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Author Topic: Epzicom Reyataz Norvir switch  (Read 2868 times)

0 Members and 1 Guest are viewing this topic.

Offline ad2san

  • Member
  • Posts: 184
Epzicom Reyataz Norvir switch
« on: October 05, 2011, 03:10:11 PM »
Hi together,

I am under Epzicom (Kivexa), Reyataz (300) and Norvir (100). My doc would like to switch Reyataz Norvir to Viramune XR

Anyone did this switch  ?

I am curious also, did anyone dropped the Norvir and increase the Reyataz to 400 ? How does this work ?

Cheers
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%
Apr 2011 CD4 523 UD 21%
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%

Offline newt

  • Member
  • Posts: 3,877
  • the one and original newt
Re: Epzicom Reyataz Norvir switch
« Reply #1 on: October 05, 2011, 04:06:28 PM »
You can do Reyataz 400mg without Norvir with Epziocm. The Norvir is a booster and needed with Reyataz when you use a tenofovir based pair of nukes (like Truvada), but this is not necessary with Epzicom.

I am a little intrigued why the Viramune switch tho...is there a reason? ...are you happy on Reyataz?

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

Offline ad2san

  • Member
  • Posts: 184
Re: Epzicom Reyataz Norvir switch
« Reply #2 on: October 05, 2011, 04:33:03 PM »
Hello Matt,

thanks for the post. I have no clue why he wants to switch me to viramune xr, except elevated bilirubine my blood works are fine. Since I switched from Truvada I lost the 10 kilos I gained in the first year, and I wake up less during the night. In short, I am very happy with Reyataz.

Maybe he expects from a change an increase in my CD4 that sort of plateaued since 2 years ....

Take care

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%
Apr 2011 CD4 523 UD 21%
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%

Offline newt

  • Member
  • Posts: 3,877
  • the one and original newt
Re: Epzicom Reyataz Norvir switch
« Reply #3 on: October 05, 2011, 06:20:45 PM »
Elevated bilirubin, if it is not causing you social problems, on Reyataz is generally not harmful. There are two types and Reyataz raises the non-harmful type.

Viramune is unlikey to improve your CD4 recovery.

I am generally of the if it ain't broke don't fix it school with meds.

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

Offline ad2san

  • Member
  • Posts: 184
Re: Epzicom Reyataz Norvir switch
« Reply #4 on: October 18, 2011, 05:31:25 AM »
You can do Reyataz 400mg without Norvir with Epziocm. The Norvir is a booster and needed with Reyataz when you use a tenofovir based pair of nukes (like Truvada), but this is not necessary with Epzicom.

I am a little intrigued why the Viramune switch tho...is there a reason? ...are you happy on Reyataz?

- matt


Hi Matt,

I had appointment today with the specialist. So the reason he wants me to switch is that I had a bleeding kidney episode not to long ago where the urology said, after examination (CT, goldbladder ...) , that, in absence of any other diagnostic the reason might be due to reyataz. The dr. Said he does not want to take the risk of a biopsy the make sure of it or not since there are other treatment possibilities.

He offered me prezista or viramune XR but recommended prezista dur to increase stroke risk using PI .
Well I have my starter set for viramune, let's see I don't get the rash ....

Cheere
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%
Apr 2011 CD4 523 UD 21%
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%

Offline eric48

  • Member
  • Posts: 1,112
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Epzicom Reyataz Norvir switch
« Reply #5 on: October 18, 2011, 06:12:56 PM »
If you switch you will become pill buddy to a few members on this forum.

I think POZOZ

http://forums.poz.com/index.php?action=profile;u=20551

did that same switch and if I remember correctly was quite happy with it.

I have a thread on V & E here where I also try to keep track of recent information about this less popular combo

http://forums.poz.com/index.php?topic=33062.0

This combo went out of fashion, but, recently a number of 'treatment naives' are offered this option as well as other patients as part of treatment tweaking.

Viramune is kind of a gamble. If you have a negative reaction to it you are going to loathe it.

Those who have successfully passed the initial period seem quite happy with it. I yet have to read a post with complaints about it (apart from the initial period, of course). It is not popular every where... But n some countries where it is (such as Spain) I think I read a report saying that this is a drug with a relatively low drop out rate.

the more recent drugs seem to be more trendy or easier to take.
Viramune is an older drug, but, apparently survived the various changes in the market.

Very few 'bad' long term side effects are being reported about it and millions of people have or had been using it. If it were 'lesser' drug, it would show...

The one that worries me a bit more is the Abacavir (part of epzicom), but , I guess there is no perfect combo anyway.

I think it is worth the try. If your body can not adjust to it, then, well... you will still have the option to switch back  

Officially Viramune is twice a day but most people take it once daily , off label, as I do

Viramune XR is once a day, already approved in the US and coming soon in other parts of the world

Wishing you good success with it

Cheers!

Eric
« Last Edit: October 18, 2011, 06:14:43 PM by eric48 »

Offline sfpvguy41

  • Member
  • Posts: 115
Re: Epzicom Reyataz Norvir switch
« Reply #6 on: October 19, 2011, 02:45:02 AM »
I am on reyataz 400 and epzicom. I am really happy with it. Without the norvir boost my bilirubin has gone down. I've lost weight and less gassy, firmer stools (i think this is all from getting rid of Norvir.) my CD4s are at an almost record high and cd4% is at record high between 38 and 41!

