Questions on NORVIR+PREZISTA+TRUVADA

[mexguynyc]

Hi everyone,

I am completely new to this forum. I got infected with hiv+  about 6 months ago or so. My CD4 count was low when I tested positive. It was 379. I got it checked again and it was 230, so I am starting treatment. My doctor prescribed NORVIR(1)+PREZISTA(2)+TRUVADA(1). I would like to know if anyone out there is/was under the same treatment. I started taking it last night and so far no major side effects but of course I have only taken it once.

I understand that these drugs are "older" than the one-pill-a-day. Has anyone any idea about the side effects of this combination that I am taking?

I am also taking K-PAX and it was scarier to take the K-PAX than then other pills.

Any comment would be appreciated.

Thanks.

[Miss Philicia]

I'm on those meds and they're fairly side effect-free.  You may get a little diarrhea from Norvir, but not much.

As far as them being "older" than the one-pill-a-day (Atripla) that's not particularly true.  Prezista was FDA approved at the very end of 2006, so it's newer than any of the meds found in Atripla.  Atripla is really Sustiva and Truvada combined in one pill, and Sustiva is actually 12 years old.

I'm not sure what you mean by your K-PAX pill being "scarier".

[mexguynyc]

Hey there Miss Phillicia,

Thanks a lot for taking the time to share your experience with me. I am now experiencing the side effect of NORVIR.

About K-PAX, it was just scary to have to take 16 pills of vitamins. I am supposed to take 2 packs a day and in each pack there are 8 pills. My mouth now smells like chemicals or a weird smell like that. That is what I meant.

Thanks again.

[Miss Philicia]

Hey there Miss Phillicia,

Thanks a lot for taking the time to share your experience with me. I am now experiencing the side effect of NORVIR.

About K-PAX, it was just scary to have to take 16 pills of vitamins. I am supposed to take 2 packs a day and in each pack there are 8 pills. My mouth now smells like chemicals or a weird smell like that. That is what I meant.

Thanks again.

Personally I think K-PAX is a bunch of hooey overkill, and I'd just take a decent multi-vitamin (no iron type).  Also, because Truvada has been show to be hard on your bone density I'd definitely also add in a Vit-D/Calcium supplement on top of it (can't remember if that's in K-PAX).  If you have a lipid profile that is out of whack then add in some Omega-3 fish oil. That's all I do, and I've been on HIV treatment now for 17 years.

[mexguynyc]

Very, very helpful. Thanks a million.

[WillyWump]

I've been on this regimine for 6 months. I love it. No side effects at all to note. No dizziness, no nausea, no intestinal issues. No nothing.

The only drawback for me is the 5 pills a day. But I feel like a Nancy for complaining when many before me had to take  3-4 times that number.

Good luck. You will do great on this regimine!

-Will

[Assurbanipal]

Personally I think K-PAX is a bunch of hooey overkill, and I'd just take a decent multi-vitamin (no iron type).  Also, because Truvada has been show to be hard on your bone density I'd definitely also add in a Vit-D/Calcium supplement on top of it (can't remember if that's in K-PAX).  If you have a lipid profile that is out of whack then add in some Omega-3 fish oil. That's all I do, and I've been on HIV treatment now for 17 years.

Just a word of caution regarding that vit-D/Calcium stuff based on my own recent personal experience.

There's a growing body of evidence for Vitamin D.  Extra calcium though can be harmful to the kidneys -- and since Truvada can also be hard on the kidneys you might want to check with the doc before adding it.   At least that's what the kidney doc told me when looking into my recent bad kidney results, before telling me to ask the endocrinologist if I really needed extra calcium. ..


Mexguynyc

Your quarterly labs won't tell you if you have low vitamin D -- your doc can test for it.  But if you are on Truvada your doc should be doing a metabolic panel periodically as part of your blood tests and it will show whether you are low on calcium -- and note the labs have recently lowered the standard ranges for adult men.

