tivicay and truvada

[Everlasting37]

Hello,
In January of this year, 2014, my Dr changed my regimen from truvada, reyetaz and novir because I was having too much indigestion.  He then put me on truvada and tivicay.  I tolerated it well until just last week when I broke out in a rash all over my arms, neck, abdomen and back. Apparently, this meant I was allergic to the tivicay.  I called my Dr, he told me to stop it immediately. He's put me on steriods for 5 days to treat the rash. At this point, he's not sure what regimen to put me on, I'm going back to see him next week for a possible new regimen.  Has any one of you had an allergic reaction to tivicay? If so, what regimen did your Dr started you on after the reaction? Thank you.

[GoForIt]

Tivicay has been working for me with no side effects.  My doctor says almost no one has any side effects with Tivicay and he has led in some of the trials with it and has seen it is more effective and causes less side effects than any of the other treatments (He says).

So it would be interesting if it really was the Tivicay causing that rash or something else.  The two side effects that were most common were Headache and Insomnia...haven't heard of a Tivicay rash from anyone yet.

I'm not really sure about what you could switch to but I know that other than Tivicay it seems the other top therapy choices are Complera and Stribild.  Might want to do some research on those or ask your doctor?

[NycJoe]

I have been on Tivicay and Truvada since December and I love it.  I had switched off from Atripla.  The first week I had headaches but then they went away.  My first set of labs my T-cell count went up even more than it has been in years.  The only thing in my blood work was my creatinine serum went up a little bit.  My doctor attended a medical conference on Tivicay and that this is normal and my kidney function is good.

Joe

[Everlasting37]

Thank you GoForit and NycJoe for replying. My Dr did tell me I was the only patient that has had a rash after taking tivicay, although, he said he had just starting prescribing it a few months ago. However, I read that among the people who took tivicay during clinical trials, there were only 1% of patients that developed sensitivity to it and those 1% had a rash. Could I be one of those patients in the 1%? Possibly.

I have been positive for 15 years and have been on different regimens over the years. I have never had any rash or anything remotely close so, this really baffles me. I am upset that this happened, because this regimen seemed to be one of the easiest.

Hopefully, my Dr. will have me on something that I can tolerate with little side effects.

Thank you all again!

[surf18]

Were watching me now on it. Liver tests went up from one month test on this drug.
Dr said liver was some of the draw backs on this drug, though I hadnt heard that.
Would suck if I cant use this amazing drug.

[xinyuan]

Just got switched to this regimen today.

I find it strange for OP's case. Most drug rashes start 1-2 weeks after being exposed to a new med. If OP started in January, then the rash appeared well past a month or so. Still, stranger things can happen.

I was unlucky enough to get a Stribild rash. Praying there's not a cross-reaction with Tivicay. If so, I'd be even more unlucky to be a case report.

Will know soon enough.

[eric48]

@ everlasting

Is this you first Integrase Inhibitor ?

Eric

[Everlasting37]

@eric48

Yes. However, I've been on protease inhibitors like viracept in the beginning. I was on reyataz and norvir recently beforer it was changed to the tivicay.

I have my fingers crossed until next week to see what regimen my Dr will come up with.

Thanks,

Jan.

[Bizkits]

Hi, I'm not trying to hijack your thread at all, but this is definitely of interest to me. I am tentatively supposed to start meds at my next appointment 04/14. My doctor told me that she is considering Truvada/Tivicay as a regimen. She also mentioned Truvada/Issentress, atripla or possibly stribild but she has to find out genotype first. She said she'll guide me in the right direction but I do have a say so too for several reasons. 

Being as how I will likely have an input in what I start on, can I ask what in everyone's opinion/experience are the true ups and downs? I'm sure each regimen has it's risks, side effects and potential long-term effects...but seriously...is there a low down?

