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Author Topic: Reyataz/Norvir/Epzicom Side Effects etc  (Read 3513 times)

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Offline BKNYLivin

  • Member
  • Posts: 76
Reyataz/Norvir/Epzicom Side Effects etc
« on: September 28, 2010, 05:56:49 PM »
Hey Guys,

Anyone with experience care to comment?

My cousin just started on Reyataz/Norvir/Epzicom last week. He is staying with me and seems to be having a hard time with it, although I'm sure some of the issues might have to do with some other stuff, or HIV/AIDS itself (CD4 last test was 25, we will get results this week, so might be lower coz he hadn't been on meds for a few months).

Since he started the meds he has been having problems with nausea, extreme fatigue, dizziness, inability to focus, blurred vision and headaches. He already had a fever and joint aches b4 we went to the docs last week, so all in all, he's feeling quite miserable. Oh and his eyes are kinda yellow, which I've read is probably the Reyataz.

Would like to hear from anyone out there on this combo, or with past experience. Are these common side effects, likely to pass after a couple of weeks? He was previously on Atripla, couldn't handle the Sustiva, didn't take meds for a year, was put on Reyataz/Norvir/Epzicom 5 months ago, took it for 1 month(but doesn't recall feeling so shitty), then got back on track end of last week. He is also on Bactrim, Zithromax. How effective is this combo for someone with a severely compromised immune system?

Obviously, there have been adherence issues. I've already given him an earful, so please try and resist the temptation to judge/bash. My concern now is getting him healthy and back on track, now that he is with me.

Appreciate the input
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline eric48

  • Member
  • Posts: 1,179
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #1 on: September 28, 2010, 07:14:45 PM »
You should be praised for taking good care of him... Sounds like he needs the personal attention otherwise SE and adherence issues will arise... His health is compromised, but my experience (in other circumstances) show that consistent, personalized care can do wonders !

I have a long thread on Epzicom (+ Viramune). Epzicom may come with SE that can be severe and close monitoring is necessary at the beginning.

While the SE (liver problem, etc) can be severe, there are also RARE (less than 1 % liver problem if he as passed the genetic test that screens people for ABACAVIR, which he most certainly has, as the test is common practice).

If he can handle the ABACAVIR that is a component of epzicom (the other component, 3TC, seems to be less of a problem), then, like most people who are on it , he will find it easy enough to take. Abacavir comes with documented POSITIVE lipids and blood sugar profile change than may compensate somehow for the less positive that   Reyataz/Norvir may have. This combo is once daily , am I correct?

 I know some people who recommanded me to take Epzicom (aka Kivexa) at nights as it can be tough. I have followed this advice but now I take it in the morning. Even if this combo is once daily, you may consider taking at different times (and monitor his adherence closely), in order to make it easier on the liver, for , say, one or 2 months before placing them back together later on. Regardless of what my own doctor commented, I think the timing in the day may have some influence on the side effect outcome. At bit of experimenting may be required...


Quite unfortunatly the side effects seem to be tougher when baseline CD4 is low.

Hopefully, as the immune system rebuilds, everything will start getting back on track

Your cousin is lucky to have people like yourself taking care of him (now). What you are doing right now makes a difference between life and death.

Cheers Eric
« Last Edit: September 28, 2010, 07:17:08 PM by eric48 »
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline BKNYLivin

  • Member
  • Posts: 76
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #2 on: September 28, 2010, 07:38:43 PM »
Thanks Eric!

Really appreciate your input. Yes it is a once a day combo and I was thinking about exactly what u mentioned - perhaps splitting the dose.

I will definitely check out your thread on Epzicom later tonite.

Time to go fix dinner. Thanks a lot!
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline ad2san

  • Member
  • Posts: 189
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #3 on: September 29, 2010, 01:48:00 AM »
Hi, I am under this combo, switched Truvada with Epzicom 3 months ago. I was also very sick at the time I started the combo with Truvada (IRIS), then it went better with time. To what concerns Epzicom I notice I have Headache, I never had any before. Also I finally made it to loose all the extra weight I'd put under Truvada (Yeahhhhh), I guess the switch to Epzicom helped here. Otherwise my lab are fine except the Bilirubine thanks to Reyataz .... but there is nothing to do about this.
Your brother should give himself some time. He gets a lot of love and rest, that will help too :-)
Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
October 2012 CD4 684 UD 29%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
May 2013 CD4 385 UD 28%
July 2013 CD4 CD4 636 UD 25%
Oct 2013 CD4 588 UD 39%
Aug 2014 CD4 639 UD 25%

knightmikey

  • Guest
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #4 on: September 29, 2010, 11:59:47 AM »
Please get the guy to the doctor.  I had a deadly side effect from Abacavir and I got over it.  Check the side effects of Abacavir and if you are experiencing more than one side effect, the normal course is to stop the Abacavir immediately and never take it again., but I'm not the physician, that's why you need to take him to one. Good Luck.
« Last Edit: September 29, 2010, 12:14:47 PM by knightmikey »

