Atripla vs Viramune and Truvada?

[Gilbert Grape]

I am about to start HIV medication for the first time. (Converted April 07). My doctor wants me to go on Atripla. A good friend who is positive feels strongly that I should avoid Sustiva at all costs and said I should ask about Viramune and Truvada.

I've been reading these posts all day and have concluded that some have adverse affects with Atripla, and some do not and there's no way to know until you start.

My question is this: If there's even a chance that the side affects will be bad with Atripla, and I can pretty much avoid them with Viramune/Truvada (I know it can be hard on the liver, but I have read that it's best to start on Viramune if TCells are under 400, and mine are 297) then why shouldn't I do Viramune/Truvada?

Besides the convenience of just one pill...is there some big benefit to Atripla that makes it worth the risk of side affects? Any big Atripla fans want to chime in?

My doctor (who is great) seemed reluctant to go with Viramune.

Thanks!

[Ann]

Hi Gilbert, welcome to the forums.

I've recently been musing about what my first combo would be, and I also want to avoid Sustiva if I can. I've pretty much settled on Truvada and Reyataz (with Norvir boost). I'm told it's a pretty good combo.

If you haven't already, you might want to read our Welcome Thread, where you'll find links to all sorts of other informative parts of this website, including the drug information.

Ann

 

[Gilbert Grape]

Thanks Ann.

My doctor suggested the Truvada-Reyataz-Norvir combo if I don't want to take Sustiva, but I am nervous about protease inhibitors also.

[Assurbanipal]

Lots of people have fully manageable or no side effects -- and so choosing based on the potential side effects might be an odd way to look at it.  But if I were starting today, knowing what I know now, I suspect I'd have headed for Atripla rather than what I'm on, because the common sides from it are in areas where I'm pretty strong, whereas my current meds play to my weak side (low cholesterol never having been a hallmark  ) But maybe I'm just jealous of those Sustiva dreams 

So you might want to look through the potential sides and see, should one occur, which you might potentially best tolerate.  But also look at the percentage who get a side effect .

But remember that, for most people, the main side effect these days is that your energy levels get better.  Good luck to you.

[Snowangel]

Welcome Gilbert,
I have been on Atripla since the 20th of Feb.  My ID took me off the Truvada, Norvir and Reyataz because my cholesterol which he thinks was from the Norvir.  One that combo, I tended to be more sensitive with what I ate.  I couldn't tolerate some foods or smells at all.  My only complaint with the Atripla so far is the change in sleep patterns but I am really new to it.  I agree, you should weigh the pros and cons of each set of meds and see what you think YOU could tolerate and what you would be comfortable with.  You are the one that is going to have to adhere to whatever you choose.  Good luck and let us know how you are doing.
Take care,
Snow

[ajm_ldn]

Hi,

I've been on Viramune and Truvada for almost one year with no issues whatsoever.  There is a trail starting for once a day dosing you might look into: 
http://www.poz.com/articles/hiv_viramune_nevirapine_761_14006.shtml

Viramune increases the "good" cholesterol:  http://www.prnewswire.co.uk/cgi/news/release?id=203651

In Europe it's sometimes prescribed as once-daily dosing even now: 
http://www.aidsmeds.com/articles/hiv_nevirapine_viramune_2151_13975.shtml


I've also read that Viramune provides better penetration of the CNS.

AJM

[J.R.E.]

Hello Gilbert,

Having never been on Atripla, it would be hard for me to comment. What I can tell you is that I have been on Viramune since October of 03.  Along with the viramune I also take Epzicom ( Epivir and Ziagen). I also take Viread, which is one of the components of Truvada.

The only thing I can tell you is I started meds with a viral load over 500,000 and a t-cell count of 16. Those meds worked very well for me to get me undetectable within 7 weeks of starting treatment. I am still on those meds today.


I've been able to tolerate this regimen fairly well. As far as the PI class of drugs. I also can't comment on those, as I haven't been on those yet. My doctor wanted to save the PI class for later.


There is a convenience in taking one pill. For some this may work very well.  For myself, twice a day dosing of the Viramune is not really that much of a deal.

I also tried taking both Viramunes together, a couple years ago, for a short period of time. This did not work well for me. I basically felt like a chemical landfill, taking both Viramunes together. I went back to taking one pill every 12 hours. It worked better for me.

I was just mentioning in another thread , I do have issues with some minor to moderate body aches at times. I am dealing with mild to moderate neuropathy at times.  I sleep well, have no digestive issues going on right now. No crazy dreams, Excellent appetite, with stable weight. All my liver panel test along with the other bloodwork, have consistently come back good. So, My liver, is at least tolerating everything so far. Viramune also has no food restrictions, so thats a good thing !


I think you really need to sit down with your doctor , and have more discussion with him, as to the different possible combinations of meds that are available to you.


You mention that your friend said that you should avoid Sustiva, But you got to remember something, not everyone is going to deal with drastic side effects from the meds. There are many on Sustiva, who do well on it.

Also, another thing to remember...Side effects can come along with most of these medications. These are all very powerful drugs.  Hopefully whatever your choice is, you will be able to tolerate things very well.

One more thing I need to mention. I had a very long talk with my doctor that day deciding on the meds, that I should be starting on. He knew I worked fulltime( Still do) He also knew that I didn't drink alcohol ( which may have been a determining factor in choosing Viramune over Sustiva. Who Knows !

Also, ask your doctor why he is reluctant to start you on Viramune. Don't hesitate to ask questions he's there for you.

Good luck at making a decision, and stay in touch with us, let us know know how things are going.


Take care-------Ray

[Desertguy]

Good Morning
I have been on Atripla since Oct 25, 2007, my CD4 cels were 120 & Viral Load 970,000!!!  30 Days my Viral Load was 970, 60 days CD4 cells 179 & Viral Load 371.  Just did blood work March 3, 2008 and hoping & praying that CD4 cells are climbing and Viral Load is undectable.  I talked to my doc about changing to Viramune & Truvad becaus my girl friend is on it and likes it.   But she wants to wait till I am undectable a few times to see where it goes.
My side effects really aren't much any more no rash, the dreams have almost gone away even thou I loved them because they were all good ones.  The only thing I can say I suffer from taking it is I get a little fatiqued some days in the afternoons.
I think it is a wonderful drug 1 a day, I have enough problems remembering to take it  once let alone remembering to take meds twice.

Good Luck

[bradmeistr]

I was on Sustiva and Truvada, the long and short is that I did not tolerate Sustiva at all.  Was on it for 2 years and that was 2 years too long.  That being said, I have numerous friends who are on Atripla and or are on Sustiva and have no issues what so ever.  I feel they are so luck.  If I could tolerate Sustiva, I would like to be on Atripla as it seems so simple and convenient.

My suggestion is if you want to experiment, try Atripla and see if you are one of the lucky ones who tolerate the Sustiva, if you can't you can always switch to Viramune later.  My friends who do well with Sustiva said the side effects took about 1-4 weeks to totally go away.  You might try Atripla for about 2 or 3 months and if all goes well stay on it, if not, or the side effects seem to only somewhat subside, you can switch.  Just don't wait too long to switch as you know Viramune can have more reactions in the initial stages if you have t cells over 400.  Mine were 440 when I switched and I had no problems at all, I feel like I have finally found my combo.

From everything I have heard and read, Sustiva is a very powerful drug in suppressing the virus, so that is why i would say give it a shot, but again, do not be afraid to switch.
Brad