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Fortovase Side Effects

Generic name: saquinavir

Medically reviewed by Drugs.com. Last updated on Sep 3, 2023.

Note: This document provides detailed information about Fortovase Side Effects associated with saquinavir. Some dosage forms listed on this page may not apply specifically to the brand name Fortovase.

Applies to saquinavir: oral tablet.

Serious side effects of Fortovase

Along with its needed effects, saquinavir (the active ingredient contained in Fortovase) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking saquinavir:

More common

  • chest pain
  • chills
  • cough
  • fever
  • increased amount of fat in the upper back and neck, or around the chest and stomach area
  • loss of fat from the legs, arms, and face
  • sneezing
  • sore throat
  • tightness in the chest
  • trouble breathing

Less common

  • blurred vision
  • cough-producing mucus
  • diarrhea
  • dry mouth
  • flushed, dry skin
  • fruit-like breath odor
  • general feeling of discomfort or illness
  • headache
  • increased hunger
  • increased thirst
  • increased urination
  • joint pain
  • loss of appetite
  • loss of consciousness
  • muscle aches and pains
  • nausea
  • runny nose
  • shivering
  • skin rash
  • sore throat
  • stomachache
  • sweating
  • trouble sleeping
  • unexplained weight loss
  • unusual tiredness or weakness
  • vomiting

Rare

  • burning or prickling sensation
  • confusion
  • dehydration
  • dry or itchy skin

Other side effects of Fortovase

Some side effects of saquinavir may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

  • back pain
  • belching
  • bloated or full feeling
  • change in taste
  • decreased interest in sexual intercourse
  • difficulty having a bowel movement
  • discouragement
  • excess air or gas in the stomach or bowels
  • fear
  • feeling sad or empty
  • headache
  • heartburn
  • inability to have or keep an erection
  • indigestion
  • irritability
  • lack of appetite
  • loss in sexual ability, desire, drive, or performance
  • loss of interest or pleasure
  • mouth ulcers
  • nervousness
  • pain or tenderness around the eyes and cheekbones
  • passing gas
  • skin rash, encrusted, scaly, and oozing
  • skin warts
  • stomach upset, discomfort, or pain
  • stuffy nose
  • tiredness
  • trouble concentrating
  • weakness

For healthcare professionals

Applies to saquinavir: oral capsule, oral tablet.

General

Nausea, vomiting, diarrhea, fatigue, flatulence, and abdominal pain have been reported the most frequently with this drug (plus ritonavir). Additional side effects have been reported during postmarketing experience that were similar to those observed in clinical trials with saquinavir (the active ingredient contained in Fortovase) mesylate and saquinavir soft gel capsules alone or in combination with ritonavir.[Ref]

Gastrointestinal

Metabolic

Antiretroviral therapy:

Protease inhibitor therapy:

Diabetes mellitus/hyperglycemia was sometimes associated with ketoacidosis during postmarketing experience.

Redistribution/accumulation of body fat has been reported with antiretroviral therapy; causality has not been established.[Ref]

Hematologic

Protease inhibitor therapy:

Increased bleeding (including spontaneous skin hematomas and hemarthrosis) in patients with hemophilia type A and B has been associated with protease inhibitors. In many of the reported cases, treatment with protease inhibitors was continued or restarted and some patients required additional factor VIII. A causal relationship between protease inhibitor therapy and these episodes has not been established.[Ref]

Hepatic

There have been reports of worsening liver disease in patients with underlying hepatitis B or C, cirrhosis, chronic alcoholism, and/or other underlying liver abnormalities.

Severe hepatocellular toxicity (which presented as increased hepatic transaminases) occurred in healthy subjects exposed to this drug (plus ritonavir) and rifampin. Transaminases increased up to more than 20-fold the upper limit of normal in some patients and were associated with GI symptoms (including abdominal pain, gastritis, nausea, vomiting). Clinical symptoms resolved and hepatic transaminases returned to normal after all 3 drugs were stopped.[Ref]

Cardiovascular

This drug (plus ritonavir) showed a dose-dependent prolongation of the QT and PR intervals.[Ref]

Other

Antiretroviral therapy:

Respiratory

Dermatologic

Nervous system

Psychiatric

Musculoskeletal

Combination antiretroviral therapy:

Protease inhibitor therapy:

Hypersensitivity

Renal

Ocular

Immunologic

Genitourinary

Oncologic

Endocrine

References

1. (2001) "Product Information. Invirase (saquinavir)." Roche Laboratories

2. Cerner Multum, Inc. "UK Summary of Product Characteristics."

3. Kakuda TN, Falcon RW (2006) "Effect of Food and Ranitidine on Saquinavir Pharmacokinetics and Gastric pH in Healthy Volunteers." Pharmacotherapy, 26, p. 1060-8

