Quantcast

Subscribe to:
POZ magazine
Newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr Instagram
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
October 23, 2014, 11:13:08 AM

Login with username, password and session length


Members
  • Total Members: 23762
  • Latest: rosie22
Stats
  • Total Posts: 643227
  • Total Topics: 48940
  • Online Today: 219
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: stopping viramune and truvada  (Read 3136 times)

0 Members and 1 Guest are viewing this topic.

Offline CJWAUS

  • Member
  • Posts: 59
stopping viramune and truvada
« on: June 21, 2008, 02:45:07 PM »
I want to stop taking my meds; however I want to do it in a way that makes it less likely that I will become resistant to them in the future.  I take Viramune and Truvada, and as I understand it I must stop taking the Viramune two weeks before I stop the Truvada, does anyone have anything to offer on this subject?

Offline BT65

  • Global Moderator
  • Member
  • Posts: 9,975
Re: stopping viramune and truvada
« Reply #1 on: June 21, 2008, 08:40:28 PM »
I don't have any experience with this, but I'm wondering why you want to stop your meds?  I went on a drug holiday and my CD4s bottomed out and my viral load went sky high.  I've read that from other people who tried drug holidays as well. 
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline CJWAUS

  • Member
  • Posts: 59
Re: stopping viramune and truvada
« Reply #2 on: June 22, 2008, 12:42:52 AM »
Itís kind of a personal choice; I was started on meds within six months of infection when I had a CD4 of around 700 and V.L. of about 10,000.  If I take care of myself my CD4 stays around 1700, lowest it got with meds was 1100 when I was on a year long methethon.  Iím now taking so many pills, that Iíd just like to try to get off all of them to give my body and brain time to figure out what Iím like without the drugs.  At present I take HIV meds, asthma meds, allergy meds, stomach meds, depression and anti anxiety meds.  Iím taking antidepressants that I started ten years ago because some head doctor thought I should because I was sad during a break up.  Well, who doesnít get sad at times, itís natural to be sad from time to time, not for long extended times, but briefly from time to time. Iím on stomach meds because of what all the pills I take do to my stomach; I need Xanax to go to sleep due to side effects of one of my antidepressants that I must take at night. Yes Iíve tried Lunesta and the like and they donít do a damn thing for me. 

So, Iím taking more pills than I should be and I want to give myself a chance to see what Iím like without all these chemicals interacting with each other. As needed, I will go back on whatever meds are needed.  For now, Iíd like to have some time away from the pill boxes and so forth that I have lived with for 5 years.

I talked to my Pharmacist and he said that stopping the Viramune two weeks before the Truvada was the way to do it, so next Sunday morning thatís the plan.     

Offline J.R.E.

  • Member
  • Posts: 7,215
  • Joined Dec-2003 Living positive, since 1985.
Re: stopping viramune and truvada
« Reply #3 on: June 22, 2008, 07:13:39 AM »
Hello Cj,

I really don't have much advice to offer you. I know that I heard it/read it before, that Viramune And/or Sustiva had to be stopped first, before stopping the other meds. I am not sure, what the time element is.
If it's three days, one week or two weeks.
But, I do wish that you approach this, with the full knowledge of your doctor. I don't take any of the other medications that you listed (Allergy, asthma, depression or anti-anxiety medication.) I can't offer comment on those.  I feel that you should sit down, relay these thoughts, to your doctor, and see if there is some better alternative in med dosing that you can achieve, or the possibility of cutting out some meds . I know how difficult it must be, taking all those meds.The most difficult med for me to take  ( or remember to take is) is my cholesterol medication. I totally hate taking that one, for some reason. The HIV meds---Not so bad with those.


Your numbers are great. maybe you can take some sort of drug holiday. Once again though, I've never taken one, and at this point it is probably doubtful that I ever will. ( at least for the forseeable future). When I started  meds in 2003, one of the first questions , I asked the doctor, was about the possibility of taking a med hoiliday. His answer. " not likely" ( he's right to the point, thats what I like about him)

Talk to your doc. Let us know what you decide to.


Take care of yourself------Ray

 
« Last Edit: June 22, 2008, 07:15:37 AM by J.R.E. »
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline BT65

  • Global Moderator
  • Member
  • Posts: 9,975
Re: stopping viramune and truvada
« Reply #4 on: June 22, 2008, 08:46:08 AM »
Well CJ, I've been on HIV medications since like 1990 when they first discovered AZT (or whichever year that was).  I've been on them ever since, save the drug holiday when my numbers went south.

