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Author Topic: Switch from Atripla to Isentress  (Read 3068 times)

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Offline MYSTERY

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  • Posts: 186
Switch from Atripla to Isentress
« on: March 10, 2009, 05:06:34 PM »
Hi All,

I was wondering if I could get any feed back from anyone that has switched from taking Atripla to Isentress. I have been taking Atripla for the past 3 years, and have had great success with it. My V.L is undetectable and my T-cells have increased. The problem that I have at times with Atripla is the Neurological issues with having a hard time falling asleep due to a busy mind. Some days I feel like I have a hard time concentrating on tasks, and feel foggy.

My ID doctor has recommended that I switch to Isentress if I want. My doctor has told me that the toxicity of the drug is very minimal and may turn out to be a once a day drug.

I have some issues with switching because I do not want to use up the line of medication that is available to me. Although I have no resistance to any meds as of yet. I might also be holding on because Atripla is the only drug I have ever taken and it has worked.

Would you think I should stick it out and stay with what has worked or do you think I am a needless worrier that should switch to a drug with less side affects. My ID doctor has told me that its silly to stay with something that gives me some Neurological issues, but my logic has been all drugs give off some side affects.

So that is my story and would appreciate any feed back good or bad about Isentress.
« Last Edit: March 10, 2009, 07:31:35 PM by MYSTERY »
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline richva

  • Member
  • Posts: 87
Re: Switch from Atripla to Isentress
« Reply #1 on: March 10, 2009, 06:33:43 PM »
Hi -

I struggled with Atripla (more specifically, the Sustiva in Atripla) for far too long; the racing thoughts and sleeplessness were absolutely horrible.  [You can track back through my comments/posts if you'd like more info.]  Let me just say this:  1) I understand your reluctance to switch meds; and 2) I should've switched sooner.

Best,

Rich

P.S. - Can't speak to Isentress; I'm sure others can and will.  I opted for Reyataz/Norvir + Truvada so that I could continue once-a-day dosing.  No regrets.
08/1989 Acquired
04/1992 Diagnosed
03/25/2008 (YUP - 16 years later!) CD4 336/21% VL 217,000; started meds
08/2012 - Alive, living! and doing just fine, TYVM (w/ props to my doc, insurance carrier and Complera. I remember every day that I'm a lucky boy.)

Offline MYSTERY

  • Member
  • Posts: 186
Re: Switch from Atripla to Isentress
« Reply #2 on: March 10, 2009, 06:37:26 PM »
Hi richva,

Thanks for your info. How have the side affects been on your new regiment. Have you been happy with it.
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline richva

  • Member
  • Posts: 87
Re: Switch from Atripla to Isentress
« Reply #3 on: March 10, 2009, 06:53:03 PM »
Well, here's the tricky thing about reporting side effects:  Lots of folks could say that they've had zero side effects taking Atripla . . . but, that wouldn't be true for you or for me, right?  So, with that caution in mind, I can report that I've had no bothersome side effects from my new combo.  The key there is bothersome; I'm gassier than I was before - don't know if that's the Reyataz, the Norvir booster, or the combination of the two - but I really don't care.  It's not uncontrollable, I'm not gassing out elevators or airplanes . . . therefore, not bothersome.  Do I fart more?  Yup.  Do I sleep like a baby?  You betcha.

Good luck!
08/1989 Acquired
04/1992 Diagnosed
03/25/2008 (YUP - 16 years later!) CD4 336/21% VL 217,000; started meds
08/2012 - Alive, living! and doing just fine, TYVM (w/ props to my doc, insurance carrier and Complera. I remember every day that I'm a lucky boy.)

Offline MYSTERY

  • Member
  • Posts: 186
Re: Switch from Atripla to Isentress
« Reply #4 on: March 10, 2009, 07:28:01 PM »
Hahaha,

Farting makes me laugh so I can deal with that if I sleep like a baby. Thanks for the info.  ;D
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline Inchlingblue

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Re: Switch from Atripla to Isentress
« Reply #5 on: March 10, 2009, 08:45:44 PM »

I have some issues with switching because I do not want to use up the line of medication that is available to me. Although I have no resistance to any meds as of yet. I might also be holding on because Atripla is the only drug I have ever taken and it has worked.

 

I was wondering if resistance issues develop merely by switching meds for reasons of side  effects  so I asked Dr. Joel Gallant, he's one of the foremost authorities on HIV, specifically the meds and this was his response:  "if you switch off a medication because of side effects but with an undetectable viral load, there should be no resistance."

I didn't ask him this but I understand it has to be done correctly when you actually make the switch in terms of the timing of when to stop and when to start certain meds (based on how long they stay in your system) but otherwise there should be no problem, meaning if you are undetectable and you switch off correctly you could always come back to Atripla if you wanted to.

Here is the link to my question and his answer:

http://www.hopkins-hivguide.org/q_a/patient/recent_questions/switching_meds.html?contentInstanceId=471267&siteId=7151

Hard to say when but chances are that Isentress will be once-a-day at some point, hopefully soon. There's a study looking into it as we write (QDMRK).
« Last Edit: March 10, 2009, 08:51:16 PM by Inchlingblue »

Offline richva

  • Member
  • Posts: 87
Re: Switch from Atripla to Isentress
« Reply #6 on: March 10, 2009, 08:55:52 PM »
Inching, thanks for adding that info.  My doctor told me the same; no worries should I decide to go back to Sustiva.  Then he laughed and said, "But I can't imagine you'd ever want to do that!"  He's right.  I'd do it in the absence of any other options . . . just.
08/1989 Acquired
04/1992 Diagnosed
03/25/2008 (YUP - 16 years later!) CD4 336/21% VL 217,000; started meds
08/2012 - Alive, living! and doing just fine, TYVM (w/ props to my doc, insurance carrier and Complera. I remember every day that I'm a lucky boy.)

