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Author Topic: any advice on changing meds safe for pregnancy?  (Read 5341 times)

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Offline uk lady

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any advice on changing meds safe for pregnancy?
« on: January 15, 2008, 10:05:45 AM »
hi all i am new here so i say hi to everyone & say what a wondeful site this is. i have been on meds now sustiva & truvada for 2 years my vl is undetectable & cd4 has risen from 230 right up to 700 more recently 400. i have been with my partner for 5 years who is hiv negative. we would really like a baby & i am aware that the meds i am on ie sustiva is not safe 2 become pregnant on, i have recently been losing body fat from the tops of my legs bum arms & had my routine bloods today & due back to the docs next tues. i discussed with the nurse today the fat loss & she said changing meds would be good for the fat loss & the becoming pregnant too. what i am wondering is does anyone know of meds that are safe for pregnancy aswell as being low in fat loss that i could switch to? my nurse mentioned i maybe on kaletra  thanks

Offline Blessed1974

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Re: any advice on changing meds safe for pregnancy?
« Reply #1 on: January 16, 2008, 02:52:20 PM »
Hi Uk,

I'm currently taking truvada, lexiva and norvir.  I haven't any problems with fat loss and I have been taking these meds before I got pregnant.  My numbers have always been great since being on these meds and I've been undetectable all thru the pregnancy.  I don't know if this would work for you but it never hurts to ask your doc.

Offline uk lady

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Re: any advice on changing meds safe for pregnancy?
« Reply #2 on: January 17, 2008, 10:12:37 AM »
hiya blessed thanks for that i will certainly ask my doc about it, as sustiva & truvada is my first lot of meds i am not very greatly informed of any other meds at all so its all new to me! thanks tho thats great. hope all is well with you x :)

Offline catwoman

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Re: any advice on changing meds safe for pregnancy?
« Reply #3 on: January 18, 2008, 12:11:58 AM »
I'm 12 weeks pregnant and I'm on Kaletra/Truvada.  I've been on this combo since '05 when I was diagnosed and started taking the meds.  My doctor knew I wanted to get pregnant so we never switched and I'm undetectable and doing very well.  I never stopped taking them and I will be throughout my pregnancy. 

Offline Ann

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Re: any advice on changing meds safe for pregnancy?
« Reply #4 on: January 18, 2008, 09:12:46 AM »
Hi Lady,

I don't know how I missed this thread... sorry!

You can read all about the up-to-date UK pregnancy/hiv guidelines by clicking on the following link:

http://www.i-base.info/guides/pregnancy/index.html

If you look towards the bottom of that page, you'll see a link where you can order a free printed copy of the information.

Good luck!

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline uk lady

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Re: any advice on changing meds safe for pregnancy?
« Reply #5 on: January 19, 2008, 02:00:49 PM »
thanks catwoman & anne sounds like kaletra & truvada as im already on that is a good idea, so does that mean i would only have top swop sustiva for kaletra? thanks again

Offline Ann

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Re: any advice on changing meds safe for pregnancy?
« Reply #6 on: January 20, 2008, 08:42:25 AM »
Hi Lisa,

You will definitely need to change the Sustiva (Efavirenz) for something else. According to the i-Base info, The protease inhibitor is likely to be be saquinavir boosted with ritonavir, lopinavir boosted with ritonavir (called Kaletra and in one pill) or atazanavir boosted with ritonavir. So yes, Kaletra would be a good choice for your swap.

However, there is a chance your doctor may also want to change your Truvada - possibly for Combivir (AZT plus 3TC), which are preferred drugs for pregnancy. I say this because according to the Truvada Lesson, levels of lopinavir, one of the two protease inhibitors in Kaletra (lopinavir/ritonavir), can decrease when the drug is combined with Truvada. Kaletra can also increase Viread levels—one of the drugs in Truvada—in the bloodstream. If Kaletra and Truvada are used together, it is important to watch out for potential side effects of Viread (e.g., kidney problems).

I'd recommend talking to your hiv doc to find out if there are any docs in your area who specialise in hiv and pregnancy - you may be able to get a referral.