4. Modjtahedi BS, Modjtahedi SP, Maibach HI (2006) "Gender: a possible determinant in dosing of dermatologic drugs--an overview." Cutan Ocul Toxicol, 25, p. 195-210

5. Ribera E, Azuaje C, Lopez RM, et al. (2007) "Pharmacokinetic interaction between rifampicin and the once-daily combination of saquinavir and low-dose ritonavir in HIV-infected patients with tuberculosis." J Antimicrob Chemother, 59, p. 690-7

6. EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid

7. Warnke D, Barreto J, Temesgen Z (2007) "Antiretroviral drugs." J Clin Pharmacol, 47, p. 1570-9

8. Cerner Multum, Inc. "Australian Product Information."

9. (2009) "Drugs for HIV infection." Treat Guidel Med Lett, 7, p. 11-22

10. Gill MJ (1998) "Safety profile of soft gelatin formulation of saquinavir in combination with nucleosides in a broad patient population." AIDS, 12, p. 1400-2

11. Figgitt DP, Plosker GL (2000) "Saquinavir soft-gel capsule - An updated review of its use in the management of HIV infection." Drugs, 60, p. 481-516

12. (2001) "Product Information. Fortovase (saquinavir)." Roche Laboratories

13. Anderson PL (2004) "Pharmacologic perspectives for once-daily antiretroviral therapy." Ann Pharmacother, 38, p. 1969-70

14. von Hentig N, Muller A, Rottmann C, et al. (2007) "Pharmacokinetics of saquinavir, atazanavir and ritonavir in a boosted double-protease inhibitor twice-daily regimen." Antimicrob Agents Chemother, 51, p. 1431-9

15. Panel on Antiretroviral Guidelines for Adults and Adolescents (2015) Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf

16. Melbourne: Therapeutic Guidelines Limited (2015) eTG complete [Online] http://online.tg.org.au/complete/desktop/tgc.htm

17. AIDSinfo. NIH. National Institutes of Health (2016) Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. https://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf

18. Carr A (2000) "HIV protease inhibitor-related lipodystrophy syndrome." Clin Infect Dis, 30, s135-42

19. Lotsch J, Harder S, Geisslinger G, et al. (2007) "Association of saquinavir plasma concentrations with side effects but not with antiretroviral outcome in patients infected with protease inhibitor susceptible HIV-1." Antimicrob Agents Chemother, 51, p. 3264-72

20. Cameron DW, Becker S, King MS, et al. (2007) "Exploratory study comparing the metabolic toxicities of a lopinavir/ritonavir plus saquinavir dual protease inhibitor regimen versus a lopinavir/ritonavir plus zidovudine/lamivudine nucleoside regimen." J Antimicrob Chemother, 59, p. 957-63

21. Zorrilla CD, Van Dyke R, Bardeguez A, et al. (2007) "Clinical response and tolerability to and safety of saquinavir with low-dose ritonavir in human immunodeficiency virus type 1-infected mothers and their infants." Antimicrob Agents Chemother, 51, p. 2208-10

22. FDA. U.S. Food and Drug Administration (2010) FDA drug safety communication: Ongoing safety review of Invirase (saquinavir) and possible association with abnormal heart rhythms. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm201221.htm

23. Biondi L (2010) Health Canada endorsed important safety information on Invirase (saquinavir mesylate). http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medeff/advisories-avis/prof/2010/invirase_hpc-cps-eng.pdf

24. Silva M, Skolnik PR, Gorbach SL, Spiegelman D, Wilson IB, FernandezDiFranco MG, Knox TA (1998) "The effect of protease inhibitors on weight and body composition in HIV-infected patients." AIDS, 12, p. 1645-51

25. Martinez E, Mocroft A, GarciaViejo MA, PerezCuevas JB, Blanco JL, Mallolas J, Bianchi L, Conget I, Blanch J, Phillips A, Gatell (2001) "Risk of lipodystrophy in HIV-1-infected patients treated with protease inhibitors: a prospective cohort study." Lancet, 357, p. 592-8

26. GarciaSilva J, Almagro M, Juega J, Pena C, LopezCalvo S, delPozo J, Fonseca E (2000) "Protease inhibitor-related paronychia, ingrown toenails, desquamative cheilitis and cutaneous xerosis." Aids, 14, p. 1289-91

27. Roling J, Schmid H, Fischereder M, Draenert R, Goebel FD (2006) "HIV-Associated Renal Diseases and Highly Active Antiretroviral Therapy-Induced Nephropathy." Clin Infect Dis, 42, p. 1488-95

More about Fortovase (saquinavir)

Patient resources

Other brands

Invirase

Professional resources

Other brands

Invirase

Related treatment guides

Further information

Fortovase side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.