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Author Topic: Drug/supplement interactions with Atripla...help!!  (Read 5510 times)

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Offline redbull

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  • Posts: 73
Drug/supplement interactions with Atripla...help!!
« on: August 28, 2009, 06:17:45 PM »
I have been prescribed atripla.  I havent started taking it yet...probably wont get it in the mail for another week or so.  I have been researching it and it interactions with other stuff...

I currently take celebrex for arthritis. On this site it is coming up as a major drug interaction with atripla but I couldv'e sworn my dr looked it up when I was there and she said it was ok.  Anyone know anything about this?

Also,  I try to work out alot...take different supplements...right now I am taking protein,  N.O. xplode and creatine.  anyone here of not being able to take no xplode or any other workout supplements with atripla? 

Any info would be greatly appreciated!!!

If you wish to see the best in others, show the best of yourself.

5/20/09  tested poz
6/2/09  CD4-94    VL-380,000
8/09   Allergic reaction to bactrim
9/09/09  started Atripla
5/10    cd4 315  vl undetectable
3/11    cd4 400  undetectable
6/11.   Cd4 520. Undetectable
12/11. Cd4 450. Undetectable
6/12.   Cd4 600. UD
2/13.   Cd4 425. UD

Offline GNYC09

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #1 on: August 28, 2009, 06:35:17 PM »
Hi, have you spoken with your physician about the benefits of these products? I may be 100% wrong on this since this is just based on my opinion and not fact, but when my CD4 was super low, I avoided the gym and any products (like NO Explode) that might tax my immune system.  Granted, I was recuperating from PCP at the time.  I wanted my body to first focus on rebuilding my CD4 count, my damaged lungs, my overtaxed liver, etc before I focused on rebuilding my lost muscle. I also ended my use of coffee/caffeine and energy drinks (like NO Explode) because they dehydrate you and deprive your body of important nutrients (source: http://www.thebody.com/content/living/art31115.html).

Everyone's mileage varies but good food for thought nonetheless since I remember you stating you also had a low CD4 count (PCP also?).  Good luck and please let me know what you find out.

Offline onemoretime

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  • Posts: 142
Re: Drug/supplement interactions with Atripla...help!!
« Reply #2 on: August 28, 2009, 06:51:55 PM »
red, i know your feeking out, your posting all over the place just like i am this week..LMAO.... and I have been on atripla for almost 4 years.. no problems except i swear im getting lipo gut and wrists and temples, but everyone says atripla should not do that.  I went 1 year with no meds and actually stated truvada sustiva due to Heb b and the side effect that it would bring that heb b vl down.. it did.  I have been undectable for 4 years.. been happy and healty for the most part, back pain... some other issues,  see my posts and mostly im fine.  get your atripla and take it.. your cd4 will start to come up and you will start to feel better about all this....

I am a wrect this week too and I don't know why,  your helping  me by posting,  I hope i can help u a little.  Peace out bro
08/04 diag 490 cd4 vl 50,000
10/25/05 436 50,513 hvb 1.1 billion
12/13/05 truvada sustiva
02/16/06 742 und, hpb 63,000
04/27/06 740 und hpb 60,000
01/05/07 458 und hvb und
03/08   470 undetectable still on atripla. Non smoking (chantex)
08/08 cd4 550 undetectable hiv, Hep B UND. Atripla
06/09  cd4 444, vl undetectable testo 130
09/09/09 CD4 687 46% UND  Testo 213 started androgel
10/12/09 cd4 682 46% und testo 597
01/12/10 cd4 842 48% und testo 434
041010 cd4 693  53% testo 492
100410 cd4 568 48% testo 523
012711 cd4 523 hcv 56 testo 596
083011 cd4 280 Hcv/HIV und
042912 cd4 158 hcv /hiv und, was on hep c for 11 months. do have ssdi filed and getting LTD
061912 cd4 151, bactrum, hep c and hiv und
071712 cd4 287 52% HIV HCV und
112012 cd4 520


Offline skeebo1969

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  • Posts: 5,705
Re: Drug/supplement interactions with Atripla...help!!
« Reply #4 on: August 28, 2009, 09:08:48 PM »


  If it is coming up as a major interaction I would definitely point it out to my doctor.  It could be an oversight on his/her part.  It does not specify what kind of interaction it is, whether it will make you sick or cause absorption issues with your antivirals.... Either way you might want to call your doctor first thing Monday morning to find out.

  Personally speaking I don't believe in supplements.  Well rounded meals supplemented with an herbal toke here and there is all I need.

I despise the song Love is in the Air, you should too.