Offline eric48

  • Member
  • Posts: 1,179
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #5 on: September 29, 2010, 02:32:07 PM »
knightmikey is right , SE of Abacavir are not to be taken lightly. Hypersensitivity is a condition that may worsen and be life threatening.

Abacavir is fine IF you can get past those SE; it is one of the meds that comes with a lot of IFs.

a visit to doc is highly recommended. Experienced people can tell the difference between the SE that are the 'normal' course of iniating meds and those that may warrant a switch.

Do as knightmikey suggests... Doc visit.

Cheers Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline BKNYLivin

  • Member
  • Posts: 76
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #6 on: September 29, 2010, 11:52:23 PM »
Can't thank you all enough for your input.

I actually took him to the doctor earlier today and then we ended up at the ER.
A lot of tests have been done and he will be seeing the specialist in the morning.

I was quite sure that the extremely elevated bilirubin levels had to do with the meds, but the ER
doctor was "puzzled", so seeing it mentioned here just reinforces what I thought.

As I said, he will be seeing the HIV specialist in the morning. He is extremely weak, dehydrated and in pain etc.

Appreciate you guys, it's been a long day, I just got home and have to be up early to head back to the hospital. I'll keep you posted.

Thanks!!!
Diagnosed 9/18/06
10/13/06 - CD4:449, 33%,  VL:>500,000
11/20/06 - CD4: 392  VL:425,000
02/08/07 - CD4: 361, 16.9% VL:133,000
02/13/07 - Started HAART: Atripla
03/08/07 - CD4:401, 23.8% VL:643
06/05/07 - CD4:614, 33.6% VL:225
09/14/07 - CD4:612, 37%  VL: <50
12/14/07 - CD4:582, 38.5% VL:<50
4/11/08 - CD4: 658, VL: <50
3/5/09 - CD4: 847, 49% VL: <50
7/29/09 - CD4: 965, 50.1% VL: <50
12/28/09 - CD4: 925, 49.2% vl <50
9/16/10 - CD4: 1011 vl: <50

Offline william1953

  • Member
  • Posts: 3
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #7 on: October 01, 2010, 01:56:30 AM »
It sounds like you are getting some excellent advice from people. Over the 15 years that I've been tested positive, I developed resistance to many drugs because at the time the medicines became available, my doctor would try them to see if they worked for me or not. Nowadays we have combination therapy, where they immediately start the patient taking a multi-drug regimen, and that might make it harder to tell which one is the problem. I was down to 140 lbs 3 1/2 years ago with chronic wasting diarrhea, but still alive and never hospitalized, until I FINALLY got on a combination of the latest antiviral drugs that worked. I'm up to 210- a little more weight than I would prefer, but it's great to be able to eat and enjoy food again. Hang in there, there's always hope for a brighter tomorrow!
Tested positive in 1990- CD4 count 600
Started HIV meds 1995- CD4 count 200
Until 1999- CD4 count 100
In 2000- CD4 dropped to 25
May 2007- CD4 <5 viral load 20K
June 2007- CD4 25 viral load undetectable
December 2007- CD4 200+ viral load still undetectable
September 2010- CD4 260+ viral load still undetectable

Offline eric48

  • Member
  • Posts: 1,179
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Reyataz/Norvir/Epzicom Side Effects etc
« Reply #8 on: October 02, 2010, 07:25:22 PM »
Hi BKNYLivin,

Keep faith! this forum has so many encouraging messages that it is sometimes easy to forget that it can be so tough on some peoples. Billirubin is some maker for the liver function... If my understanding is correct, both Reyataz and Abacavir can be tough on the liver. In terms of efficiency/resistance, sounds to me that Truvada (tenofovir+FTC) has a similar profile to Epzicom (Abacavir + 3TC); Truvada can be rough for the kidneys and Abacavir on the other hand, on the liver. So docs have options...

Hang on and keep us posted

Cheers ! (well, I believe you need a Double - Cheers !!)  Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

 


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