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Author Topic: Switching from Atripla to Truvada and Reyataz  (Read 4250 times)

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Offline LittlePill

  • Member
  • Posts: 19
Switching from Atripla to Truvada and Reyataz
« on: August 07, 2007, 06:47:58 PM »
Hello everyone, after a little over two months of being on Atripla, my doctor and I decided today that the side effects of the atripla were just too much for me. My brain fog wasn't really going away and at times it seemed to be worse. It's a shame too because it was doing a bang up job on this virus. I went from a VL of 584,000 to 1730. It's disappointing to me that I have to stop this drug because I just can't take the fog and feeling like a zombie all the time.  As of today, I'm off Atripla and next Monday I start Truvada (which is my understanding two meds in one) and then adding Reyataz onto it. Does anyone have any positive info on this combination? Any help or advice would be much appreciated.

Offline aztecan

  • Member
  • Posts: 5,399
  • 29 years positive, 57 years a pain in the butt
Re: Switching from Atripla to Truvada and Reyataz
« Reply #1 on: August 07, 2007, 09:02:44 PM »
Hey Littlepill,

I started taking Reyataz close to a month ago. Love it. No problems at all. I also stopped Sustiva for the same reason you stopped Atripla, and then some.

I don't take Truvada, though. I take Combivir.

But, I know Jan (AnnieBC) just started taking Reyataz/Truvada (or the components thereof). She may be able to chime in with some advice.

I think you will like the combo.

By the way, are you boosting the Reyataz with Norvir?

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline JamieD

  • Member
  • Posts: 259
Re: Switching from Atripla to Truvada and Reyataz
« Reply #2 on: August 08, 2007, 12:08:23 AM »
I'm on the same combo, it has no noticeable side effects for me.

I take unboosted, which isn't so great because the Truvada can decrease the amount of Reyataz in the blood. The problem is my doctor wrote out a prescription for 400 (2x 200mg) mg a day, and it was a 3 month prescription which I paid for. I may have good insurance, but I certainly do not have the type of money to be throwing away one medication or another. I am going to ask about switching to Viramune once I have finished all the Truvada, though. I don't really care for the Truvada.

Offline LittlePill

  • Member
  • Posts: 19
Re: Switching from Atripla to Truvada and Reyataz
« Reply #3 on: August 08, 2007, 09:31:16 AM »
Thanks Aztecan and JamieD. I start the new meds on Monday. The doctor told me to stop the atripla immediately because it was aggrivating brain fog that I already had prior to the meds. I also asked my doctor about the norvir boost and he said that I'm "treatment naive" and therefore don't need it. He assured me it will all still work and if need be, if I need the norvir boost then my doctor will put me on it. He doesn't seem to believe I will. Also, my doctor is retiring in the middle of all this so I start a new doctor in September. It's really stressfull!

Offline LittlePill

  • Member
  • Posts: 19
Re: Switching from Atripla to Truvada and Reyataz
« Reply #4 on: August 08, 2007, 09:32:48 AM »
Also another question for you two.  I've read and heard that the Reyataz can yellow your skin and eyes. Did this happen to you? Is it permanent?

Offline David_CA

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  • Posts: 3,246
  • Joined: March 2006
Re: Switching from Atripla to Truvada and Reyataz
« Reply #5 on: August 08, 2007, 02:57:52 PM »
I'm curious about why Viramune, along with Truvada, isn't prescribed more often when Atripla isn't agreeable.  Is it not as effective as Sustiva?  I guess I can consider myself (and Hubby too) lucky with Atripla.  It seems to be working for me... slowly, but very well for him. 

David
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
02-13-12 CD4 911 @41.4% VL<20
You must be the change you want to see in the world.  Mahatma Gandhi

Offline antibody

  • Member
  • Posts: 525
  • "every man thinks his burden is the heaviest"
Re: Switching from Atripla to Truvada and Reyataz
« Reply #6 on: August 08, 2007, 03:13:54 PM »
i dropped sustiva back in march and glad i did. i have no complaints with boosted reyataz. it also made it easier to get back to work.
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline LittlePill

  • Member
  • Posts: 19
Re: Switching from Atripla to Truvada and Reyataz
« Reply #7 on: August 08, 2007, 03:29:54 PM »
I'm curious about why Viramune, along with Truvada, isn't prescribed more often when Atripla isn't agreeable.  Is it not as effective as Sustiva?  I guess I can consider myself (and Hubby too) lucky with Atripla.  It seems to be working for me... slowly, but very well for him. 

David

Hey David,

It's my understanding that Viramune seems to work best if your CD4 count is less than 400. If your CD4 count is more than 400, there's a risk of liver damage.

Offline JamieD

  • Member
  • Posts: 259
Re: Switching from Atripla to Truvada and Reyataz
« Reply #8 on: August 08, 2007, 03:36:03 PM »
I did not get any yellow eyes or skin. I don't know why people are so afraid of this side effects, it's not all that common. But no, I didn't get it.

