Switching from Atripla to Truvada + Raltegravir

[ElZorro]

I've been on Atripla for just shy of a year and have been having a lot of issues relative to sleep quality, mood swings, and inability to concentrate. I've been hesitant to change because it's worked so well, but, as a programmer/software architect, the inability to "focus" was just becoming too much to deal with (within about two hours of taking the pill, I'd have to basically "give up" trying to design any complex code). I met with my ID doc today and we/she decided to switch from Atripla to Truvada + Raltegravir. She indicated that others have made the same switch and "generally tolerated" it very well.

Atripla was great as a once daily treatment and I have been 100% adherant, but I figure I can be just as adherant to having to taking pills twice daily.

Can anyone else who has made the same switch let me know how it worked out for them? Specifically, I'd be interested in knowing:

1) are you glad you made the switch?
2) any side effects you experienced from the Raltegravir and how long they lasted or if they never went away.
3) any adherance challenges?


Also, if there is anyone in the Tampa area, I have some unopened Atripla that I want to donate but am not sure where to donate it...

Thanks!

[Rev. Moon]

Zorrito,

Not much to say about the side effects of your new regimen.  I have however read that it is tolerated quite well, and that those switching to it from Atripla really love the change.  Good luck and health now that you're moving on (the number of pills is just that, a number).

[ElZorro]

Thanks, Rev...that's the way I look at it...3 pills instead of 1...IF it means I get to return back to my pre-HIV self (mentally), I'd gladly take as many pills as they feed me 

[ElZorro]

Well, today is day 3 of the new meds and all I can say is "woo hoo"!  Thanks to everyone who sent me information about the switch. I finally feel more like my old (pre-HIV) self.

I hope this regimen works as well as the Atripla did because I haven't felt this great since I started HAART last December. I feel like I have more energy and have been sleeping like a baby.

Here's to hoping that being on meds for this "manageable" chronic illness doesn't mean a change in quality of life!

[numbersguy82]

Congrats EZ! I'm glad to hear that your change has thus far proved to be a positive one. You will have to keep us posted on how its going... now what will you do with all that renewed mental clarity and energy???

[ElZorro]

Congrats EZ! I'm glad to hear that your change has thus far proved to be a positive one. You will have to keep us posted on how its going... now what will you do with all that renewed mental clarity and energy???

Thanks, Numbers. Today, I'm going to use some of that energy to go play poker at the local casino.   

[AboutToStart]

Hi E-Z,

I'm about to do the same switch you did tomorrow morning (I just picked Nov 1st as a cutoff date).

Did you just take your last Atripla one night and then started Truvada + Isentress the next morning, plus another Isentress at night? What hours intervals you keep between your meds? Did you experienence any side effects while first days of switch? Are you completely satisfied so far with the switch?

Thanks!

[ElZorro]

I can't say enough good about my switch (knock on wood). If this works for a loooong time, I'm going to be one very happy camper (thank you, Mark!  ) . In fact, I've recommended to my doctor that she have discussions with others on Atripla and make them aware that the CNS side effects do not have to be tolerated just for convenience sake.

Originally, I was going to skip the Atripla the night before since I had never missed a dose prior and went undetectable very quickly, but then I thought "why get cocky"? So, I ended up taking the Atripla a couple hours later than normal, around 10 pm.  I woke in the morning and took the two pills around 8 am

Your mileage may vary, but I hope it's the same. Good luck and keep us posted so others who find this thread will be informed!

[AboutToStart]

Thanks for your reply. I'm def. looking forward to try the switch. I can't really say that I'm having problems concentrating or mood swings.. I do have serious fatigue issues but even that I'm not sure if it's the atripla to blame (I had severe obstructive sleep apnea issues that I took care of. It had improved significantly but not completely, so I am not really sure why I'm so fatiggued now, but I'll find out once I make the switch..)

So did you have any side effects what so ever the first few days or was it just a walk in the park? And also - are there any major "No-No's" you're aware of with the Isentress like there are with the atripla (like no food with meds, certain herbs/roots/vitamins to be avoided etc) or am I free now to do whatever I want to??

[ElZorro]

So did you have any side effects what so ever the first few days or was it just a walk in the park? And also - are there any major "No-No's" you're aware of with the Isentress like there are with the atripla (like no food with meds, certain herbs/roots/vitamins to be avoided etc) or am I free now to do whatever I want to??

I'm not aware of any "no-no's" but that's a question best answered by your doctor & pharmacist. I have read that St John's Wort can affect some HIV drugs but I don't know if this combo is one of them. The only other things I take are a mult-vitamin, an aspirin, and omeprazole for acid reflux and there are no contradictions there. Again, ask your doctor about that.

I, too, was not sleeping very well and felt tired throughout the day. My doctor and I suspected those could be caused by mild depression which I attribute to a CNS side effect. Melatonin helped sometimes, but I never woke up feeling "refreshed" or "fully-recharged". Now, I sleep like a baby and wake up feeling like a new man.

As to side-effects, my pharmacist had warned me that I would have "loose stools" as a result of the Atripla and he was absolutely correct. Those went away on the T+I, and if anything, I'm a bit more constipated than I was for the previous year. I suspect, though, that what I'm deeming to be constipation is actually a return to normalcy  

edited to add: you can take these meds with or without food. The Atripla recommendation to "take on an empty stomach" does not apply.

[AboutToStart]

BTW, I also have a full bottle of Atripla left over, but I'm still holding on to it, at least for the first month before donating it. If for some reason the new Isentress/Truvada combo won't work for me - my Dr. says I can always go back to previous combo, no bridges burned..

[AboutToStart]

BTW 2: I agree the larger number of pills a day with the new combo (3 Vs. 1) is just that - a number. And with 100% adherence I had with the Atripla in the past year I've been taking it I expect the same after the switch. However, I do travel a lot for work, sometimes unexpectedly, and the amount of pills I'm gonna have to carry with me around now will triple.. It was pretty nice to always have a couple of Atriplas in my wallet or in my pocket that would get me going for a day or two in case of an unexpected pop-up.. now the challenge would be the larger amount of pills to have readily available at any time.. I hope it won't be much of a hardship..

[ElZorro]

BTW 2: I agree the larger number of pills a day with the new combo (3 Vs. 1) is just that - a number. And with 100% adherence I had with the Atripla in the past year I've been taking it I expect the same after the switch. However, I do travel a lot for work, sometimes unexpectedly, and the amount of pills I'm gonna have to carry with me around now will triple.. It was pretty nice to always have a couple of Atriplas in my wallet or in my pocket that would get me going for a day or two in case of an unexpected pop-up.. now the challenge would be the larger amount of pills to have readily available at any time.. I hope it won't be much of a hardship..

I was (still am?), a bit nervous about a) not having my pills handy because of my travel schedule and b) paranoid about carrying a pill case or something that might prompt someone to ask me what "the pills" are for. I found that I could fit four Atripla pills very neatly into a contact lens case (the one with the screw on lids) which fits very nicely into my front pocket and has never so much as raised an eyebrow when I've pulled it out (e.g. going through airport security with colleagues)  Now, I can carry a single day's meds in the same case. I also have several stashed into a traditional pill holder that remains in a pocket of one of my laptop bags.  

[surf18]

i do the pill case. i have always taken tons of supplements so now i add the three pills a day to the case. which is easy for the morning dose, but the night time dose since the selzentry is the only pill i take at night that is time sensitive,i keep one in my wallet. and then when i get home and take my night time supps i take out my selzentry and put it in my wallet to replace the one that was there.