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Norvir Advisory
Preparing One's Own Gel Caps
from Presentation 4, Norvir Community Update
QUESTION: One of the ideas that is circulating both on the Internet and throughout the
community is to take an eye dropper and fill purchased gel caps with the liquid and then
take them. That bypasses the taste issue. The problem is that we know what the absorption
in the oral mucosa is when we take these gel caps that particular way. Is there a difference
in the absorption rate in the stomach or in the intestines, when taking the oral medication
through these gel caps? Most people with HIV do not have the acidity in their stomach that
may be necessary to dissolve the gel caps. Should they be taking, some kind of acidic juice
along with it to help that? We dropped the gel caps in Ensure and it dissolves very slowly.
We dropped them in vinegar and they dissolved immediately. Are you going to be doing
any studies or giving some information so that people can use alternative ways to take the
oral medication?
JAPOUR: We have not directly studied that specifically, but it's something that we have
also thought of. Various AIDS physicians have also thought about it and have had their
patients use these gel caps in cases when they can't tolerate the liquid. Although we don't
have any definitive answer, most physicians will tell you that, since they're gelatin caps, they
will dissolve in the stomach. And as long as the correct amount of liquid is put in, then it
should be fine.
To answer the question from the physician from South America who was asking about
instructing patients - one of the ways you might do it is to have them come into your office
the first time with the bottle of liquid and show them or have a nurse show them that this
is the line that you need to go for the dose that you're on, the 400 milligrams versus the 600
milligrams. We can't currently make any changes to the cup, but we are exploring what we
can do to make it more legible so that people know what they're doing.
Posted 12/28/98
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