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Author Topic: If shingles wasn't enough, now I see what looks like a severe Atripla rash  (Read 5978 times)

0 Members and 1 Guest are viewing this topic.

Offline kuttakamina

  • Member
  • Posts: 45
While I was dealing with a sudden onslaught of Shingles (first time in my life) that started a few days ago and am taking treatment for it, posted here http://forums.poz.com/index.php?topic=37056.0

now I see lots of tiny and mid-sized dots all over the body, that tend to itch a little which I try not to rub, but just massage them gently. It appears it is Atripla rash (have been on it for 11 months) and it's the first time I'm getting these rashes (of course some people can get them after a long time, while some soon enough and some never).

I have insurance but I can't run to an hiv doctor as I've had insurance for less than six months and with a pre-existing condition I don't think I'll get treatment regardless (if covered less than six month). The only option may be to slowly wean off Atripla and deal with whatever happens. Unless it's the Acyclovir that I'm taking for Shingles that's causing the rash. Guys, my mind is spinning and I'm trying to stay calm in all this.

Any thoughts or suggestions will be very much appreciated. It's amazing how soon the situation can change, my last lab work showed OK levels of liver function...




Offline mecch

  • Member
  • Posts: 12,082
  • red pill? or blue pill?
A number of questions.

How did you get the HAART - isn't your insurance covering that? So why would another trip to whatever doctor gave you the prescription be forbidden?

Why worry about your liver function because of a rash, and without new blood work to prove that your liver is having a problem?

I wouldn't quit the HAART without a doctor's consultation first. 
Also - you can try some antihistamines and see if the rash gets worse or chills and maybe even fades.

I have had rashes and each times was fixed by a change in HAART combo.  Maybe that would be in order for you too. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline kuttakamina

  • Member
  • Posts: 45
Mecch,

I picked the meds overseas by paying cash and my doctor is overseas in India. I picked almost a year's supply of which I only have 4-5 months supply left. Everytime I have talked to him (last time was two months ago) he says the same thing, no, you cannot stop the meds.

So, it's possible that liver function can go off the chart in less than two months? Without getting another test (pay from my pocket) I can't say. Isnt' prednisone an antihistamine? I'm taking 20 mg everday and it's a 21 day course.

To change meds I would have to see a hiv specialist here in US, and I'll run into the pre-existing condition limitation that will deny me meds, so that may not be an option until I finish my six months of employment.

Phew! btw, I love your pic of Guru Gobind Singh ji!

Offline mecch

  • Member
  • Posts: 12,082
  • red pill? or blue pill?
Ah that explains a lot.
Well I know nothing about the shingles drugs. I am not in health care whatsoever.  I just shared my experience with rashes from HAART.  Like you, doctors said never to stop, I just had to switch the next day to the new combo.
Can't you call your Indian doc then and ask him what to do?  What a dilemma.
Can you go to a clinic where you are, for a consultation at least?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline J.R.E.

  • Member
  • Posts: 7,260
  • Joined Dec-2003 Living positive, since 1985.
Hi,

How long have you been on Prednisone ? The rash might be  associated with that drug.


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 8/25/14,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
What JRE said about prednisone, it is a noted side effect and more likely as you have started the drug recently. It probably isn't doing much for your shingles anyway.

Efavirenz rash tends to happen at the beginning of treatment. You cannot diagnose a rash without other indicators,. In the case of efavirenz, liver markers are important (the test is cheap) cos this is the serious point of harm (if it is efavirenz).

If the rash blisters or you get fever it is an emergency.

There is no weaning off efavirenz. Stopping without other ARV cover carries a 50% resistance to the two most common NNRTIs, efavirenz (in Atripla) and nevirapine (Viramune).

Good luck, let us know how it goes.

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

Offline kuttakamina

  • Member
  • Posts: 45
Ray,

Started the first dose of prednisone (3tabs all at once) this morning around 7:30am and the rashes do seem little worse around 12:30pm and onward...The dosage is 3tabs once daily for 1 week, then 2T daily for 1 week, then 1T daily for one week.

Started Acyclovir last night and took three doses (one last night and two today -it's a 1 tabx4 times a day).

Which also makes me to ask the question...is the prednisone also for shingles or it is just to get the swelling around the eyes down, the area most affected by shingles? Rather, if Prednisone is stopped, could it affect treatment of shingles with Acyclovir possibly?

Offline J.R.E.

