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Author Topic: Combivir and Kaletra - posted from the loo  (Read 2576 times)

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Offline usernotdefined

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Combivir and Kaletra - posted from the loo
« on: February 10, 2011, 08:48:43 AM »
Ugh.

Dose 4 this morning and GI side effects are increasing, but bearable at the moment. I'm also completely shattered, feel like I have been pole-axed. If I let myself I could easily sleep 12 hours straight, and each one of my frequent trips to the loo leaves me exhausted.

I know that this isn't a popular combination for treatment naive patients, but as some of you will know, I am pregnant and this is the recommended regimen for use in pregnancy.

I'm just wondering if my experience of this particular combination is typical, or if the tiredness is a pregnancy rather than HAART related symptom and for some idea how long it will take my body to get used to this.

Cheers!

UND x

Online Miss Philicia

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Re: Combivir and Kaletra - posted from the loo
« Reply #1 on: February 10, 2011, 08:59:24 AM »
I took both of these meds ages ago and yes, many patients had severe diarrhea from Kaletra.  As you need to be on this due to pregnancy I guess you'll just have to tough it out for nine months, but if the diarrhea persists you may request a prescription for loperamide (or something similar, I see you are in the UK) to control the diarrhea.

Otherwise I have no idea what "pole-axed" actually means :) If it's fatigue it is probably the AZT (retrovir) contained in Combovir.  Usually side effects are most severe during the first 3-4 weeks of starting any HAART regimen, but then subside a bit after that.

I can't imagine dealing with being pregnant AND commencing HIV treatment -- hope things settle down a bit for you.
« Last Edit: February 10, 2011, 09:01:36 AM by Miss Philicia »
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Offline Ann

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Re: Combivir and Kaletra - posted from the loo
« Reply #2 on: February 10, 2011, 09:02:03 AM »
We have a lesson about trips and tips for managing diarrhea (dire-rear, as I like to call it) and nausea. You may find some of it useful.

You should also ring your doctor to find out if you may use something like immodium, which can be bought OTC. There's no problem taking it as far as the hiv is concerned, so you could even just ask the chemist at Boots if you can use it in pregnancy.

As for the tiredness, my best guess would be that it is the combination of your pregnancy and the meds. I remember becoming really tired for about four-six weeks, from around the eighth week until to the fourteenth, give or take a week or so in either direction. I was pregnant 24 years ago so it's getting a bit hazy now.

The AZT in Combivir can also cause feelings of fatigue.

Hopefully all of this will settle down soon for you. Always remember, if in doubt, ring your doctor or clinic.
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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 Ann

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Re: Combivir and Kaletra - posted from the loo
« Reply #3 on: February 10, 2011, 09:12:26 AM »
Miss P, the British expression "pole-axed" is similar to the American saying "hit by a mack truck".

UND, You do have other options available if the Kaletra proves to be intolerable. From the UK iBase pregnancy guide...

This  third drug will probably be a protease inhibitor.

The protease inhibitor is likely to be lopinavir boosted with ritonavir (called Kaletra and in one pill) or either atazanavir boosted with ritonavir or saquinavir boosted with ritonavir.

Another drug that is often used is an NNRTI called nevirapine, which is a drug that has been widely used in pregnancy.

There is however a caution against the use of nevirapine for women with CD4 counts above 250 cells/mm3 because of a risk of liver (hepatic) toxicity.

Nevirapine appears to be safe for women with lower CD4 counts (below 250 cells/mm3). There is no concern with people who have used nevirapine successfully in their combination and now have a higher CD4 count on treatment.

You will probably receive nevirapine if you start your treatment with a CD4 count less than 250 cells/mm3.


I'll give you a tip about the dire-rear problem. If you're anything like I was while pregnant, you've probably already bought in a supply of baby-wipes. Take some into the loo with you and use them. You'll end up raw and sore if you use loo paper.
« Last Edit: February 10, 2011, 09:14:14 AM by Ann »
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 Ann

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Re: Combivir and Kaletra - posted from the loo
« Reply #4 on: February 10, 2011, 09:18:02 AM »
And I just discovered iBase has a whole page devoted to med side effects while pregnant.

Hope some of this helps!

Condoms are a girl's best friend

Condom and Lube Info  



"...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 usernotdefined

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Re: Combivir and Kaletra - posted from the loo
« Reply #5 on: February 10, 2011, 09:23:54 AM »
Miss P - Thanks for sharing, I too hope things settle down a bit, at the moment I would settle for being able to sit down, my @ss is like the Japanese flag!

Ann - Thanks for translating for me, I will educate these forums as to English colloquialisms! And the baby wipes tip too, will hopefully restore my rear to its former glory!

My nosing around in the forums has warned me of most of this, but I figured I would have a better time of it on the Kaletra tablets rather than the capsules but just to be on the safe side I have taken all doses so far with food - is this a good idea or an unecessary hassle trying to serve meals to coincide with my dosing times?

Offline Ann

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Re: Combivir and Kaletra - posted from the loo
« Reply #6 on: February 10, 2011, 09:35:12 AM »
As I suffer from chronic dire-rear, my loo is never without baby wipes. In fact I was in the shop the other week buying two special offer multi-packs of them when I ran into a mate I haven't seen in ages. She cocked an eyebrow at me and asked if there was something I wasn't telling her. ;D

I can't remember the food recommendations off hand, but you'll find them for each med you're on in the meds section of the website.
Condoms are a girl's best friend

Condom and Lube Info  



"...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

Online Miss Philicia

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Re: Combivir and Kaletra - posted from the loo
« Reply #7 on: February 10, 2011, 09:52:08 AM »
IIRC when the tablet version of Kaletra came out (years after the gel caps) the labeling changed to "with or without food" but I'd still say if you're having diarrhea issues then WITH FOOD will help you tolerate it more.  Mind you, this doesn't require having a huge meal, just some sort of food helps.  I've found just having a toasted bagel with a small amount of butter makes a difference, or something like that. 
"Iíve slept with enough men to know that Iím not gay"

Offline Sweet_C

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Re: Combivir and Kaletra - posted from the loo
« Reply #8 on: February 12, 2011, 10:11:41 AM »
It's hard to tell if your side effects are more from your pregnancy or from the drugs or a combination of both.  Both diarrhea and fatigue can be symptoms of pregnancy.

I'm pregnant and I'm on Combivir, Reyataz, and Norvir, and I've been on them since before I conceived.  Even before I got pregnant, every now and then I would a have a sudden bout of diarrhea soon after I took my meds.  Then my doc told me that the Norvir can cause diarrhea and suggested that I take it with food.  I didn't have any more issues whatsoever with diarrhea after I started taking it with food, and I'm sure it's the same for the Kaletra.

On the fatigue, I didn't have any noticeable issues with fatigue from the Combivir before I got pregnant.  When I first started I got headaches and I might have been fatigued--I don't remember.  If I was, I definitely was not completely wiped out from it.  I was extremely fatigued during my first trimester and just laid in bed the whole time when I wasn't at work.  Then the fatigue completely went away my second trimester, so I'm pretty sure that the fatigue was mostly due to the pregnancy and not the drugs in my case.
 
Definitely talk to your doc about your symptoms.  Since you just started treatment, you might want to wait a few days before switching to something new to see if your body adjusts to the regimen.   Be sure you're taking your prenatals too.  Your doctor also might advise you to take additional vitamins to help out.  If none of that works, there are definitely other safe alternatives you can try during pregnancy that might agree with you better.

Hope you get some relief soon!
Tested positive on September 11, 2008

 


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