[eric48]

This thread demonstrate that 2 pills combos
Offer more flexibility at iniation
E.g. : if on strib. But have issue w/ TNF you have to switch away from Truv AND EVG

Once daily is cool
One or 2 pill makes little difference

Mob.eric

[GoForIt]

Hi, I'm not trying to hijack your thread at all, but this is definitely of interest to me. I am tentatively supposed to start meds at my next appointment 04/14. My doctor told me that she is considering Truvada/Tivicay as a regimen. She also mentioned Truvada/Issentress, atripla or possibly stribild but she has to find out genotype first. She said she'll guide me in the right direction but I do have a say so too for several reasons. 

Being as how I will likely have an input in what I start on, can I ask what in everyone's opinion/experience are the true ups and downs? I'm sure each regimen has it's risks, side effects and potential long-term effects...but seriously...is there a low down?

My doctor says the best combo is Tivicay & Epzicom (Only if you are not allergic to Epzicom).  A low percentage of people are allergic to Epzicom and it can be found out in a simple lab test.  Results take a week or so. 

Unfortunately my lab came back saying I am allergic to Epzicom because I have the gene proven to be allergic.  So instead of Epzicom I am using Truvada with Tivicay.  (2 pills)

Truvada and Epzicom both work just as well with the Tivicay but a new formula is coming out very very soon containing the Tivicay & Epzicom in 1 pill. 

So, if you want the ease of 1 pill a day.  Tivicay & Epzicom would be a good start so that you could switch from the 2 pills a day to just one a day once it comes out....only if you are not allergic to Epzicom of course.  Otherwise Truvada & Tivicay seem to be working well as you can see from my labs in my sig. 

My VL has gone to UD and CD4's keep rising.  Hoping this trend continues.


(Also, a new form of Truvada is coming out soon called TAF and it is supposed to be in smaller dose but have more efficacy....No word if we will see a 1 pill formula combined with Tivicay yet.....but Truvada is improving as well)

[Miss Philicia]

(Also, a new form of Truvada is coming out soon called TAF and it is supposed to be in smaller dose but have more efficacy....No word if we will see a 1 pill formula combined with Tivicay yet.....but Truvada is improving as well)

TAF will be manufactured by Gilead -- Tivicay is Glaxo; the intention thus far is for Gilead to only use TAF in their own fixed-dose combinations, so they will deprive patients and doctors of using it as a stand-alone drug.

http://www.treatmentactiongroup.org/hiv/taf-letter

A ridiculous and greedy decision if that is how it ends up.

[GoForIt]

TAF will be manufactured by Gilead -- Tivicay is Glaxo; the intention thus far is for Gilead to only use TAF in their own fixed-dose combinations, so they will deprive patients and doctors of using it as a stand-alone drug.

http://www.treatmentactiongroup.org/hiv/taf-letter

A ridiculous and greedy decision if that is how it ends up.

I have been reading about this today.  I really hope that they do not deprive the patients such a new innovation in medicine.  That doesn't seem like the ethical thing to do.

Gilead makes Truvada in its own standalone pill.  Why would they deny the same for the clearly better version?

Doesn't make any sense to not just make it in a standalone dose and sell it that way.  It would make them more money anyway from everyone wanting to use their pill.

[Matts]

As we know Gilead there will be never  a FDC of Tivicay and TAF. It's the same with Their HCV drugs.
Anyway, I started Tivicay and Kivexa (Epzicom) one week ago as part of a clinical study. It's going well so far. I was a bit nervous the first days, because of the possible allergic shock caused by Abacavir. But nothing happened.
My doctors said, that Kivexa (Epzicom) is better for kidneys and bones than Truvada in the long run. I will see what happens in this 3year study.

[Pontus]

I am wondering, it seems like tivicay is used in conjunction with another med,,,  so I am taking Stibild and so far it I am undetectable with no symptoms. May I ask if you are switching to Tivicay because of the stribild rash or it is a better alternative?

*just wondering*

Just got switched to this regimen today.

