Switch Viramune to Stocrin?

[joemutt]

My Dr advised me to do this, but I see no reason. CD4 s etc are very good. He doesnt say why, he just said "shall i prescribe it now" and I said "Lemme think about it" (meaning : 'ask aidsmeds'  )
I m on Viramune (generic) and 3tc (generic) and Viread now. Is that still regarded as an ok combination or is it old hat? Thanks and 

[ARMANDO]

if the drug combo is working for you i dont understand why your doctor would want to change it?i'm really surprised that he is not worried about you becoming resistant to some of the drugs by doing this!!!

[thescot]

Joe,

I'll let someone with more experience using viramune / stocrin answer that one.
The alternative is a boosted PI. I currently use boosted Reyataz prescribes here in Thailand but it's still very expensive.

Finally to add ..... my doc at advises me that Truvada (original) will be available here later in the year which should drop the pill count by 2 if you decide to change.

TS

[trellium]

Stocrin/Sustiva (efavirenz) is once daily, whereas Viramune (nevirapine) is recommended twice daily.
The maker of Viramune is currently testing a new once daily formulation
http://clinicaltrials.gov/ct2/show/NCT00561925?term=VERXVE&rank=1

Personally I would ask doc the reasons for suggesting the switch before making a decision, or your labs indicate Viramune is affecting your liver enzymes/functions.
Stocrin/Sustiva is known to affect (↑ bad LDL,↓ good HDL) cholesterol and ↑ triglycerides more so than Viramune, but Stocrin/Sustiva has shown higher efficacy compared to Viramune in trial studies so that’s one of the reasons/trade-offs why it is listed as the preferred option.
 
I did ask doc about the option of me switching over to NNRTIs: Viramune or Sustiva after my Kaletra trial ends.
My doc will only advocate Sustiva and is quite adamant about switching to Viramune due to my current high CD4 numbers, unless I go psycho-shit on Sustiva ... I can always go back on Kaletra again.

Here is a somewhat related article about switching from Efavirenze to Nevirapine (just the opposite)
http://www.hivandhepatitis.com/recent/2006/ad1/120806_d.html

[J.R.E.]

Hi,

I would also question the doctor, and ask why he is insistant, on changing you over. I've been on Viramune, since October of 2003, I couldn't imagine a change of meds, unless the combination was beginning to fail, or other tests possibly indicated that a change was neccessary.  How's your liver function tests doing ?   


Take care----Ray

[J.R.E.]

By the way, I am on the non-generic Viramune, non-generic 3-tc, viread and Ziagen (abacavir)

The Epivir and Ziagen (abacavir) is taken in the once a day Epzicom. So, I am on Viramune, Epzicom and Viread.

Is your doctor getting a kickback from prescriibing Stocrin? I will be curious as to the answer/reason that he gives you.

Take care----Ray

[joemutt]

Thank you all for your answers. I will ask my doctor to explain this.
I'm good on viramune (though I take all my meds at the same time
not twice a day, again without any problems) My liverfunction is ok,
my cholesterol finally down , my cd4 1000-something. Also I'm pretty sure I wd suffer from Sustiva's secondary effects. He insisted,so I will ask him why and let you know. THANKS AGAIN.

[Tempeboy]

http://positivelife.org.au/factsheet/1

Viramune is just as effective against HIV as Efavirenz, and can be taken once a day, and Viramune dosn't cause nightmares, fatigue, hallucinations, depression, bad cholesterol, raised triglycerides, facial lipo, needs to be taken at night, can't be taken with food - ICK.  These side effects affect adherence, risking resistance to this entire group of drugs.

Also recent research demonstrates that Efavirenz dosn't penetrate the seminal vescicles as well as viramune, meaning that it dosn't translate to undectable viral load in semen, like viramune, and other drugs do.

But it's made in the USA.