Offline David_CA

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #5 on: August 28, 2009, 11:47:01 PM »
http://www.drugs.com/drug-interactions/atripla_d05847.html

I wonder about some of those listed.  For example, aspirin is supposed to have major interactions with tenofovir.  Androgel supposedly has moderate interactions with efavirenz.  I know quite a few guys who are on Atripla and are prescribed Androgel, and I've certainly not read or heard that aspirin causes any problems... strange.
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 redbull

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  • Posts: 73
Re: Drug/supplement interactions with Atripla...help!!
« Reply #6 on: August 28, 2009, 11:51:56 PM »
yea im gonna call my dr monday but I was reading some people on thebody.com talking about their doctors putting them on celebrex after they were taking atripla and had no problems...so i am not sure...guess we will see what the dr says.
If you wish to see the best in others, show the best of yourself.

5/20/09  tested poz
6/2/09  CD4-94    VL-380,000
8/09   Allergic reaction to bactrim
9/09/09  started Atripla
5/10    cd4 315  vl undetectable
3/11    cd4 400  undetectable
6/11.   Cd4 520. Undetectable
12/11. Cd4 450. Undetectable
6/12.   Cd4 600. UD
2/13.   Cd4 425. UD

Offline physicsguy

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  • Posts: 59
Re: Drug/supplement interactions with Atripla...help!!
« Reply #7 on: August 29, 2009, 12:51:58 AM »
Quote
I wonder about some of those listed.
Me too.  If something as common as aspirin were really causing major problems, one would think BMS/Gilead would have some mention of it on their web site or in the prescribing information, yet it's not mentioned at all.

Edit: They do list nephrotoxic substances in the prescribing information, so that's probably where they're getting the "major interaction" with aspirin, although the evidence would seem to indicate that's based more on rumors and guessing than on science.
« Last Edit: August 29, 2009, 01:04:00 AM by physicsguy »

Offline BT65

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #8 on: August 29, 2009, 06:53:12 AM »
yea im gonna call my dr monday but I was reading some people on thebody.com talking about their doctors putting them on celebrex after they were taking atripla and had no problems...so i am not sure...guess we will see what the dr says.


Maybe you should call a pharmacist, preferably one at an HIV-specialty pharmacy, and ask him/her.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline mecch

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  • red pill? or blue pill?
Re: Drug/supplement interactions with Atripla...help!!
« Reply #9 on: August 29, 2009, 08:14:43 AM »
If your doc is an HIV specialist - just point out the information you have found on your own, to him/her, and ask him/her to explain why the drug you are concerned about does not concern him/her.
Maybe it is from experience that most of the time its OK, and only a few times its not, and the doctor will simply monitor that.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Ann

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  • It just is, OK?
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Re: Drug/supplement interactions with Atripla...help!!
« Reply #10 on: August 29, 2009, 08:36:50 AM »
Hi Redbull,

If you go to http://www.hiv-druginteractions.org/ and click on the "links" link in the bar across the top of the page, then chose "drug interactions", you'll find quite a few other sites where you can check this out. I can't link you directly to the link page, because it's one of those sites where every page has the same URL. (Don't ask me why... )

I tried to look at any interactions listed on the site I linked to, but they don't list any NSAIDs. (NSAID = Non-steroidal anti-inflammatory and Celebrex is a NSAID) I have to wonder if this is because there aren't any interaction problems between any NSAID and any antiretroviral. After all, NSAIDs are quite commonly prescribed.

But yes, you do need to talk to your doctor about this and/or a pharmacist who is knowledgeable when it comes to hiv meds.
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 Inchlingblue

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #11 on: August 29, 2009, 11:50:04 AM »
As far as aspirin, all NSAIDs should be used with caution with tenofovir because they can potentially affect the kidneys. Since tenofovir has been shown to have effects on the kidneys, combining them is a bit of a double-whammy.

Examples of NSAIDs: aspirin, Alleve, Naprosyn (naproxen), Motrin, Advil (ibuprofen)
« Last Edit: August 29, 2009, 11:52:38 AM by Inchlingblue »

Offline GNYC09

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #12 on: August 29, 2009, 02:06:28 PM »
Inchlingblue, my understanding was that caution should be used when combining NSAIDs with tenofovir only if one has a pre-existing kidney disorder.  I am currently on a strong NSAID, Toradol, and was told it was fine to take it with my Atripla.  The product literature that came with this med cautions that it shouldn't be taken if one has a kidney problem.  Could you let me/us know if you gathered your info from the web or a doctor? 