  • Member
  • Posts: 7,260
  • Joined Dec-2003 Living positive, since 1985.
It probably isn't doing much for your shingles anyway.


- matt



Having shingles several times over the past 25 years, I was only given Acyclovir for that.  However, I have been on Prednisone before, the only issues I had with that was some intense anxiety.  Prednisone can be a tough drug to handle.

I am also wondering, if you might be able to drop the Prednisone.  Something you should ask your doctor about.

Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 8/25/14,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline kuttakamina

  • Member
  • Posts: 45
Ray and others,

It's possible most of you may have gone to bed by the time I post this but after four hours of waiting for the doctor and three calls later, all in vain, I was finally able to talk to the "on-call" physician who also did not seem the brightest tool in the shed.

His suggestion is to stop the Acyclovir and continue the Prednisone (which is anti-allergenic) even though I said I suspect it's the prednisone. But he didn't think so. So, I have to make a decision here in the next hour if I should follow his advice or my instinct (which has deceived me on occasion in the past).

So, a touch of more dilemma...
« Last Edit: March 23, 2011, 12:11:19 AM by kuttakamina »

Offline J.R.E.

  • Member
  • Posts: 7,260
  • Joined Dec-2003 Living positive, since 1985.
Ray and others,

It's possible most of you may have gone to bed by the time I post this


No,...I had to go into work last night.! :P   It's a tough decision, because both these medications can cause similar side effects.

http://www.drugs.com/sfx/prednisone-side-effects.html

http://www.drugs.com/sfx/acyclovir-side-effects.html


If you decide later on that you need to stop the Prednisone, make sure to discuss with your doctor , how to do this properly.


Let us know how things are going.

Ray

Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 8/25/14,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
Prednisone is a palliative and controversioal (ie non-standard) in managing nerve damage post-shingles.

Aciclovir treats the virus that causes shingles.

Alternatives to prednisone: Neurofen (ibuprofen) etc at a strong dose may be as good (or better) if it works at all. Post-herpetic neuralgia is kinda hard to treat. The best medicine is time...

Know what my choice would be (not prednisone).

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

Offline kuttakamina

  • Member
  • Posts: 45
Guys,

So it seems quite certain that it's the Acyclovir that is giving me serious rashes over the body. The doctor also suspected that and had me stop this medicine for now. I am continuing to take Prednisone and since I have not taken Acyclovir all day today I do feel little relief with new rashes, though old ones are still  there. It may be several weeks before they clear out.

We really are puppets in the hands of these doctors who are really looking at a computer screen, and doing click, click, click to get to a page where the system tells them what to prescribe. I could do a lot of clicking too and arrive at the same page.

There's still zero relief to the swelling in the eye which is sealed shut for three straight days now...one of the many collateral damages of this illness...

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
Hello India!

Well you have made you choice, hope the rash etc resolves, let us know what happens.

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

Offline J.R.E.

  • Member
  • Posts: 7,260
  • Joined Dec-2003 Living positive, since 1985.
Good luck to you...

I never had shingles on the face, but I do know how painful they can be.   If Calamine lotion is available to you, i would give it a try on the rash. It has always helped for me.


Ray

« Last Edit: March 23, 2011, 08:14:43 PM by J.R.E. »
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 8/25/14,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline kuttakamina

  • Member
  • Posts: 45
All,

Six long hours at the doctor's, two of them actually, one regular MD and one eye-doctor this morning and the determination is that I need to get admitted to ER or to a hospital immediately. They are trying to find a suitable location that accepts my Anthem BC insurance. They want to give Acyclovir again, only through IV this time as I had a serious rash to the tablet form.

My other option is to try two new drugs, only one FDA approved but the hiv specialist warned that these drugs have had a substantial renal failure in quite a few people so he does not feel comfortable in giving them, but the risks and choice is mine.

So, in an hours time, off I go, to a brand new adventure. As one Son of God might say "Oh, Lord, why hast thou forsaken me"? but I'm not going there yet...I'm still counting my blessings...however small they may appear to be at the moment.

Adios all, If I make it, I'll stop by to say hi again, if I have to take the deadly drugs tied to renal failure, you can guess what happened.

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
Good luck. Opthalmic shingles is a serious matter.

In hospital you will be closely monitored so I expect you'll be back.

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

Offline J.R.E.

  • Member
  • Posts: 7,260
  • Joined Dec-2003 Living positive, since 1985.
Kutta,

Sorry about the tough time your having.  You'll get through this, hang in there.


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 8/25/14,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

 


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