Offline LittlePill

  • Member
  • Posts: 19
Re: Switching from Atripla to Truvada and Reyataz
« Reply #9 on: August 08, 2007, 03:39:53 PM »
I did not get any yellow eyes or skin. I don't know why people are so afraid of this side effects, it's not all that common. But no, I didn't get it.

Thanks Jamie! Good to hear!

Offline David_CA

  • Member
  • Posts: 3,246
  • Joined: March 2006
Re: Switching from Atripla to Truvada and Reyataz
« Reply #10 on: August 08, 2007, 05:54:27 PM »
Hey David,

It's my understanding that Viramune seems to work best if your CD4 count is less than 400. If your CD4 count is more than 400, there's a risk of liver damage.

That makes sense.  Somehow, I must have missed that or just forgot it.  So, Sustiva is good if one can handle it, and Viramune is good if one has a low VL.  Good luck with your med change!

David
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
02-13-12 CD4 911 @41.4% VL<20
You must be the change you want to see in the world.  Mahatma Gandhi

Offline newt

  • Member
  • Posts: 3,885
  • the one and original newt
Re: Switching from Atripla to Truvada and Reyataz
« Reply #11 on: August 08, 2007, 05:54:35 PM »
Jamie is right, you need the Norvir boost for Reyataz with Truvada because one of the drugs in Truvada (tenofovir) lowers Reyataz levels significantly.  Using a Norvir booster indicated in the prescribing info for Reyataz and recommended in the CDC guidelines on HIV treatment.

CDC guidelines PDF

Loads of stuff on Reyataz

- matt
"The object is to be a well patient, not a good patient"

Offline aztecan

  • Member
  • Posts: 5,399
  • 29 years positive, 57 years a pain in the butt
Re: Switching from Atripla to Truvada and Reyataz
« Reply #12 on: August 08, 2007, 06:53:08 PM »
Hey Littlepill,

I never yellowed either. Never a problem for me. Come to think of it, I have rarely heard of anyone having the jaundicing issue and, when I did, it was just a temporary thing.

Oh, by the way David, it is the CD4 of more than 400 in men that contraindicates the use of Viramune, not the viral load. In women, it is a CD4 of 350 or more.

Littlepill was right about the reason though. Serious liver complications are much more likely when people with the above CD4s take Viramune.

HUGS,

Mark
« Last Edit: August 09, 2007, 10:35:31 PM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline LittlePill

  • Member
  • Posts: 19
Re: Switching from Atripla to Truvada and Reyataz
« Reply #13 on: August 08, 2007, 09:12:02 PM »
Hey Littlepill,

I never yellowed either. Never a problem for me. Come to think of it, I have rarely heard of anyone having the jaundicing issue and, when I did, it was just a temporary thing.

HUGS,

Mark



Thanks Aztecan, that's good to know. I wasn't sure if it was a permanent thing or not. My doc told me it could happen just didn't say whether it was long term. As for the Norvir booster, my doc said I'm "Naive" still and don't need it yet. Also unfortunately, my doctor is retiring so I'm switching to a new doc in September. My current doc told me he has had several patients on the combo that I'm going on and they do quite well without the Norvir. But he added that my new doctor will know if I have to add the norvir. *Crossing fingers and holding on for dear life!*

Offline JamieD

  • Member
  • Posts: 259
Re: Switching from Atripla to Truvada and Reyataz
« Reply #14 on: August 08, 2007, 09:16:16 PM »
My doctor also said that the Norvir booster is not entirely neccesary either. I am going to ask about an NRTI-sparing regimen after I finish these 3 months worth of medications.

Offline mrtallguy

  • Member
  • Posts: 199
Re: Switching from Atripla to Truvada and Reyataz
« Reply #15 on: August 08, 2007, 10:28:44 PM »
Hey LittlePill,
I started the same combo with the Norvir booster a month ago and I did notice some yellowing in my eyes....if my skin was affected then it showed up as more of a tan than a yellow look.   The yellow eyes are more noticeable in the morning shortly after I take it but it fades through the day.....otherwise no other side effects.

Good luck and keep us posted on your situation!

Be Well...

Craig
I AM DETERMINED TO SEE THINGS DIFFERENTLY!
--ACIM

Offline newt

  • Member
  • Posts: 3,885
  • the one and original newt
Re: Switching from Atripla to Truvada and Reyataz
« Reply #16 on: August 09, 2007, 02:35:38 AM »
From the Reyataz prescribing info:

"Tenofovir may decrease the AUC [total exposure to the drug each dose] and Cmin [lowest level of the drug per dose] of atazanavir. When tenofovir coadministered with tenofovir, it is recommended that REYATAZ 300 mg be given with ritonavir 100 mg ... REYATAZ without ritonavir should not be coadministered with tenofovir [publisher's emphasis].

