Switching Atripla to Truvada/Isentress on day 3?

[freaky_dream]

Hey guys I just recently started my meds and chose Atripla without thinking of the consequences. I have a job where I have to get up at 4 am to be at work by 5 and the Atripla hangover isn't going to allow me to drive my car to work. Now I need to switch ASAP as I don't have the luxury of taking a couple weeks off work while my body sorts Atripla out. Is it safe to do a quick change from one regimen to another when just starting off or should I just tough it up and wait till I am undetectable? I don't want to endanger myself and others by crashing my car while driving to work.

If I it's not recommended to make the change so abruptly then I am going to have to take the pill very early in the evening.

[Inchlingblue]

You should be able to just switch from one to the other.

If I were you I would not just stop taking Atripla without starting the other combo since this can lead to resistance, especially since you likely still have a viral load.

Have you talked to your doctor already?

If you have leftover Atripla, there are people on here who might need it or there is a great organization that supplies HIV meds to developing countries:

www.aidforaids.org

[mecch]

Excuse me, but what does your doctor have to say about this? No direction and no preparation on fitting your HAART choice to your lifestyle needs? 

Seems strange, to me, to start and already need to switch - and if you do need to switch, seems like a doctor should be advising you.

[freaky_dream]

Yeah I don't plan on just stopping out right. Called the clinic but they gave me the run around and ended up making me leave a message with the triage nurse which means no is going to returns my call. I am going to show up in person tomorrow and get this sorted. Fuck can't wait till my private insurance kicks in. And yes I do plan on donating my left over Atripla, they actually have a drop off there at the clinic.

It's a free clinic so instead of getting my usual doctor, who happens to be one of the best in the area, they stuck me with the new guy doing his residency. He is pretty inexperienced and I get the feeling the staff themselves hold unfavorable opinions about him but I take what I get since it is free. He doesn't know what questions to ask his patients and seemed to not be very knowledgeable (he's new so I will cut him some slack).

Mecch you are right I should be asking the doctor however I honestly do not trust this new guy at all. Yes call me weird but I put more credence and faith into the advice of those on this board who have been dealing with this disease for a long time.

Thanks Inchling! I just hope I can get this squared away before I start work on Friday my brain is completely fried right now.

[phildinftlaudy]

Hey Freaky -
Have you tried taking your dose at a different time?  Most of the effects (dizziness, etc) fade after a week or so at the most --- I've been on it for about 8 months - I take around 11 -- after the first week I didn't really get any dizziness - and even when I did have it early on, it wasn't too bad - I am starting to move the time up now because it is causing some insomnia --- but I pretty much can take it and not get tired, not get dizzy or anything.  Only real effect I get is if I eat right before I take it - then I usually get the dreams (once I do fall asleep).  Maybe try to take the dose at a different time that is more agreeable with your life schedule.  Just a thought.  At any rate - let us know how it goes w/ the doc.

[mecch]

Yes it seems to me you should immediately switch to taking it sometime soon after you finish work, when you are home safely.
The hangover will resolve quickly I would expect.
If this is your first HAART experience, I would guess that any combo will ask your body for a little adjustment time, so switching to Isentress may not make much of a difference. 
Hang in there.

[phildinftlaudy]

I found that the "hangover" effect early on was reduced substantially if I made sure that I was drinking plenty of water.  Most people don't drink enough water as it is -- and I am a believer that people with HIV definitely need to make sure that they keep their water consumption up there (even when not thirsty I drink it).

[freaky_dream]

Currently I take the pill before bed at around 10 pm and the hangover lingers pretty much all day the next day and doesn't let up until probably an hour two before my next dose. I plan on taking it very early tonight at around 8 so the hangover lets up a little earlier tomorrow. I wish I could let my body get used to it as suddenly changing meds is not a good practice but If I don't do something about it I won't be able to go to work at all. On my work nights I typically only sleep at the most 6 hours. I tried getting myself up early this morning to take care of some business at the DMV but slept straight through the alarm in my Atripla haze. Thanks Phil I will try the water thing and see how it goes tomorrow morning.

[phildinftlaudy]

Currently I take the pill before bed at around 10 pm and the hangover lingers pretty much all day the next day and doesn't let up until probably an hour two before my next dose. I plan on taking it very early tonight at around 8 so the hangover lets up a little earlier tomorrow. I wish I could let my body get used to it as suddenly changing meds is not a good practice but If I don't do something about it I won't be able to go to work at all. On my work nights I typically only sleep at the most 6 hours. I tried getting myself up early this morning to take care of some business at the DMV but slept straight through the alarm in my Atripla haze. Thanks Phil I will try the water thing and see how it goes tomorrow morning.

No problem Freaky - it is definitely an adjustment and I understand the issue you are having.  Really "OD" on the water - I typically only get about 6 hours of sleep on work nights also.  Hopefully, the water will help offset some of the effects.  I also drink a cup of coffee on the way to work and that also gets me going - because I do have the morning grogginess on work days.

[Inchlingblue]

I'm on Isentress Truvada and it's great but remember that Isentress is twice a day and has a low barrier to resistance meaning you need to be vigilant about not missing any doses, especially in the beginning while you still have a viral load.