Remember, it's very important to ditch the Sustiva BEFORE you attempt to become pregnant. Good luck and have fun putting that bun in the oven. ;)

Ann
 
« Last Edit: January 20, 2008, 08:43:57 AM by Ann »
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline uk lady

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Re: any advice on changing meds safe for pregnancy?
« Reply #7 on: January 20, 2008, 11:19:40 AM »
thanks anne well i am a little worried about changing meds altho really want to. its just i am losing fat loss from bum, legs, arms so i would like to change to something thats not known for fat loss & someone sent me a link saying that sustiva when combined with truvada that im on is known to cause fat loss so obv i am worried about changing to something & the fat loss becoming worse. i have heard azt is connected with fat loss is that right? i am very med naive these are my first meds & know nothing of any others. thanks for your help i very much appreciate it

Offline newt

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Re: any advice on changing meds safe for pregnancy?
« Reply #8 on: January 20, 2008, 12:03:20 PM »
Hello

Ann asked me to comment (even though I am a bloke)

First, what makes up an anti-HIV combination of drugs?

Usually this is 2 nukes + either a boosted PI or an NNRTI.  In your case the 2 nukes are in Truvada (a mix of tenofovir and FTC) and the Sustiva is an NNRTI.

The key thing drug wise on having a child is to change the Sustiva for something else -- as Ann says before you get pregnant.  This is important because Sustiva has a (small) risk of causing problems to the baby in the first 12 weeks in the womb.

What to use instead? Any boosted PI (Kaletra, Invirase + Norvir, Reyataz + Norvir etc) or even the NNRTI Viramune will do. 

The most important thing in terms of preventing passing HV to your baby is to have an undetectable viral load.

As for the fat loss -- the drugs you are on are not usually associated with fat loss.  But, regardless of combination, women (especially with an African background) tend to experience this more often. AZT, a drug often recommended in pregnancy, is associated more with fat loss, so perhaps best avoided.

Hope this helps.

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

Offline uk lady

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Re: any advice on changing meds safe for pregnancy?
« Reply #9 on: January 20, 2008, 03:07:49 PM »
thanks newt great help even tho you are a bloke u obv know your stuff! it def sounds like staying away from azt is the way forward, my nurse who took my bloods said i would prob be changed to kaletra & maybe azt but i will say thats not what i want. i have docs for results & discuss this on tues not sure if i am changing my meds then or just having a good discussion about it, quicker the better really. the nurse did say tho maybe you will have to worry about the fat loss after pregnancy but to be honest i dont want to lose any more fat loss. hope i can sort this thanks again

Offline uk lady

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Re: any advice on changing meds safe for pregnancy?
« Reply #10 on: January 22, 2008, 07:00:15 AM »
hiya an update on my results today. numbers are all good undetectable & cd4 is 440 & percentage is 40 not sure what the percentage actually means! anyway we discussed changing meds & will be doing it next visit which is 2 months instead of 3 months time. still not sure what meds i am going on but he did mention kaletra maybe & azt too. i am very worried about azt as i know it is associated with fat loss & as i stated before i have experienced a little of that already(not much tho).  so still unclear as to what meds i can be on apart from azt, i asked if i could maybe just sawp the sustiva to keletra as catwoman stated before that shes on that & i thought then id only have to swap the sustiva for kaletra which would be great but he seems to wanna add azt as he said its great for keeping the transmission to the baby so still confused on what to do! :-\ thanks all

Offline catwoman

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Re: any advice on changing meds safe for pregnancy?
« Reply #11 on: January 23, 2008, 10:53:57 PM »
My doctor did not add the AZT for me.  I thought I was going to need that, but she said it was not necessary.  I was very happy to hear that, because that means I didn't have to change anything.  She told me I will only be getting AZT via IV during labor.  I've been undetectable since '06, on only Kaletra/Truvada. 

Offline uk lady

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Re: any advice on changing meds safe for pregnancy?
« Reply #12 on: January 24, 2008, 05:19:50 AM »
hey catwoman, that what i would like to do but for some reason he wants to add azt, i know that these docs know what they are talking about but i just dont want to lose any more weight & i am worried about azt. thanks for the info tho really helps. :)

 


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