I don't know why this combo isn't more common it seems simpler and I am so happy to say I love it. No side effects to speak of.

Can't speak to viramune. Good luck!
Labs: (undetectable since 2005)
12/13: 634 cdr, 37.3%, 758 cd8, total chol 183, triglycerides 131
8/13: changed to Edurant from Reyataz
12/12: 828 cd4, 34.5%, 1078 cd8, total chol 192, tri 196
12/11: 787 cd4, 37%, 979 cd8.
9/11: 758 cd4, 38%, 944 cd8, und.
8/11 dropped norvir, incr reyataz to 400 mg
6/11: 621 CD4 CD4% 41, CD8 680! Undetectable. Creatinine and eGFR are ok now.
Switched from Truvada to Epzicom in late April 2011
AGT/AST and creatinine back to normal mid-April.
Cut Norvir from regimen.
Switched back to Reyataz/Norvir late Feb 2011
2/11: CD4 664 34%, CD8 963, diagnosed with osteoporosis, high AGT/AST and creatinine.
12/10: CD4: 676 CD4%: 34 CD8: 1012
Switched from Reyataz/norvir to Isentress 10/10
8/10: CD4: 731 CD4%: 40 CD8: 866
Diagnosed Sept. 2002 started meds May 2005.

Offline ad2san

  • Member
  • Posts: 184
Re: Epzicom Reyataz Norvir switch
« Reply #7 on: October 19, 2011, 02:51:34 AM »
Right the combo is easy to use. I have the same bilirubine issue. No big deal. I think that the switch is more motivated by the cristals in the kidney that happened to me. This is a side effect that impact very few people, the doc means that it may be something genetic since the only patient they follow in the hospital that have this problem originate from my country  :)

Anyway @eric48 I like the idea of having a Walabi pill buddy :-). I'll keep u posted guys on how do with this combo.

Cheers
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%
Apr 2011 CD4 523 UD 21%
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%

Offline newkrr

  • Member
  • Posts: 32
Re: Epzicom Reyataz Norvir switch
« Reply #8 on: October 25, 2011, 09:53:10 AM »
Hi I'm currently midway through my fourth week on this combination. (Kivexa, Reyataz and Norvir)

Had elevated Billirubin levels (66?) at my two week check which seems to be a pretty common side effect.

Just the past few days my upper back is really sore on both sides, feel totally wiped out, my legs feel like lead.

Anyone else have similar side effects on this combo?

Going back Thursday for a check up so will discuss it then, hoping it will pass as this seems to be an easy combo to take!

Cheers

Offline ad2san

  • Member
  • Posts: 184
Re: Epzicom Reyataz Norvir switch
« Reply #9 on: October 25, 2011, 01:43:34 PM »
Hi Newkrr,

it might be the Immune Reconstitution syndrome stuff .... as well as a common cold.
Talk about it with your doc but you should not worry too much and yes it is very easy to take except the with food (Norvir Reyataz) element that in some circumstances forces you to eat a cereal bar or a twix  ;)
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%
Apr 2011 CD4 523 UD 21%
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%

Offline newt

  • Member
  • Posts: 3,877
  • the one and original newt
Re: Epzicom Reyataz Norvir switch
« Reply #10 on: October 25, 2011, 01:44:03 PM »
Starting meds hammers a serious viral infection which is like long-term flu, and your body will do recovery things like ache, sleep et al.

This said, any symptoms post-meds like this eg upper back pain, fatigue etc in the first few weeks are worth checking out, but not worth a panic over.

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

Offline newkrr

  • Member
  • Posts: 32
Re: Epzicom Reyataz Norvir switch
« Reply #11 on: October 25, 2011, 04:56:43 PM »
Hey Guys,

Thanks for your replies, yeah i'm not panicking yet, just wanted to get the right combo first time but like you say will wait and see!

Will have a chat on thursday and see what they say.

I'm sure all will be well  :)

Offline ad2san

  • Member
  • Posts: 184
Re: Epzicom Reyataz Norvir switch
« Reply #12 on: January 31, 2012, 05:29:57 PM »
Three months later ... I am totally happy. CD4 raised, % raised to an historical high  ;D UD. No side effect at all. Easy to take. Glad I switched. Cheers
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%
Apr 2011 CD4 523 UD 21%
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%

Offline eric48

  • Member
  • Posts: 1,112
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Epzicom Reyataz Norvir switch
« Reply #13 on: January 31, 2012, 06:36:51 PM »
so now, you're a pill buddy of mine...

welcome to the club !

http://forums.poz.com/index.php?topic=33062.0

Eric


Offline deibster

  • Member
  • Posts: 153
Re: Epzicom Reyataz Norvir switch
« Reply #14 on: January 31, 2012, 10:48:55 PM »
Viramune is an old drug. I was on it for a long time & it was fine until I developed complications with another drug I was on, & the doc switched both of them at the same time.
I would say that, Viramune is Fine for the treatment Naive. If you are switching meds because you are failing the regimen that you are on, then there are probably better drugs for you than Viramune. Hugs, Deibster
Poz since Dec 1992. Meds since 1995. Disability since 2005.

Prezista/Norvir, Epzicom, Cytomel, Prevacid, pravastatin, Fenofibrate, Remeron, Zoloft, Concerta, doxazosin, Allegra180, Nasocort, Centrum, Flax Oil, Fish Oil

 


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