[freaky_dream]

Saw the doctor today and he hesitantly changed my regimen to Truvada/Isentress. He didn't want to prescribe it to me due to the perception that Isentress is still seen by most as salvage treatment even if it's been approved for front line treatment. He wanted to do prestiza/reyataz/norvir but I relented as I didn't like the side effect profiles of of the last two so I said no thanks! Will start taking my taking Isentress tonight at 10. My head's still in the clouds and my apetite is pretty shot right now, lost 3 pounds this past week ugh. Anyways thanks all for the words of advice.

[Inchlingblue]

It should go fine, keep us posted on the progress.

So your evening dose will be Isentress/Truvada and your morning dose will be just Isentress, right?

[freaky_dream]

Yes it will be. I would rather have taken the Truvada with the morning dose but since I last took Atripla at night I don't want there to be 36 hour gap from my last Truvada dosage especially since I have just started taking meds.

Oh and the doctor seemed a lot more confident this time around, guess he is settling in to his job.

[newbieguy]

Saw the doctor today and he hesitantly changed my regimen to Truvada/Isentress. He didn't want to prescribe it to me due to the perception that Isentress is still seen by most as salvage treatment even if it's been approved for front line treatment. He wanted to do prestiza/reyataz/norvir but I relented as I didn't like the side effect profiles of of the last two so I said no thanks! Will start taking my taking Isentress tonight at 10. My head's still in the clouds and my apetite is pretty shot right now, lost 3 pounds this past week ugh. Anyways thanks all for the words of advice.

This is partly why I stopped taking Reyetaz/Norvir/Truvada combo because I felt it was a bit harsh for someone with my good numbers and also the side effects that I experienced and also heard about. I am going to ask to try Atripla or possibly Truvada/Issentress. Best of luck to you.

[max123]

It should go fine, keep us posted on the progress.

So your evening dose will be Isentress/Truvada and your morning dose will be just Isentress, right?

inch, isn't it advised that truvada/isentress be taken in the morning, and isentress again at night to avoid any potential for sleep disturbance from the truvada?

[Billy B]

inch, isn't it advised that truvada/isentress be taken in the morning, and isentress again at night to avoid any potential for sleep disturbance from the truvada?

This was the recommendation of my IDS and the schedule I follow.
Billy

[freaky_dream]

Just thought I would give an update on where I stand. Been doing great on the new regimen and saw the doctor for my regular check up today. He commented on how much better I looked then before and I ended up gaining back some of the weight that I had lost. The swollen lymph nodes in my neck have finally gone back to normal. Only concern is that I am sleeping a little too deeply as of late. I have slept through two alarms and was late to work an hour twice last week so we decided to move my Truvada dosage to the morning. Strangely enough I don't feel groggy or anything which is rather strange.

[Billy B]

Just thought I would give an update on where I stand. Been doing great on the new regimen and saw the doctor for my regular check up today. He commented on how much better I looked then before and I ended up gaining back some of the weight that I had lost. The swollen lymph nodes in my neck have finally gone back to normal. Only concern is that I am sleeping a little too deeply as of late. I have slept through two alarms and was late to work an hour twice last week so we decided to move my Truvada dosage to the morning. Strangely enough I don't feel groggy or anything which is rather strange.

As I stated eariler my IDS told me to take the Truvada in the AM. You body was beat up by Atripla and sleep is GOOD so go to bed eariler if you can. 
Billy

[beefbud]

I found that the "hangover" effect early on was reduced substantially if I made sure that I was drinking plenty of water.  Most people don't drink enough water as it is -- and I am a believer that people with HIV definitely need to make sure that they keep their water consumption up there (even when not thirsty I drink it).

I work out avidly and drink over a gallon of water a day.  The Efavirenz in Atripla did not get along and fucked with me big time!  Everyone is different and I wish that I was smart enough to switch from Atripla to Truvada/Isentress as quickly rather than dealing with 9 months of shit!

[freaky_dream]

Just to give an update. Had my labs done at the end of July and went back mid August. The results came back undetectable after only being on the regimen for 2 weeks. Didn't get a viral load prior to starting however my VL usually hovers between 30-50k. My ID was pretty elated at the news. Got to admit I feel a whole lot better now that I am on meds. The twice a day thing is kind of pain, hopefully once a day isentress will get approved soon.

[eric48]

2 weeks ? that was fast!

congrats!

Eric

[newbieguy]

I was hoping maybe I would adjust to the atripla but im feeling really groggy and sleepy everyday like I just wanna sleep for hours even after I wake up. I know this isnt natural. There have been good days but all in all I think the sustiva isnt going to be my friend lol

[eric48]

Hi,

I know thisi is a bit off topic, but you sign: Stopped due to anxiety issues.

I have this problem too. But, I recognize them as anxiety that will hopefully fade. What makes me anxious is a possible drug failure (resistance...). I guess switching because of stress due to fear of failure would be an inadequate route...

What were your anxiety issues ? did change of med help?

Thanks

Eric

[newbieguy]

Hi yea when I started my first treatment regimen (rey/nor/truv) I was scared to have to take threee pills a day and couldnt seem to wrap my head around that prospect. However, physically I seemed to do ok on them. Im almost two weeks into atripla, and its been ok but I just feel very tired and groggy every day like I want to sleep all the time. Physically I feel worse and run down. So not sure what to do now. I dont have anxiety about HIV meds anymore, I honestly feel maybe truvada/isentress might be better for me because I HAVE to be fresh in the mornings an cant be a zombie all day.