The standard dose of Fuzeon is 90 mg,whichisinjected into the upper arm, thigh or abdomen after being “reconstituted,” or mixed with sterile water, twice a day. It is important to rotate the injection site with each dose.

Evaluation: Fuzeon was approved by the FDA in March, 2003. Fuzeon represents a new class of HIV drugs: It is a “fusion inhibitor,” which means that it prevents HIV from fusing with your t-cells.

Fuzeon gives those who have developed resistance to other HIV drugs a second chance. The drug was not tested on newly diagnosed patients, but instead tests were conducted among long-term HIV patients who had taken an average of a dozen anti-HIV drugs in the past. Those who added Fuzeon to a multiple-drug regimen selected by their doctor were much more likely to have increased T-cell counts and undetectable viral loads than those who did not.

There are drawbacks to the drug, however. For one thing, it doesn’t come in pill form. It is an injectable medication, which means that those who take it have to give themselves two shots a day. The process of “reconstituting” the drug—mixing it with sterile water before you inject it—is time-consuming and has to be done just right. Many people have an adverse reaction at the injection site. And because the drug is very difficult to manufacture, it is very expensive—reportedly as much as $25,000 for a year’s supply.

When Fuzeon was first approved it was expected that demand would far exceed supply—but that hasn’t happened so far. Many people have had trouble getting reimbursement for the drug through ADAP or Medicaid, and others are reluctant to use an injection drug. It is still a valuable resource for those who have run out of other options.