I just want to caution you about abruptly stopping Xanax.  That's not a good idea.  I've done it before and, believe it or not, the withdrawals from Xanax, or any drug in that class of meds (benzodiazepenes) is horrendous.  Those things need to be weaned.  The same is true of antidepressants.  The body becomes tolerant of these things, and to stop them abruptly could be disaster.

I agree with Ray.  Please talk to your doctor about a game plan.  You don't want to end up feeling worse than you do now.  Good luck.
  Luv,
Betty
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline ARMANDO

  • Member
  • Posts: 251
Re: stopping viramune and truvada
« Reply #5 on: June 22, 2008, 10:44:21 AM »
i took a drug holiday last year ,i just wanted to see how my body would improve without the meds,after 3 months my vl shot up to 750,000 and my cell count went under 200 and the biggest effect was that i came down with BELLS PALSEY!!!I THINK IT WAS A BAD DECISION ON MY PART AND I WILL NEVER TAKE A DRUG HOLIDAY AGAIN!!

Offline redhotmuslbear

  • Member
  • Posts: 605
  • A genuine certified freak of nature, and a hot one
Re: stopping viramune and truvada
« Reply #6 on: June 24, 2008, 10:44:55 AM »
I want to stop taking my meds; however I want to do it in a way that makes it less likely that I will become resistant to them in the future.  I take Viramune and Truvada, and as I understand it I must stop taking the Viramune two weeks before I stop the Truvada, does anyone have anything to offer on this subject?

While it's sensible to start Viramune or Sustiva before other meds, in order to isolate potential adverse reactions, there is no reason to stagger stopping the meds.  Still, as others have pointed out, the physical effects of stopping meds are likely to be dramatic and fairly immediate, and the let-down of having to deal with those consequences worse than coping with your current pill burden.

Have you discussed your pill burden issues with a counselor or therapist who could help you developing coping strategies?

"The real problem is not whether machines think but whether men do." - BF Skinner
12-31-09   222wks VL  2430 CD4 690 (37%)
09-30-09   208wks VL  2050  CD4 925 (42%)
06-25-08   143wks VL  1359  CD4 668 (32%)  CD8 885
02-11-08   123wks off meds:  VL 1364 CD4 892(40%/0.99 ratio)
10-19-07   112wks off meds:   VL 292  CD4 857(37%/0.85 ratio)

One copy of delta-32 for f*****d up CCR5 receptors, and an HLA B44+ allele for "CD8-mediated immunity"... beteer than winning Powerball, almost!

Offline penguin

  • Member
  • Posts: 747
  • The Penguin Whisperer
Re: stopping viramune and truvada
« Reply #7 on: June 24, 2008, 11:41:57 AM »
While it's sensible to start Viramune or Sustiva before other meds, in order to isolate potential adverse reactions, there is no reason to stagger stopping the meds.

er, yes there is. like, the pharmokinetics of nnrti's, their half life & longer rate fo decline - if not done properly, there is a high risk of developing resitance from efectively being on monotherapy while they work themselves out of your system
slighlty less of an issue with truvada than say... combivir, as tfv & ftc have longer half lives. but still.

cjwaus, yr pharmacist's recommendation is one strategy, or alternatively  you can switch viramune to a PI (like kaletra) for 14 days &  stop the truvada 5 days before the PI. this should prevent developing resistance to the viramune adn truvada, and mean you keep these drugs (and others in their classes) to use at a later point

as others have said, if htis is something yo ufeel strongly about doing, do talk to your dr to 1) set up more regular monitoring of cd4/vl, perhaps set a point at which you will reconsider haart and 2) work out strategy for stoppign the other meds too, esp anti depressants & anxiolytics

kate
« Last Edit: June 24, 2008, 11:45:33 AM by penguin »

Offline newt

  • Member
  • Posts: 3,885
  • the one and original newt
Re: stopping viramune and truvada
« Reply #8 on: June 24, 2008, 01:53:28 PM »
Hello

First, what penguin said about NNRTIs and half-lifes, very important.

If you want to preserve NNRTIs in the future it is important to swap the Viramune for something else short-term, like 2 weeks.  You would just swap all the meds for a boosted PI for 2 weeks even if it's simpler.

Second, for me a key consideration here us that


Quote
I was started on meds within six months of infection when I had a CD4 of around 700 and V.L. of about 10,000.

So this is more like stopping ARVs after an extended treatment-on-diagnosis episode rather than starting treatment sometime into infection and having a break. I personally would be dead cautious about a break in the second scenario. But since you started bang on getting HIV more or less, it's a bit different.

