double dose or missed dose - what's worse?

[walkingpoz]

just a hypothetical question:

in case i am not sure whether i have already taken my dose of isentress, is it worse to double dose or to miss a dose?

i take one isentress in the morning and one isentress + truvada in the evening.

thank you in advance

[mecch]

I never understood this but I'm going to ask my doctor in the next weeks when I see him.   I thought it makes sense to take your missed dose as soon as you remember you missed it, and then just take the next dose as scheduled.  The caveat being that makes sense if you are NOT yet at your next scheduled time.

 I dont see the point of double the amount of drugs taken at the same time, after a missed dose.  Hypothetically, it would seem the past is in the past, so if the level of drug has dropped, you can't correct the past by a double dose now.  Wouldnt the regular dose just return the drug level in your blood back to normal. Why could a double dose help? Seems like it would just put too much drug in circulation.   

[walkingpoz]

thanks for the answer, but i think you've got me a little wrong

i was talking about not remembering whether i have taken the pill or not. so i might have taken a pill but might as well have not taken a pill because i am just not sure. in that case (me being not 100% sure if i have taken my dose of isentress) should i just take an(other) isentress which could mean that i have then eventually taken two doses or should i not take an isentress which could mean that i have then eventually missed a dose of isentress in worst case scenarios.

[mecch]

I got you  pretty right. I  am on the same combo and as I dont pill count, though I should, and so should you, right? then we wouldn't be wondering - it does not make sense to me to double dose at any time.  Each prescribe dose is putting the right amount into the body, and a double dose is NOT going to correct the 12 hours in the past when the level may have dropped.  Right?

So you are also asking, what if you DID take that last dose.  Then there was no problem, so why double dose.....  And if you didn't, well the new double dose is not going to correct the past.   

So I am going to ask my doc about this as I said, and post back.  But I dont see him for two weeks.  In the meantime, I think more experienced people will pipe in here.

I think I have occassionally taken the truvada 12 hours apart instead of 24.  Or 36 hours apart, instead of 24. 

[mecch]

And thanks for asking.  Reminded me to start pill counting!!  My old ID told me I could take all 3 pills just once a day but my new ID told me to go back to the split dosing......

[leatherman]

since adherence needs to be >=95%, one shouldn't worry about a missed dose. And as meech pointed out, it seems pointless to double the med in your system. It's not like it'll fight HIV any harder just because you put more into your system. It's actually probably a lot more toxic doubling up the amount of HAART in one's system anyway

[vaguesbleues]

I remember trying to count pills when I first started taking Atripla (and at 1 pill a day, you'd think that'd be easier!).  I eventually just went to Walgreens and picked up one of those weekly pill boxes, one that has a slot for every day of the week.  That way, on Sunday I can put in the pills for the entire week.  It's very easy that way to tell if I've missed a dose when I wake up in the middle of the night and am debating "Did I take it?  Or no?"  The pill boxes are only a few bucks and save tons of worrying and time in having to count pills.