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Author Topic: Stopped Truvada/Reyataz/Norvir*, next options.  (Read 4283 times)

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Offline newhorizon80

  • Member
  • Posts: 37
Stopped Truvada/Reyataz/Norvir*, next options.
« on: November 03, 2010, 05:01:58 PM »

I started this combo (*part of a blind study comparing Norvir to Gilead's GS9530) on a few weeks ago, however, a week into this combo, I developed very intense jaundice, primarly in the eyes, but then started to affect my skin tone (I stayed hydrated, etc.).  Went to my study visit and expressed concern over the intensity and my doctor decided to pull me off and switch out the Reyataz.

I have no resistances and my doctor gave me the following options to think over to restart soon:

Truvada+Kaletra (5 pills/once day)
Truvada+Prezista+Norvir (4)
or I may just go with Atripla.

I'm not keen on the five pills; I'm looking for ease of use, the ability to take my meds and have minimal side effects (minus Atripla).  My DR supports any of my choices but seems like he wants me to do the Kaletra.

I know I'm  happy my eyes are returning to normal quickly! :)
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline newt

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  • the one and original newt
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #1 on: November 03, 2010, 05:09:44 PM »
Not the Kaletra (has 200mg Norvir, bad for lipids). Other two are good choices, subject to how you react to them, obviously.

Personally, I think it at least 2 cents short of a dollar in this circumstance not to switch straight away without a break (avoiding viral rebound etc)

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

Offline mecch

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  • red pill? or blue pill?
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #2 on: November 03, 2010, 05:10:56 PM »
Well here's to success on the next combo.

Newt - "not to switch straightaway"?

I'm wondering why OP wasn't immediately switched to a new combo for the next day.  Everytime I switched the doctor instructed me to start the new one 24 hours after the old one.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline thunter34

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  • Posts: 7,318
  • His name is Carl.
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #3 on: November 03, 2010, 05:48:26 PM »
Reyataz turned me absolutely goldenrod from head to toe, but took about a year to do so.  I totally recommend Prezista+Truvada+Norvir.  I do that combo now.  4 pills once a day.  The BEST combo I have been on so far.  No yellow, no poops, no sky high blood lipids.  It's been a great combo for me.
AIDS isn't for sissies.

Offline eric48

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Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #4 on: November 03, 2010, 05:51:34 PM »
Hi,

I would love to have more buddies on Viramune + Epzicom...

But your liver could be a bit sensisitive... so better opt for meds that do not affect the liver too much.

What about Isentress + TRUVADA or good old atripla (Efavirenz + truvada) ?

Cheers

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline surf18

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  • Posts: 525
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #5 on: November 03, 2010, 07:27:43 PM »
how come no one ever mentions selzentry which is what im on? not this posters doctor ,not anyone.  i never hear anyone on hear mention selzentry. just curious.

Offline newhorizon80

  • Member
  • Posts: 37
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #6 on: November 04, 2010, 12:05:55 AM »
This was my first attempt at treatment and I tried to really just stick to dealing with the jaundice (as I asked for various accounts on some other posts); yellowing was OK-- day three and four but then just got wildly yellow and sometimes seems like dark yellow with some blood shot veins too.  It look like I had an infection. The combo itself, minus the jaundice, was tolerable: some slight headaches, bubbly stomach.

There were a lot of factors that were going on in regards to why I didn't switch right away.

My DR at first only offered Kaletra option, but I asked for additional options.  I'm not a fan of the five pills.  Right now, since I'm pretty sure I won't be needing to wake up at 4 a.m. for work for a while, I'm leaning towards Atripla or Prezista.
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline newhorizon80

  • Member
  • Posts: 37
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #7 on: November 21, 2010, 01:25:11 PM »
Hi Everyone,

Just wanted to give an update: I started treatment again on 11/10 with Truvada/Prezista/Norvir.  Today, 11/21, I woke up with small hives around my arm, upper chest, and thighs.  They don't itch and are not blisters and have some have since become less noticeable.  Not sure if it is a sulfa reaction or just my body getting use to this regimen.  About two days into taking, stomach discomfort started and still persistant, but generally tolerable (didn't need to call off work like I did when my jaundice). Today, I haven't taken my dose yet (usually take it between 10:30a-12N, when I eat), I'm going to phase in trying night dosing.  So, I plan on taking today's in a few hours, then tomorrow with dinner (so no more than +3 hours lapse time).