Talk to your doctor about what you need and make sure that (s)he knows every supplement you take.   The  drugs save your life,  but each has its own potential riisks and it is important your doc know what you are taking so those risks are monitored.

and welcome to the forums

Assurbanipal

[Miss Philicia]

Just a word of caution regarding that vit-D/Calcium stuff based on my own recent personal experience.

There's a growing body of evidence for Vitamin D.  Extra calcium though can be harmful to the kidneys -- and since Truvada can also be hard on the kidneys you might want to check with the doc before adding it.   At least that's what the kidney doc told me when looking into my recent bad kidney results, before telling me to ask the endocrinologist if I really needed extra calcium. ..

My HIV specialist prescribed it for me so I guess I can at least point the finger at him if/when something goes wrong.  So are you saying that one should take Vit D alone, as it seem that aside from my prescription all that I see in stores is both of them together?  Are they saying that this is what caused your bad kidney problems, or just that in light of having these results don't do it?

[Assurbanipal]

My HIV specialist prescribed it for me so I guess I can at least point the finger at him if/when something goes wrong.  So are you saying that one should take Vit D alone, as it seem that aside from my prescription all that I see in stores is both of them together?  Are they saying that this is what caused your bad kidney problems, or just that in light of having these results don't do it?

Same here... my endocrinologist prescribed it for me too.  The one I'm seeing because HIV or Truvada or both gave me osteoporosis.  That's sorta the point.

Now something -- the HIV, the Truvada, the calcium is giving me these repeated bad kidney scores.  And although my calcium level hasn't changed -- the normal range has decreased for adult men and so they are reconsidering and maybe fingering the calcium or maybe not.  Who knows?  There's more tests and doctors and....

My main points were:
 - the "normal" levels of calcium for adult males were decreased recently by Labcorp
- too much calcium can hurt you
- speak to your doctor and look at the calcium scores (which you probably already have) before adding it.

[mexguynyc]

Dear All,

I am learning so much thanks to your posts and the discussions in these forums. Thanks to all of you.
I am about to take my second set of pills.

My doctor said to always take them at the same time and I just wonder if you all do the same.
I was also advised to take them with some food even if it is a small meal. I take my medication at 9:30 p.m. (my choice) by this time I have already eaten so I eat a little more.

Have a wonderful night.

[Miss Philicia]

"same time" generally means at least +/- hour or two.  And yes, both Prezista and Norvir say to take it with food and your bottles should be labeled like that clearly.

[ByTheBay]

I am on the same combo -- mild side effects (headache) went away after about 2-3 weeks.  Take my pills with dinner (6pm) each night.  My schedule is pretty regular so it helps remind me.

One thing you should watch for on this combo -- make sure your pharmacy gives you the correct strength Prezista pills. If this is your first combo, you are likely on 800mg Prezista (with Norvir and Truvada) once per day (This is two 400mg Prezista pills). 

People who are "treatment experienced" usually take Prezista 600mg twice per day.  This is the more usual dose. (i.e, the one the pharmacy is more used to giving out)

Two times in the last 6 months, my pharmacy has given me 600mg pills instead of the 400mg.  Both times the 400mg label was on the 600mg bottle.  The 400mg is a smaller bottle, and the pills are a lighter color orange.  The tech explained to me, "We almost always give out the 600s -- way fewer people take the 400s"

It is a good idea to look at, double check, and ask questions when you pick up your meds (BEFORE you get them home and have to make a return trip -- inspect the bottle, not just the pharmacy label).  Pharmacy mistakes happen all the time.  Being on an atypical dose of a med like 400mg Prezista (or one that is just becoming more common) means you have to be on your toes.

Just a thought if this is your first combo and you are new to meds.  In terms of response, this combo has shown great results at getting people to undetectable.  Good luck.

[nixsmail]

am on the exact same set of meds for several months now. have had no problems at all. take at night with food and all has been well. knock on wood, or at least something hard.