugs that now require fewer pills
(officially approved by the U.S. Food and Drug Administration)
Drug Before Now
Epivir (lamivudine, 3TC) 2 pills a day 1 pill a day
Kaletra (lopinavir/ritonavir) 6 pills a day 4 pills a day*
Rescriptor (delavirdine) 12 pills a day 6 pills a day
Retrovir (zidovudine; AZT) 6 pills a day 2 pills a day
Sustiva (efavirenz) 3 pills a day 1 pill a day
Videx & Videx EC (didanosine; ddI) 4 pills a day 1 pill a day
Viracept (nelfinavir) 10 pills a day 4 pills a day
*Kaletra tablets (approved October 2005), compared to older Kaletra capsules

Medications Containing More Than One Drug
Drugs used individually # pills a day Combination Name # pills a day
Lopinavir & Norvir (ritonavir)* N/A* Kaletra 4
Retrovir (AZT) & Epivir (3TC) 4 Combivir 2
Retrovir (AZT), Epivir (3TC), & Ziagen (abacavir) 6 Trizivir 2
Sustiva (efavirenz), Viread (tenofovir DF), & Emtriva (emtricitabine) 3 Atripla 1
Ziagen (abacavir) & Epivir (3TC) 3 Epzicom 1
Viread (tenofovir DF) & Emtriva (emtricitabine) 2 Truvada 1
*Lopinavir has never been available for use, alone, without the addition of Norvir. As a result, it is not known how many
pills of lopinavir and ritonavir would have been necessary if they were to be used together as individual drugs.

Most companies have studied whether or not their drugs can be used once a day, and it turns out that a number of them can, at least in people who are just starting HIV treatment (twice-daily dosing generally achieves higher blood levels of a drug, which may be necessary to treat drug-resistant HIV).

Following is a list of once-a-day drugs:

Atripla (Sustiva + Viread + Emtriva)*
Lexiva (fosamprenavir), combined with Norvir (ritonavir)*—only for HIV-positive people starting a protease inhibitor for the first time.
Kaletra (lopinavir/ritonavir)*—only for HIV-positive people starting treatment for the first time.
Reyataz (atazanavir)*
Sustiva (efavirenz)*
Epivir (lamivudine)
Emtriva (emtricitabine)
Videx EC (didanosine)
Ziagen (abacavir)
Epzicom (Ziagen + Epivir)
Truvada (Viread + Emtriva)*
* These once-daily drugs are listed as preferred options for HIV-positive people starting treatment for the first time
by the U.S. Department of Health and Human Services. Reyataz is preferred only when combined with low-dose Norvir.

If you are interested in starting or switching to a once-daily drug or a once-daily drug regimen, be sure to discuss the possibility with your health care provider.


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Last Revised: December 18, 2007

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