Skipping a Dose

[Matthew_74]

My doctor told me to skip a dose of Atripla in order to get on a different schedule. I was taking it at night, but wanted to switch it to the AM, he said to skip tonights does, and take it at 9 AM everyday.

Opinions, Advice? Could this do any damage or cause the HIV to be resistant to the Atripla?

[ad2san]

Hello Matthew, trust your doc   

[Hellraiser]

My doctor told me to skip a dose of Atripla in order to get on a different schedule. I was taking it at night, but wanted to switch it to the AM, he said to skip tonights does, and take it at 9 AM everyday.

Opinions, Advice? Could this do any damage or cause the HIV to be resistant to the Atripla?

Once you are undetectable, you can do a lot of things with the timing of atripla.  If a medical professional told you to skip a dose and take it in the morning then follow his instructions.

[LoboDog]

I read someplace that 90% adherence to your meds is satisfactory. I skip a dose every 2 weeks or so (just so that I have stock pile if my life goes to hell in a handbasket). I've been undetectable for over 3 years now...

But as ad2stan said, trust your doc

[leatherman]

I read someplace that 90% adherence to your meds is satisfactory.

studies say 95%. efficiacy begins to fail after that and resistance begins to become a factor

Successful long-term treatment of HIV/AIDS requires at least 95% adherence to HAART in order to prevent emergence of drug-resistant HIV variants that lead to regimen failure and limit options for future therapy--
http://www.ncbi.nlm.nih.gov/pubmed/12737640

Effect of adherence to HAART on virologic outcome and on the selection of resistance-conferring mutations in NNRTI- or PI-treated patients.--http://www.ncbi.nlm.nih.gov/pubmed/17956829

google 95 adherence to haart

[buginme2]

I skip a dose every 2 weeks or so

Skipping one dose every two weeks would be a 92% adherence rate (your missing about 24 doses per year).  Reduce that to 18 and your at 95%.  However, me thinks Atripla may be a bit more forgiving than some other treatment options.  Just a thought though.

[J.R.E.]

Sounds like the right way to transition a timing change of your medication.  Your doctor didn't want you to take a dose ( at lets say)  11:00 pm, and then another dose at 9:00 AM the following morning.  If I was on Atripla, that's the way I would want to do it.

There's no problem---Ray

[bufguy]

The FOTO study, Five On Two Off, studied undetectable patients who took Atripla Monday through Friday then didn't take it Saturday and Sunday. The study showed no statistical difference in those on the 7 day regimen and those on the 5 on, 2 off. The effavirenz component has a very long half life.
I discussed this study with my doc and he said he would never recommend the FOTO regimen because it leaves little room for error, as in missing additional doses. What it does show is how forgiving Atripa is to missing a dose here and there.

Like everyone says trust your doc. Atripla is a very well studied regimen!

[leatherman]

However, me thinks Atripla may be a bit more forgiving than some other treatment options.  Just a thought though.

quite possible as the FOTO study (http://www.natap.org/2009/IAS/IAS_63.htm) has shown that Atripla can be taken 5 days on, 2 days off a week. there was even some evidence gathered in this study that showed accidentally skipping a third daily dose in a row did not compromise treatment - but this was not a regular occurrence and was not studied.

Of course changing to any other dosing schedule than once-a-day, as prescribed by YOUR doctor, is improper, risky, and needs to be discussed with your doctor to get his/her approval. However missing an occasional dose of HAART is NOT the end of the world and not a concern for resistance.