Kaletra/3TC/Tenofovir - Acne problem :-(

[vt5john]

I've been on the meds for 10 weeks now.   But before I started the treatment - I noticed I had a lot of new acne problem on my upper chest and face....  at the time my dermatologist prescribed RoAccutane (main ingridient: Isotretinoin) - it worked magically.   Then I found out I was HIV+ and my weakened immune system was probably the reason I was having this acne outbreaks.   

My acne has again flared up and someone here suggested that I talked to my doctor about minocycline (which not only good for acne but it's beneficial if taken with HAART).   The problem is that minocylcine is unavailable to my knowledge here in Thailand.   

I was wondering if it would be OK to take RoAccutane to help this acne problem at the same time as my HAART meds.   At this time I am scheduled to see my Doctor June 10th.

Thank you in advance for your advise.

[Matty the Damned]

Holy Christ! Roaccutane? I took that shit 20 years ago, it was one hell of an experience.

But presumably things have evolved since then.

The main thing with Roaccutane is liver toxicity. If you're going to take it with something like tenofovir, your liver function should be monitored carefully.

One of the best things about AIDSmeds is the Check My Meds tool. You can enter your medications (HIV and non HIV ones) into that groovy device and it will spit out interactions and contraindications and such.

MtD

[vt5john]

Hi Matty... I knew someone will mention about liver toxicity    RoAccutane is a very strong drug indeed.

For the 1st 4 weeks I was on Nevirapine - and my SGOT and SGPT shot up to 175 and 422   - then the doctor switched to Kaletra in less than two weeks they went back to normal level i.e: 20 and 18.

So no!  I'm not going to take anything without asking or doing some research first    

The last time I saw my doctor, I mentioned to him about my Acne problem - he said wait until we get the 3 months complete blood test (which is on June 10).   I was just wondering If my results were good, should I mention to him about RoAccutane? - I just don't want him to scold me    

For now I'm just using Retin-A (external use) - let's hope it gets better in a week.

[Matty the Damned]

Hi Matty... I knew someone will mention about liver toxicity    RoAccutane is a very strong drug indeed.

For the 1st 4 weeks I was on Nevirapine - and my SGOT and SGPT shot up to 175 and 422  - then the doctor switched to Kaletra in less than two weeks they went back to normal level i.e: 20 and 18.

So no!  I'm not going to take anything without asking or doing some research first     

The last time I saw my doctor, I mentioned to him about my Acne problem - he said wait until we get the 3 months complete blood test (which is on June 10).   I was just wondering If my results were good, should I mention to him about RoAccutane to him - I just don't want him to scold me     

For now I'm just using Retin-A (external use) - let's hope it gets better in a week.

Heh.

Look I would think Nevirapine and Roaccutane would be a no go. I can't say for sure if the same applies to Roaccutane and Tenofovir or even Roaccutane and Kaletra.

As I understand it Roaccutane is often used for cystic acne where medications such as Minocycline have failed. So I'm thinking if you've had Roaccutane in the past you probably have fairly severe acne.

Don't be afraid to ask your doctor. Having used Roaccutane myself, I can understand that your acne must be quite a burden and I can see the attraction of that particular drug. It stops cystic acne dead.

MtD

[vt5john]

Hi Matty:  Actually my acne problem is not that bad.. they're not big like volcano craters or something - they're more like a cluster of small bumps (orange peel) - I'm just afraid it's going to get worse that's all.

Another question is this:  two weeks ago I complained to my doctor about arthritis like join pain on my left toes. Right away he stopped the D4T (Thank GOD) - and switched to Tenofovir (On May 14th) - but I think the pain hasn't completely gone away.  Is this normal??   Can any of the 3 meds I'm now taking cause this?

As mentioned earlier - I'm due to see my doctor again with my complete blood test result on June 10th - so I will definitely ask him then.

[Matty the Damned]

Hi Matty:  Actually my acne problem is not that bad.. they're not big like volcano craters or something - they're more like a cluster of small bumps (orange peel) - I'm just afraid it's going to get worse that's all.

Another question is this:  two weeks ago I complained to my doctor about arthritis like join pain on my left toes. Right away he stopped the D4T (Thank GOD) - and switched to Tenofovir (On May 14th) - but I think the pain hasn't completely gone away.  Is this normal??   Can any of the 3 meds I'm now taking cause this?

As mentioned earlier - I'm due to see my doctor again with my complete blood test result on June 10th - so I will definitely ask him then.

I don't think such a brief period of d4T treatment would result in PN but I could be wrong. I believe that PN is usually bilateral (ie occurs on both the right and the left sides) rather than on one side alone.

Moreover, PN is usually described as a numbing/tingling or burning sensation rather than being athritis like.

The reality is that you should never have been given d4T in the first place. Your current regimen (Kaletra/3TC/tenofovir) are very unlikely to cause PN, and certainly not after only 10 weeks of treatment.

That said if the pain in your toes hasn't gone away or is getting worse - consult your doctor.

MtD

[vt5john]

Thank you Matty for your answers.... you know us newbies.... worry nellies.... we're paying too much attention to every little changes in our bodies.