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Q: Food with Kaletra
I'm thinking of making a change to Kaletra (from Crixivan). The dosing information from the Kaletra/Abbott site says to "take with food". I'm not sure what they mean by food...is that a cracker or is that a Big Mac Meal Deal? I can't seem to find anything on the Net that talks about that aspect. It has actually been easy for me to starve with the fasting periods for Crixivan and am worried that it will be harder for me to take the Kaletra with food. Thanks! (April, 2001)
(Administrator's Note: For those interested in what a "Crixivan diet" would look like, see Jennifer's Picnic Basket for her article Protease Perfection: Flawless Fasting, and for more general information on how and why some drugs work better with food and some without, see her article Feasting, Fasting & Side Effects.)
A: Charlie Smigelski, RD responds:
Kaletra is a protease inhibitor that includes a little bit of Norvir in it. Norvir is a drug that gives many people some stomach cramps and nausea, even in small doses. It also goes through about four break-down stages in the liver before it is eliminated from the body.
I often suggest that people have their liver in good shape for drug processing by taking some Designer Whey protein or two grams of NAC and a few grams of glutamine each day when they start the drug. (Reminder, I think people ought to be taking these amino acid supplements always, anyway. See the Q&A on Lypodystrophy for my recommended supplement regime to keep your liver healthy).
As for the food, people find that having 10 or 15 fat grams in some food they eat with their Norvir/Kaletra helps them avoid some of the stomach cramps. Sample food doses are:
Peanut butter and jelly sandwich
2 oz cheese and some crackers
2 scoops of ice cream
A handful almonds, walnuts or sunbflower seeds, & a piece of
fruit.