My VL on my last day of the Reyataz regamine was 105, almost UD after two weeks, it's to bad the jaundice was making me crazy (billirubin level was 14.6!).

Here's to finishing up my second week and hope the symptoms will start to subside!
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline numbersguy82

  • Member
  • Posts: 292
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #8 on: November 24, 2010, 05:35:21 PM »
Hey New,
I'm on Prezista/Truvada/Norvir and had a similar reaction. Hives that didn't itch, but occasionally would tingle. I'm proud to say that after 2 wks all side effects vanished and I have felt great ever since. Good luck and I'm glad you made a good switch ;)
8/10- 73 cd4, 7%, and 300k VL *First Labs*
9/10- Started Norvir, Prezista, and Truvada
10/10- 511 cd4, 22%, and 886 VL
12/10- 498 cd4, 22%, and 106 VL
3/11- 529 cd4, 29%, and 101 VL
8/11- 620 cd4, 30%, and 74 VL- Switched to Atripla
10/11- 580 ce4, 30%, and 62 VL
12/11- 684 cd4, 31%, and FINALLY *UD*

Offline Zohar

  • Member
  • Posts: 249
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #9 on: November 24, 2010, 06:31:02 PM »
I'm also on this OP's new combination and have suffered from very itchy hives ever since I started. I take loratidine to bring down the itching but I'm hoping that, after 4 months, the hives subside soon.
''Poor is the man whose pleasures depend on the permission of another.''

Offline mecch

  • Member
  • Posts: 12,049
  • red pill? or blue pill?
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #10 on: November 25, 2010, 12:00:29 AM »
4 months seems a long time to have hives. What does your doc say about this?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Zohar

  • Member
  • Posts: 249
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #11 on: November 25, 2010, 04:46:03 AM »
Yeah, I think it's quite a long time too, but this is my third combination in a year so am trying to stick with it for now to see if they calm down.  I was on nevirapine and my skin flared badly on that one too, probably slightly worse, so I had to stop that back in the early summer.

The doctor said that it could be an immune response (IRIS) and that as my immune system gets better the hives should stop. My CD4 count is gradually going up and was just over 200 2 months ago, so will probably have gone up a bit more since, and my last viral load was 300, so only 100 away from undectectable.

I've just been given 4 months supply of my tablets so will see if the hives have cleared up by the time I'm next due to see my doctor in March. 2011.
''Poor is the man whose pleasures depend on the permission of another.''

Offline Tempeboy

  • Member
  • Posts: 359
  • Like St Francis of Assisi I am wedded to Poverty
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #12 on: November 26, 2010, 01:03:58 AM »
how come no one ever mentions selzentry which is what im on? not this posters doctor ,not anyone.  i never hear anyone on hear mention selzentry. just curious.

Hey Surf,

I am on Maraviroc and I loooooooove it - no side effects, very forgiving of missed/late doses and may have other benefits like protection against cancer - according to some early research, no pychiatric side effects, no hassles with blood fats or diarrhoea or rash and great penetration of the brain.

The difficulty with switching to Maraviroc is that you need a detectable viral load to see if you have the right 'tropism' - or surface structure on your CD4's - and most docs are reluctant to let people develop a detectable viral load to perform this test - so it's mostly used first line.

It's a cool drug.
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline Tempeboy

  • Member
  • Posts: 359
  • Like St Francis of Assisi I am wedded to Poverty
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #13 on: November 26, 2010, 01:06:14 AM »
I started this combo (*part of a blind study comparing Norvir to Gilead's GS9530) on a few weeks ago, however, a week into this combo, I developed very intense jaundice, primarly in the eyes, but then started to affect my skin tone (I stayed hydrated, etc.).  Went to my study visit and expressed concern over the intensity and my doctor decided to pull me off and switch out the Reyataz.

I have no resistances and my doctor gave me the following options to think over to restart soon:

Truvada+Kaletra (5 pills/once day)
Truvada+Prezista+Norvir (4)
or I may just go with Atripla.

I'm not keen on the five pills; I'm looking for ease of use, the ability to take my meds and have minimal side effects (minus Atripla).  My DR supports any of my choices but seems like he wants me to do the Kaletra.

I know I'm  happy my eyes are returning to normal quickly! :)


Truvada and Prezista would be the best in terms of risk of side effects, why not try it - you can always change.
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #14 on: November 26, 2010, 04:15:42 PM »


It's a cool drug.

but not yet availalable everywhere... Here, it is still reserved for treatment experienced people with resistance issues...

