Atripla Day 1 - Dizzy, Fever, Shivering, Ended up in ER. What to do?

[JackSmith]

Hi, I found this forum by googling "atripla dizzy" and I was comforted to know - last night- (day 1) that what i was feeling was normal.  So, first - thanks for being such a helpful resource when I could barely walk last night (it's actually still wearing off).

Since then, things have gotten a little crazy. I couldn't go to bed last night & I felt really weird - dizzy but also sort of "off" - it's hard to explain.  I finally fell asleep & and woke up 2 hrs later extremely hot. 

I took my temperature and it was normal, but I was shivering (full body and chin) like CRAZY on and off -  after I woke up.  I could barely dial the phone w/ my hand shaking & had to wait for it to stop in order to put the thermometer in my mouth.

I've never had a reaction to any drug like this, and I am also on klonopin which shares the same pathway in the liver as the Efavirenz component (I think... maybe the other two as well but I think it's just that one).  I was just really scared about what was happening (especially since Atripla has like 10 black box warnings - and I've been on a million pills w/o any side effect -ever), so I went to the ER.

They kept me there for 4 hrs, and I had a fever of 99.7...was no longer shivering.  They did very basic blood tests & then released me with the diagnosis of "adverse drug reaction" and told me to take Truvada (and gave me an rx).  They gave me a saline IV and a benadryl (for god knows how much... I could've had some salt water & benadryl here for $1!)  They didn't explain much to me at any point.  Though,  of course they said (multiple times) that I had a lot of "anxiety" - stating the obvious, regardless of the fact  I've had much worse problems in my life that do not cause uncontrollable shivering, fever, and dizziness (hello).  Finally, they just said to follow up with my doctor (who isn't available today - sunday - so starting on saturday night was ingenious of me).  They did very basic labs (no wbc) that were normal (I read them when they were out of the room...they didn't mention them).

So there are a few reasons I wanted to post here... obviously I am wondering -  has anyone ever had a reaction like this??  I felt completely crazy... I was glad to hear the dizziness is normal, but the 2 hours of sleep and full body shaking & shivering + fever was just scary as hell. 

Also, I am worried that if I switch, now I exposed the virus to Efavirenz for a day & it can get resistant (or is that a crazy worry) to that drug. Also, isn't Efavirenz much stronger / more potent than the other two drugs (that make up truvada).  Would I have to add a PI then?

Thank you in advance for any thoughts / advice on any of this - i know i was sort of rambling..

[Ann]

Hi Jack, welcome to the forum.

A temperature of 99.7 isn't really a fever, it's just more of a slightly elevated temperature.

Some people just cannot tolerate the Sustiva component of Atripla. You may be one of them.

You also may just be one of those persons who needs an adjustment period to the meds.

If you've only taken the one dose of Atripla, the odds are in your favour of not developing any resistance issues if you don't take your second dose.

You could take your second dose and see what happens, or you could just stop right now. The more doses of Atripla you take, the greater your chances that you may develop resistance to some of the meds in the Sustiva class.

You mention Atripla in your title, and then go on to say that the ER recommended you take just the Truvada (the other two meds in Atripla). If your meds come in separate forms, this is the way to go, but if you're on the one-pill of Atripla, you don't have this option.

As it's a Sunday, if your doctor is one who will respond immediately to a phone call in the morning, you could hold off on your second dose (if I'm reading you correctly) until you speak to your doctor in the morning and take it from there.

Keep us posted.

Ann

[JackSmith]

Ann - Thank you so much.  You provided more info to me than anyone in the ER did all day!  I greatly appreciate it.  That is good to know that the 1-dose thing probably will have nothing to do with resistance. That's what I hoped, so it is good to hear another opinion on the matter.

Perhaps the doc just thought he'd subtract the sustiva & then that's why he gave me the truvada rx.   He never said anything about it.  They just handed it to me with my discharge note & said to fill it and/or call my doctor.  I will try first thing tomorrow - there are a few docs I can probably see - but Mondays can  be hectic.

Regardless, I will try first thing tomorrow to call someone and to see what the best next step would be.  It might be best to lay off all meds today & just try to get some rest.  I l do now look like a zombie from all this...and was supposed to have an important meeting tomorrow (and prep a bit on the weekend for it... ugh! nothing is done now...I messed that one up.  Well, I guess I still have tonight). 

[Ann]

Jack, shit happens, eh? While I understand that your job is important, right now the MOST important thing is YOU. Get this little blip out of the way and then worry about meetings.

I now understand the ER gave you a script for Truvada. The safest way to go would be to take just the Truvada tonight and see what your doc says tomorrow. You should not have such a reaction to Truvada alone and it would protect you from resistance issues this one time around. The doctor in the ER was correct in doing what he did - although the urgency of the matter isn't quite as ... er... urgent... as you have only had one dose of the meds.

You might want to read one of the last entries in my blog that kinda deals with this sorta thing. I've since been retested on the resistance front with no problems found. You'll understand when you read. Damn, I need to get blogging again!

Please make sure you speak to your doctor, no matter what course of action you decide upon in the mean time, before you are due for your meds tomorrow evening.

Ann

[Hellraiser]

Ann are you sure about the one dose being less likely to cause resistance?  I had never heard this.

[Ann]

Ann are you sure about the one dose being less likely to cause resistance?  I had never heard this.

I told my doctor about taking the one dose of Sustiva/Truvada and he told me that one dose was not likely to cause resistance. He said it's possible, but not probable. He's an hiv pharmacologist, so I trust his word.

I mentioned above that I had a new resistance test done after the Sustiva incident, but it wasn't my regular hiv doc who ordered it, it was a young, panicky doctor who was in the clinic on rotation. She saw a brief note in my file about the Sustiva and went nuts. I was like; "Whatever. Take as many phials of blood as you please, I can always make more of the stuff."


edited because sometimes I just go on and on and on......