Offline RapidRod

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #13 on: August 29, 2009, 02:25:51 PM »
I wonder about some of those listed.  For example, aspirin is supposed to have major interactions with tenofovir.  Androgel supposedly has moderate interactions with efavirenz.  I know quite a few guys who are on Atripla and are prescribed Androgel, and I've certainly not read or heard that aspirin causes any problems... strange.
If you click on the drug name it explains it. ie asprin http://www.drugs.com/drug-interactions/tenofovir_d04774_aspirin_d00170.html

Androgel Interactions  http://www.drugs.com/drug-interactions/efavirenz_d04355_androgel_d00558.html

Offline Inchlingblue

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #14 on: August 29, 2009, 02:44:21 PM »
Inchlingblue, my understanding was that caution should be used when combining NSAIDs with tenofovir only if one has a pre-existing kidney disorder.  I am currently on a strong NSAID, Toradol, and was told it was fine to take it with my Atripla.  The product literature that came with this med cautions that it shouldn't be taken if one has a kidney problem.  Could you let me/us know if you gathered your info from the web or a doctor?  


If one's kidneys are fine it probably doesn't mean that taking NSAIDs with tenofovir automatically means you are going to ruin them but I do think there is enough evidence (links below) to at least warrant proceeding with caution (even with no obvious current kidney damage).  As the link from CATIE (below) states it, there is a potential for complications when combining certain drugs, not just NSAIDs, with tenofovir.

At the end of the day, we each have to make the best decision that's right for us but at least we should have as much information as possible when making those decisions. For me, I'm taking Truvada and so far I have normal kidney function but I like to err on the side of caution and have decided not to take any NSAIDs because I want to avoid as much as possible overtaxing my kidneys.  

LINKS:

http://www.catie.ca/tu.nsf/df739470490ae50d8525717f0061769d/685dfc48c90078188525760e006b150c!OpenDocument

http://forums.poz.com/index.php?topic=27888.0

http://www.catie.ca/tu.nsf
« Last Edit: August 29, 2009, 02:47:21 PM by Inchlingblue »

Offline redbull

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #15 on: August 29, 2009, 08:47:33 PM »
this is the reply I received from the Dr.  on Thebody.com


http://www.thebody.com/Forums/AIDS/SideEffects/Archive/Interactions/Q203608.html
If you wish to see the best in others, show the best of yourself.

5/20/09  tested poz
6/2/09  CD4-94    VL-380,000
8/09   Allergic reaction to bactrim
9/09/09  started Atripla
5/10    cd4 315  vl undetectable
3/11    cd4 400  undetectable
6/11.   Cd4 520. Undetectable
12/11. Cd4 450. Undetectable
6/12.   Cd4 600. UD
2/13.   Cd4 425. UD

Offline David_CA

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  • Joined: March 2006
Re: Drug/supplement interactions with Atripla...help!!
« Reply #16 on: August 29, 2009, 09:41:23 PM »
If you click on the drug name it explains it. ie asprin http://www.drugs.com/drug-interactions/tenofovir_d04774_aspirin_d00170.html

Androgel Interactions  http://www.drugs.com/drug-interactions/efavirenz_d04355_androgel_d00558.html

Yeah, I saw and read those.  I still wonder why, if these really are such a problem, that Dr's don't mention them.  Instead, they prescribe them (Androgel and Celebrex) along with Atripla or its 'offending' components.
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 RapidRod

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #17 on: August 29, 2009, 09:53:16 PM »
Yeah, I saw and read those.  I still wonder why, if these really are such a problem, that Dr's don't mention them.  Instead, they prescribe them (Androgel and Celebrex) along with Atripla or its 'offending' components.
I think it's a heads up to monitor those that take both.

Offline bufguy

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #18 on: August 29, 2009, 11:10:29 PM »
Read the August 28 Treatment News...." tenofovir not necessarily hard on kidneys". I take diclofenac for arthritis in my knee on an as need basis...not every day, and my doc says not to worry, plus he has told me to take a daily baby aspirin for heart health....another NSAID. Moderation is the key as well as proper monitoring.
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .9

Offline Inchlingblue

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #19 on: August 30, 2009, 01:11:55 AM »
Read the August 28 Treatment News...." tenofovir not necessarily hard on kidneys". I take diclofenac for arthritis in my knee on an as need basis...not every day, and my doc says not to worry, plus he has told me to take a daily baby aspirin for heart health....another NSAID. Moderation is the key as well as proper monitoring.

The study found that tenofovir may not be any worse than other NRTIs, that doesn't mean that it's not bad on the kidneys. Additionally, they did find a link with tenofovir when used with a boosted PI and decreased kidney function.

