Are there any other precautions or warnings for this medication?
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 this medication.
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 this medication, your doctor will monitor your heart rhythm regularly with a test called an electrocardiogram (ECG). You should not take this medication 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, droperidol, pimozide, gatifloxacin, moxifloxacin, mefloquine, pentamidine, arsenic trioxide, probucol, 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 this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Cholesterol: This medication 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 this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is required.
Fat redistribution: Over time, this medication 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 this medication. If you have hemophilia, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Immune reconstitution syndrome: This medication 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. If you are taking saquinavir, your doctor may request that you have regular liver function tests. People with 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 this medication (See "What medications can interact with this medication?"). 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 this medication?"). Saquinavir should never be used on its own and should always be used in combination with ritonavir and other HIV medications.
Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, 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 this medication have not been established for children younger than 16 years of age.