I find it strange for OP's case. Most drug rashes start 1-2 weeks after being exposed to a new med. If OP started in January, then the rash appeared well past a month or so. Still, stranger things can happen.

I was unlucky enough to get a Stribild rash. Praying there's not a cross-reaction with Tivicay. If so, I'd be even more unlucky to be a case report.

Will know soon enough.

[GoForIt]

As we know Gilead there will be never  a FDC of Tivicay and TAF. It's the same with Their HCV drugs.
Anyway, I started Tivicay and Kivexa (Epzicom) one week ago as part of a clinical study. It's going well so far. I was a bit nervous the first days, because of the possible allergic shock caused by Abacavir. But nothing happened.
My doctors said, that Kivexa (Epzicom) is better for kidneys and bones than Truvada in the long run. I will see what happens in this 3year study.

TAF should come in a standalone dose so that patients who can't take the FDC with Epzicom like me (Genetically proven allergic) can still get the benefit of TAF with Tivicay.

TAF really should just replace Truvada...simple as that.  Why keep around Truvada with its kidney and bone problems if you have TAF available?  Doesn't make much sense.

Sure they won't combine TAF with other brands meds....obviously.  But TAF is clearly a better solution to Truvada so why treat it like its not?

[Ann]

TAF really should just replace Truvada...simple as that. 

Um, no, not quite that simple. TAF (tenofovir alafenamide fumarate) is only one drug and Truvada is two: tenofovir DF + emtricitabine.

[Ann]

TAF should come in a standalone dose so that patients who can't take the FDC with Epzicom like me (Genetically proven allergic) can still get the benefit of TAF with Tivicay.

I'm wondering - you do understand that FDC means "fixed dose combo", right?

Epzicom is two meds: abacavir + lamivudine. You don't actually have a genetic hypersensitivity to Epzicom, you have the hypersensitivity to the abacavir. You could still take the other component, lamivudine.

[GoForIt]

Yes I know what FDC means.

My mistake about Truvada.  I did not realize truvada was 2 different meds and TAF was just one.

It was my understanding that TAF was almost like a better form of Truvada.

I see I was wrong now.

[Matts]

I hope you're right. I think that TAF+emtricitabine (let's call it Truvada2.0) will be superior to Epzicom (Kivexa). TAF seems to be great. The Truvada patent is running out in July 2017, and then Gilead will be so merciful to release finally TAF.
 I don't care if I take 1,2 or 3 pills. Then I will skip the "Trii" FDC (Tivicay + Epzicom) for Tivicay+TAF/Emtricitabine  if i am still alive then
Maybe it will be already old-fashioned in 2017 and everybody gets the follow-up drug GSK744 as 4-month shot. My Doctor talked about the LATTE-study. I didnt understand everything, but he said it was succesful and will be the future.

LATTE study:
http://www.natap.org/2014/CROI/croi_27.htm

[xinyuan]

I am wondering, it seems like tivicay is used in conjunction with another med,,,  so I am taking Stibild and so far it I am undetectable with no symptoms. May I ask if you are switching to Tivicay because of the stribild rash or it is a better alternative?

*just wondering*

Kind of for the rash. No, not because I thought Tivicay/NRTI superior to Stribild. Although 1 meta-analysis suggested a trend to that effect. However, no actual head-to-head study of Stribild vs Tivicay/NRTI currently exists.

http://natap.org/2013/EACS/EACS_30.htm


Really, I wanted to reduce the side effects.

I knew Prezista/Norvir made me fatigued, brain fogged, and worried about my next explosive diarrhea episode. VL was trending down well, so my doc and I gave Stribild a try. Other symptoms went away. But got a rash 10 days in. Reverted to my old regimen until VL UD.

I knew from the FLAMINGO study that Tivicay/Truvada was superior to my previous regimen (Prezista/Norvir/Truvada).

http://www.natap.org/2013/ICAAC/ICAAC_24.htm

1 week in on the new combo. So far, only mild headaches. Other side effects gone again. Hoping for no reaction.