When they say that after 18 months kidney function "stabilised" that isn't clear.  "Stabilised" could mean that it did not get any worse, not that it returned back to original levels.

Kidney function declined in all patients during the first six months of therapy, regardless of whether they were treated with tenofovir or an alternative NRTI. Moreover, there was no difference in the magnitude of the change in estimated glomerular filtration rate between the tenofovir and NRTI-treated patients. Kidney function then stabilised in both groups of patients during the next 18 months of HIV treatment.

Furthermore, similar proportions of patients taking these tenofovir and an alternative NRTI experienced a decline in their estimated glomerular filtration rate of 25% or 50% during the first two years of HIV treatment.


LINK:

http://aidsmap.com/en/news/1149DDFA-BA74-4307-8C61-F61478FA9613.asp


Offline clsoca

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #20 on: August 30, 2009, 04:35:50 PM »
My ID Doc advise me to not take baby aspirin once a day like I have done for many years.
10/07 Infected
11/07 Seroconversion
07/08 Tested Poz
07/08 VL 487  CD4 658  (No Meds)
10/08 VL 286  CD4 724  (No Meds)
01/24/09 VL 30,100   CD4 329 CD4 30% (No Meds)
02/06/09 VL 44,000   CD4 367 CD4 36%  Blood Work @ UCLA (No Meds)
02/06/09 VL 44,000   CD4 317 CD4 35% Blood Work @ USC (No Meds)
02/12/09 VL 52,000   CD4 297 CD4 29%
02/12/09  Started Atripla
04/01/09 VL 60  CD4 667   CD4 48%
06-05-09  VL UD CD4 427   CD4 39%

Offline onemoretime

  • Member
  • Posts: 142
Re: Drug/supplement interactions with Atripla...help!!
« Reply #21 on: August 30, 2009, 05:34:28 PM »
i take the baby asperin.. i have factor five dna mutation.  my mother had a pulminary embilism and found she had this dna.. i got the test and started the baby asp..  i am not haing any side effects with it..  with the number of drugs i have done in my day i don't really worry about atripla and asperine
08/04 diag 490 cd4 vl 50,000
10/25/05 436 50,513 hvb 1.1 billion
12/13/05 truvada sustiva
02/16/06 742 und, hpb 63,000
04/27/06 740 und hpb 60,000
01/05/07 458 und hvb und
03/08   470 undetectable still on atripla. Non smoking (chantex)
08/08 cd4 550 undetectable hiv, Hep B UND. Atripla
06/09  cd4 444, vl undetectable testo 130
09/09/09 CD4 687 46% UND  Testo 213 started androgel
10/12/09 cd4 682 46% und testo 597
01/12/10 cd4 842 48% und testo 434
041010 cd4 693  53% testo 492
100410 cd4 568 48% testo 523
012711 cd4 523 hcv 56 testo 596
083011 cd4 280 Hcv/HIV und
042912 cd4 158 hcv /hiv und, was on hep c for 11 months. do have ssdi filed and getting LTD
061912 cd4 151, bactrum, hep c and hiv und
071712 cd4 287 52% HIV HCV und
112012 cd4 520

Offline AboutToStart

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #22 on: August 30, 2009, 08:48:49 PM »
I've been on Androgel for years.. lately I started Atripla. Doc didn't say anything about potential drug interaction.. Guess I'm gonna have to quiz him on that next time I see him.. As to the baby aspirin - it is such a low dosage I doubt it matters.. Alkaseltzer I take occasionally on groggy mornings has 100 fold the aspirin than in a baby...

Offline beefbud

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #23 on: September 01, 2009, 04:41:54 AM »
Hi there, on Atripla since March and take NoXplode as well.  All tests have come back fine, the only thing is I have to stop taking it one week before labs as it elevates my creatinine output and my doc gets upset ;)
This is by no means medical advice.
"first impressions are cheap auditions"

Offline AboutToStart

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Re: Drug/supplement interactions with Atripla...help!!
« Reply #24 on: September 01, 2009, 07:01:50 PM »
Just an update:

I met with my ID Dr and picked his brain about several potential drug interactions with the Atripla. His input was: Androgel and Ambien CR are NOT an issue (though classified as "Moderate interactions" with efavirenz); Propecia may be increased if hair lose is noticed but since I was taking it on an "every other day basis" - he just recommended to go back to every day dosage (as the original prescription says); Advil, Aleve and ibuprofen are OK to be taken "on occasion" (though classifed as "Major interaction" with tenofivir) for those whose blood work (i.e. kidney numbers) are fine. Taking "Baby" Aspirin daily is ok too!!

 


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