Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

Will start meds within the year

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Lurch:
Hi all.

Well, it's been a while since I left a message or even logged on (I had another log on name, but forgot it so I created a new one).

My Doctor says I need to start thinking about going on meds within the year and suggested I start reading up on what's out there to familiarize myself.  As you can guess, I am a bit overwhelmed with all the different meds out there. I want to have the easiest regimen I can so I was wondering what your opinions are on what the best meds for someone to start with.

Thanks

doyourowndamndishes:
CRAP!!  I just lost the entire entry!!

OY VAY!!  Let's try again.

Hey Lurch!

Ok, condensed version .... I have a meeting in 15 minutes!  If you have not done so, read the Lessons, especially the section: When Should I Start, What should I take first?  The US HDSS guidelines are very easy to read.

Now, to answer your question is very difficult: it is impossible to predict which side effects we will get, if any, and to what extent.  It could be none, mild, or very severe requiring a change to medications.

I went the PI route but I know many people swear away from them as tmany of them are known to cause lipo.  That's one side effect that many hivers just don't like getting and try to avoid it like the plague.  I started off on Nelfinavir (PI) + Combivir (NRTI) and quickly switched Nelfinavir to Kaletra.  The most common first timer PI regime would be Kaletra + Combivir.  Both are strong meds with great track records.  Kaletra is also known NOT to cause lipo but it is notorious for screwing up your cholesterol and tryglicerides; something you and your doctor will want to monitor.  If memory serves me, that combo is 4 pills 2 times a day: 3 Kaletra + 1 Combivir.  Another choice is Atazanavir + Combivir.  Atazanavir is considered an alternative combination but like myself and many others I know on Kaletra, eventually they make the switch to Atazanavir.  If you go the PI route I know that you don't have to worry about staggering the pills; both combos I mentioned are fine to take together (some pills need to be taken at different intervals and that can be a pain in the ass to deal with). 

If you go the NNRTI route, Sustiva is the main choice.  That one is a hit or miss, love/hate relationship.  Some people love it and respond well, some respond well but hate the side effects and want to get ride of it.  I have no personal experience with it but many of use on here have.  There is a Lesson on this site dedicated to tricks to taking Sustiva.  If you decide to go this way, it would be a good idea to read it first as well.

If you are worried about missing doses and yes, 100% compliance is extremely important for drug success, that you may want to do a Smarties (I'm an M&M kinda guy) trial run first.  Get yourself some pill boxes and fill it with your choice of delicious sweets! according to the number of pills you would be taking with the combo you decide to go with.  Then, set an alarm or anything (I use the alarm function on my cell phone if I feel I may lose track of time) to help remind you to take your pills.  I dose at 7:00 am and 7:00 pm as many meds are absorbed better and it's easier on the stomach if taken with food.  Anyway, do the Smarties dry run for a week or two depending on how confident you feel in remembering to take them once you start.  And if you think 4 pills 2x/day is a lot it really isn't.  I take more vitamins and supplements daily than I do anitvirals!  Once you get into the habit it becomes second nature: you don't even need to think about taking them.  I also find taking pills with meals is just another simple reminder that it is pill time. 

Let me know what you decide to take!

Cheers,

Alan

J.R.E.:
Hello Lurch,

Just to add, to what Alan has stated, if you click the link below, there is a good lesson from this site, on starting meds. Take your time going through it

Click here to start :

 http://www.aidsmeds.com/lessons/WhenToStart1.htm


 Several pages into that lesson, is this chart, which shows the three classes of drugs, and the preferred regemens, I think you will find this helpful also :


 http://www.aidsmeds.com/lessons/WhenToStart7.htm



Take care----Ray



Blixer:
Lurch,  You have already gotten some great advice here.  I only had three months after my diagnosis before I started meds.  I talked to a lot of people and did some reading and my first choice would have been sustiva and truvada.  But I had the opportunity to join a study.  Part of the study was double blinded. I took the study because I thought it would give me closer monitoring and because it had the resources of the Washington University Clinical Trials unit behind it. (in the end, that really didn't make a difference).  I ended up being in the sustiva arm.  But I did have some serious side effects to the "other" drug.  They were serious enough that the study was unblinded. I found out I was on sustiva and epzicom.  I had none of the normal side effects, just some intense pain, probably from the abacavir.  Anyway, they changed one of the drugs and I'm on sustiva, epivir, and videx ec.  After about 40 doses the pain and aching side effect seems to be clearing up.   So basically, go with a good combo and maybe you won't have any side effects at all.  If you do, most people say they will clear up or at least be tolerable.  I've known individuals who had some issues for a week and then it got better and now a year down the road they say they have virtually no side effects at all.  For me, it looks like a couple of months may take care of my side effects.  AT least I'm hoping.

I'm still partial to the sustiva/truvada (which I've never been on because of being in the study).  But that combo will be available as a single pill later this year.  On the PI side, I'm told that one of the better tolerated combos is Reyataz boosted with Noriv and Truvada.  The Epzicom is also a very effective drug as long as you don't have a reaction to the abacavir in it.  I have a good friend who was in South Dakota who was on sustiva and combivir and after a short bout with side effects he says he does great and goes on with life like normal.

There are plenty of combos out there.  Just find the one that works for you and is easiest to remain compliant with.  I like the once a day dosing of several of the combos.  It just seems to be so much easier to make sure I get them taken. I take mine all together at about 6 AM every morning.  With many of the once a day dosings you do have a bit of a window for taking the drugs.  My pharmacist said that I had about a 4 hour window and would still be considered totally compliant if I did it within that window.  But it all depends on the combo you are on.

blondbeauty:
My Dr. is going to put me on Sustiva/Truvada. Donīt ask me why...because its the first line treatment he uses in all his patients. He says I am going to do great.  :-\

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