Offline aztecan

  • Member
  • Posts: 5,394
  • 29 years positive, 57 years a pain in the butt
Re: Switch from Atripla to Isentress
« Reply #7 on: March 11, 2009, 12:49:26 AM »
Hey Mystery,

I am also considering changing to Isentress. I now take Ritonavir-boosted Lexiva.

I have had great success with a PI-based regimen, but my lipids are just out of control and no combo of cholesterol-reducing drugs seems to help much.

I was just wondering what other component you would be including in your regimen. At the moment I am also taking Combivir, but don't know if I would stay with that or switch to something else.

Isentress is a twice-a-day med, so sticking with Combivir would be fine as far as that goes.

Any thoughts as to what other component you would add to your regimen?

HUGS,

Mark

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

Offline MYSTERY

  • Member
  • Posts: 186
Re: Switch from Atripla to Isentress
« Reply #8 on: March 11, 2009, 01:42:56 AM »
Hi Aztecan,

I would add the Truvada with the Isentress. My Doctor told me they are currently conducting a trial for once a day dosing which would be nice.

Big hug back at ya Mark.  ;D
« Last Edit: March 11, 2009, 01:45:51 AM by MYSTERY »
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline buca45

  • Member
  • Posts: 187
Re: Switch from Atripla to Isentress
« Reply #9 on: March 13, 2009, 12:20:34 PM »
I have  not taken Atripla as I had some horrendous mind side effects from taking Sustiva for around 6 months or so. I was one of I think 1% who experienced hallucinations, thoughts of suicide and other psychotic episodes. I was even admitted to a mental ward because of this happening....not a good story.
During my last resistance testing, it was found I am now resistant to Sustiva (thanks) along with many of the other older drugs.
Currently I am on Isentress, Intelence and Epzicom and have been taking it for three weeks now. One huge thing I noticed was that my PN has lessened greatly and I have become drozsy enough to cut back on my Xanax to get a good night's sleep. Other than that, zero side effects!
I was taking Prezista, Epzicom and Norvir (Norvir for years and that is what was causing the severe PN and many other side effects). As long as I had been on that combo, my CD4s never rose above 400 but my VL was undetectable for about 2 years.
Such a game playing with these combos...a huge give and take until you find one that works to improve your numbers without reeking havoc on your system.
Good luck to you on your new combo...I hope you tolerate it as well as I have!!
"Love and Laughter and Happiness Ever After"

Offline Inchlingblue

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Re: Switch from Atripla to Isentress
« Reply #10 on: March 13, 2009, 06:40:47 PM »
I didn't ask him this but I understand it has to be done correctly when you actually make the switch in terms of the timing of when to stop and when to start certain meds (based on how long they stay in your system) but otherwise there should be no problem, meaning if you are undetectable and you switch off correctly you could always come back to Atripla if you wanted to.

I asked Dr. Gallant a follow up question about how to make the switch and if there is a concern with the timing of it etc, here's the Q & A:

FOLLOW-UP QUESTION Posted on Mar 11, 2009
That's good to know. Can one simply stop the old regimen one day and then begin the new regimen the next? Or do you have to time it depending on the specific medications and how long they stay in your system? Thank you.

On Mar 11, 2009 Joel E. Gallant, M.D., M.P.H. replied:
You can just stop the old regimen and start the new one the next day.

Offline MYSTERY

  • Member
  • Posts: 186
Re: Switch from Atripla to Isentress
« Reply #11 on: March 14, 2009, 02:41:09 AM »
Hi All,

Thanks for all the info, it is much appreciated. I think I am going to make one last effort to remain with Atripla. I am going to take it in the A. M after I get up. The dizziness is not really a problem for me it's just that I can't fall asleep, and I get a busy mind at bed time. I just got my test results back today from my ID doctor and they remain great with my T-cells gaining another 50 points in 4 months and I remain undetectable. I hate to change something that has worked really well for me. If this doesn't work I think I will try the Isentress/Truvada combo. My doctor told me that it would probably be the best option for my body with the least amount of side affects.

And yes I am slowly adjusting my dosing time by 1 hour per night until I get to my desired A.M dosing time.  ;D
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline John2038

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  • Posts: 1,529
  • Happiness is a journey, not a destination.
    • HIV Research News (Twitter)
Re: Switch from Atripla to Isentress
« Reply #12 on: March 15, 2009, 03:04:48 PM »
Despite it's a very new study, you maybe want to invest 75$ to this test in order to see if you get the gene this study mention.

http://www.poz.com/articles/hiv_efavirenz_dose_761_16265.shtml

The question is were to do this test..

Offline MYSTERY

  • Member
  • Posts: 186
Re: Switch from Atripla to Isentress
« Reply #13 on: March 16, 2009, 01:53:40 AM »
Hi John2038,

I have seen the information on that study and I am going to bring it up to my ID doctor. Right now I am switching my dosing times to 11am rather than just before I go to bed. I hope that helps. Thanks for the info.  ;D
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

 


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