If you're gonna do this:

1) Consider swapping the Viramune for something else short-term, or decide now it's bye-bye NNRTIs next time round

2) Decide on a reasonably high CD4 to restart combo, 500, 400, 375 whatever, but not less than 350, before you stop

3) Get your doc to monitor your d-dimer levels, this may be a key marker for inflammation on stopping ARVs, if it's high and stays high, do think about restarting combo soonish. It may save you a lot of illness. It's a simple test to do from a standard blood draw.

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

Offline ubotts

  • Member
  • Posts: 347
Re: stopping viramune and truvada
« Reply #9 on: June 25, 2008, 08:45:01 AM »
I want to also add that I was on Lunesta too and it did shit..

So they put me on nueroton, 600 Mg's to help me sleep and it has no effects on the liver at all..

I have hep c so I have to watch what I take, but most of our hiv meds effect the liver anyway, so I try to eliminate what I can.

I never have done a drug holiday, and I really don't think its a good idea for you. And like
Betty said, you would have to come off some of your meds gradually..If you do it all at once you will have horrible withdrawals...

Believe me, I have been there and it isn't pretty..I was feeling like I was going into a seizure...and that's a very scary feeling..

I would definitely advise you to talk all this over with your doctor and see what he has to say...

Good luck and I am wishing you the best.. ;)
Live Love Laugh and dance like no ones watching.
Laughter is the best medicine, so try to have a laugh everyday..Even if your not feeling your best, think about something that was funny at one time in your life and work with it..   :o)

Offline OutOfDarkness

  • Member
  • Posts: 90
Re: stopping viramune and truvada
« Reply #10 on: June 26, 2008, 06:43:44 PM »
Hi CJ,

I take the same "types of meds" that you do except for the stomach one.  I got sick of taking all of these medications too and I thought that my counts were really good so why not take a break?  I took a break and my counts started to get worse and I even started to feel weak and fluish.  My doctor also informed me that there is a risk of building a resistance to these meds if you are not consistently taking them.  If you do decide to change just make sure you do so with your doctor knowing every step of the way.  I feel lucky that when I started taking the same meds again my counts got better again.  I was really nervous that I might have began a resistance to them.  I am taking sustiva and truvada, there is a once a day pill for these as well if you prefer.  I have read here and heard from the doc that these new meds are having less of the negative side effects that the older drugs have such as lipo, so if you build up a resistance to these you will probably end up having to take older meds with more negative side effects. 

Maybe you can try different types of other prescriptions that you are taking.  I have changed the dosages of my anti-depressant and anti-anxiety since starting hiv meds and that has helped with those issues.  I also take all of my meds before bedtime and fall asleep soon after.  I do have insomnia at times, usually a couple of times a month.  I have coped with that by just letting myself putter around the house and accepting it as part of the side effects.  I am also going to be switching my anit-anxiety which is paxil to an OCD chlomapramine which is supposed to help with sleeping as well.  This drug is a gradual increase when you start so I have to keep track of it. 

Do you have to use an inhaler regularly for asthma?  My asthma is mainly allergy-induced, so taking my allergy medication Zyrtec every night controls the asthma for the most part, and I need my inhaler maybe a couple of times a year.  I have also quit smoking because I was using my inhaler more and more and smoking was just really taking its toll on me.  This has not been an easy thing to do, I have quit many many times.  I am currently in a quit status for the last 3 months or so.  I have put on weight and it seems harder to loose, but eventually I will get there.  I go walking, but when it is humid I have to take it easy.  At least I have this place for help and support through all of this :).  I seroconverted when I was diagnosed and was told by the docs that I probably had caught HIV within the 3 months prior to my symptoms of the seroconversion.  I was fortunate to catch it in the very beginning.

Let us know how it goes for you, but do let your doctor know before making any changes in any of your medications.

2000 - seroconverted
2005 - cd4 350, VL 113,000
3/06 - started sustiva/truvada
3/08 - cd4 1,300 VL >50(undet.)

Offline CJWAUS

  • Member
  • Posts: 59
Re: stopping viramune and truvada
« Reply #11 on: July 04, 2008, 02:43:21 PM »
Thanks for all the input, in the end I decided to stay on the meds.

Offline OutOfDarkness

  • Member
  • Posts: 90
Re: stopping viramune and truvada
« Reply #12 on: July 04, 2008, 07:47:28 PM »
Hi CJ,

Hope you are feeling better with your meds!  Let us know if we can help.

2000 - seroconverted
2005 - cd4 350, VL 113,000
3/06 - started sustiva/truvada
3/08 - cd4 1,300 VL >50(undet.)

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.