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline newhorizon80

  • Member
  • Posts: 37
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #15 on: November 29, 2010, 04:03:40 PM »

I just posted in another thread (Hives- IRIS) about how I developed impetigo/staph over the last week and now on antibiotics.  The hives on my arms went away after three or four days (or became faint enough people couldn't see)-- luckily, I wear a suit-uniform and didn't have any hives on my face.  However, the impetigo made it look like I had acne on my cheeks and chin, plus it's highly contagious so again, missed four days of work.

I did phase in taking my meds at night and the results have been much better.  I think since at dinner I eat a bigger meal, the meds don't effect my stomach as much-- not nearly as much as when I was taking it during the day!
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline newhorizon80

  • Member
  • Posts: 37
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #16 on: December 23, 2010, 10:54:07 PM »

I just wanted to report that my labs from 11/16 came back: CD4/499 and VL/<50.  My DR wasn't expecting to go undecetable so quickly, but I guess I did, even with only being on treatment for two weeks (10/19-10/31), stopping (11/1-11/9), restarting 11/10. Most recent lab is 12/15, with results next week, hopefully another measurable increase in CD4, but we'll see.

Now, a month into being on Prezista: I found that taking my meds >30-60 mins after eating gives me no stomach issues versus taking it "with food", which did give me an upset stomach.  I'm having a lingering issue with my skin, I'm not sure if it impetigo related even though that cleared up on my face, but my legs are looking a little beat up (folliciuitis?).  I'm using an over the counter skin detergent that may be helping versus going in to a dermatologist for now (or maybe a skin reaction to Prezista?).
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline buginme2

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  • Posts: 3,209
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #17 on: December 25, 2010, 10:32:13 PM »
Why dont you just go with the Atripla.  You said you wanted ease of use.  There isnt a regimin thats easier at the moment.   The side effects arent THAT bad.  Ive only been on it for a few weeks and the side effects are getting better each and every day.   If resistance isnt an issue you may want to consider it.  Plus only have one copay is a bonus.
Don't be fancy, just get dancey

Offline newhorizon80

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  • Posts: 37
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #18 on: December 26, 2010, 08:23:37 AM »

Buginme2,

Atripla was a top choice (I have no resistance issues), however I had to be mindful of my own personal needs and I felt as though, right now, Atripla was not a good choice due to the potential side effects.  While I may not know what those side effects would be until I actually try it, I felt better about being on Prezista.

One main concern is my work schedule; I'm currently on a rotating weekly schedule that either I have to be up at 2 a.m. for work one week, the next week working afternoons.
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

Offline buginme2

  • Member
  • Posts: 3,209
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #19 on: December 26, 2010, 06:50:30 PM »
isentress/truvada seems to be well tolerated and is pretty simple.  Truvada once a day and isentress twice a day.

Hopefully the other one pill/once a day treatments (yet to be approved) will have less side effects than Atripla.
Don't be fancy, just get dancey

Offline Inchlingblue

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Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #20 on: December 27, 2010, 08:22:52 AM »
Are you in the US? I don't get why some doctors don't stick to recommending the preferred options for first-line use:


http://www.hopkins-aids.edu/q_a/patient/recent_questions/lost_on_choosing_medication.html?contentInstanceId=513447&siteId=7151


Kaletra is not bad but many times comes with strong GI side effects. Why would he try and push Kaltera on you as a second choice? It makes no sense to me.

Offline newhorizon80

  • Member
  • Posts: 37
Re: Stopped Truvada/Reyataz/Norvir*, next options.
« Reply #21 on: December 28, 2010, 08:42:08 AM »
Yes, I'm in the U.S.

When he took me off the Reyataz, he only offered me Kaletra as my next option, but I spoke up and said "well, what else do we have?" knowing that there were other once-a-day options.  I guess I felt he was very happy with Kaletra maybe in other patients and that I would be OK with it.  When I mentioned Prezista, he was also very supportive of that combo.

My requirements was that I wanted a once-a-day combination. 
10/30/08: CD4: 486 VL: 13,000
04/23/09: CD4: 456 VL: 8,890
10/27/09: CD4: 358 VL: 6,260
04/27/10: CD4: 413 VL: 7,800
10/19/10: CD4: 416 VL: 26,400*
11/15/10: CD4: 499 VL: 0*
04/05/11: CD4: 521
09/20/11: CD4: 585
03/06/12: CD4: 634
05/29/12: CD4: 643
08/21/12: CD4: 968

 


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