Reyataz prescribing info PDF

- matt
"The object is to be a well patient, not a good patient"

Offline chrism1973

  • Member
  • Posts: 38
Re: Switching from Atripla to Truvada and Reyataz
« Reply #17 on: August 09, 2007, 04:14:32 AM »
I have been on reyataz,truvada and norvir since dec of 05 no problems with side effects really jsut a little of the squirts fromthe norvir.I have never had any yellowing of the eyes or sklin.I thinks its a great combo.I jsut got my #'s yest and am doing well.1248 cd4 43% undetect.
                                                                                                                                  Chris
Love yourself,love life and live.

Offline LittlePill

  • Member
  • Posts: 19
Re: Switching from Atripla to Truvada and Reyataz
« Reply #18 on: August 14, 2007, 10:25:31 AM »
Hey all, just to update. I took my first night's dosage of Truvada and Reyataz and didn't really notice any side effects, like I did when I was on Atripla. So far so good. Hope the meds work. I am still experiencing some "brain fog" that I've had since I got sick in February. Does anyone know anything about that? How do I get rid of this permanently?

Offline antibody

  • Member
  • Posts: 525
  • "every man thinks his burden is the heaviest"
Re: Switching from Atripla to Truvada and Reyataz
« Reply #19 on: August 15, 2007, 10:26:54 PM »
no yellow here. no problems either. back to work, busy doing 48 hours. tired but still able to pull it off.
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline alberche

  • Member
  • Posts: 212
  • a distancia del mundo incierto, saludo mi suerte
Re: Switching from Atripla to Truvada and Reyataz
« Reply #20 on: August 30, 2007, 02:54:44 PM »
Hiya Littlepill!

I am on Truvada + Reyataz + Norvir since one year ago. I also started first with Sustiva plus Truvada, but had to quit Sustiva due to an allergic reaction: severe rash and joint pain. Brain fog and strange dreams were also there, but went away in the first few weeks, so I could normally keep going to work and so on. Sustiva was powerful and quickly reduced my VL, but got no time enough to see the effects on my CD4 count.

Reyataz have been milder from side effects. No yellowing, no joint pains... just feeling tired from time to time and also with a sensation of "heavy" stomach, but I thinks it's mostly due to Norvir.

Labs show normal levels of cholestherol, sugar and the rest of markers. True, I care about what I eat, I don't smoke and only drink from time to time. The only "vice" I haven't quitted is poppers boosted sex from time to time... (one is human, after all!!!)

I started treatment just a few weeks after infection, and I have been since then almost always above 1.000 CD4. Last labs were VL under 20 copies and CD4 in 1640. When I was diagnosed, in may 2006, I was 1100 CD4 and a VL of 265.000. The lowest CD4 was in january, 920, VL below 50.

Reyataz combo could be even better if one could take it without Norvir...

The most noticeable side effect or symptom I am feeling is pain in the lower back. This happens since I got infected and has not gone away nor increased with meds. Now is a milder pain, but this is still there. Labs (including X ray and magnetic resonance) do not show anything strange... and doctor says this is not due to meds...

In addition to meds, I am taking L-carnitine, Alpha Lipoic Acid, Omega 3, Linoleic Conjugated Acid and multivitamin.

Big hugs!
love is blindness...  a wonderful song!

Offline Srb

  • Member
  • Posts: 10
Re: Switching from Atripla to Truvada and Reyataz
« Reply #21 on: August 31, 2007, 01:57:32 PM »
Oh waiter....waiter......Another round of Reyataz with a norvir boost for everyone Please  ;)

littlepill I too was considered "naive" as I was diagnosed . 11 years ago but just started meds about a month ago with a 5 day interruption due to the phenomena that my bactrim failed to prevent. Granted it was most likely a garden variety phenomena, but a phenomena none the less.

I have tolerated these drugs soooo much better that what i had expected and if this continues I can begin to see where hiv has become a manageable chronic illness as apposed to puking to stay alive death sentence.

Good luck with the swith, I suspect you'll do just great....

Oh waiter, waiter!!!!  LOL
« Last Edit: August 31, 2007, 04:29:34 PM by Srb »

Offline mrtallguy

  • Member
  • Posts: 199
Re: Switching from Atripla to Truvada and Reyataz
« Reply #22 on: September 06, 2007, 09:30:32 PM »
Does anyone on this Truvada/Reyataz/Norvir combo get really tired late in the day?  At 5pm everyday I start to yawn profusely and get this fatigue phase that lasts for about an hour or so....by 7pm it passes and I am awake again.

I have never experienced getting SO tired at the same time every day....

Survey says??

Craig
I AM DETERMINED TO SEE THINGS DIFFERENTLY!
--ACIM

Offline aztecan

  • Member
  • Posts: 5,399
  • 29 years positive, 57 years a pain in the butt
Re: Switching from Atripla to Truvada and Reyataz
« Reply #23 on: September 07, 2007, 01:09:26 AM »
Hey Craig,

It could be possible you are either just tired or your body is running low of fuel. I found by eating five meals a day, I usually avoid these periods of severe tiredness.

In other words, have an ice cream break between 3 p.m. and 5 p.m. and you may feel better.

If not, at least it was fun trying.

HUGS,

Mark
« Last Edit: September 07, 2007, 01:10:59 AM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

 


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