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Author Topic: Truvada and Borderline Osteoporosis..Epzicom Substitute?  (Read 2519 times)

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Offline cityboy

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  • Posts: 143
Truvada and Borderline Osteoporosis..Epzicom Substitute?
« on: April 06, 2012, 04:13:22 PM »
I have been on Reyataz, Norvir and Truvada since I was diagnosed in 2007.  I took a second bone density test and my numbers fell back.  A couple parts of my body are borderline osteoporosis. I am starting to get pain in my right hip and lower back.  I am understanding Truvada is most likely the cause.  My doctor suggested a change to Epzicom.  Have any of you guys been in this situation, and switched to Epzicom?  Any side effects initially or permanently?  Anybody using biphosphates like Fosamax?  What are your side effects like with that?   

Offline ad2san

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  • Posts: 182
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #1 on: April 06, 2012, 05:51:26 PM »
Hi there I did this change. Primarily because of kidney problems (polyurie) and my knew that was reduced to smashed potatoe by just falling off my own weight. I had  the HLA-B alele exam done that came negative and started it with reyataz. Frankly, it is much better than truvada, you finally stop to fart! And it works great on the bio chemie side as well. One yellow tab a day. Good luck.
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 LiveWithIt

  • Member
  • Posts: 377
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #2 on: April 06, 2012, 08:35:50 PM »
I've been on Truvada for over 5 years, I'm not sure how long and I am having back problems now.  I just got an MRI a few days ago and don't have the results.  A regular xray didn't reveal anything that looked degenerative.  My back has been messed up in the past for a few weeks, but never like this.  I can hardly put weight on my left leg, it's  a bit numb and so is my left hip.  I can hardly get out of bed and am only comfortable when lying down.  When I can get up I can only be up long enough to walk to the bathroom or to the kitchen to get something quickly and it's back to bed.
Pray God you can cope
I know you have a little life in you yet.
I know you have a lot of strength left.

Offline cityboy

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  • Posts: 143
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #3 on: April 07, 2012, 07:17:05 PM »
I've been on Truvada for over 5 years, I'm not sure how long and I am having back problems now.  I just got an MRI a few days ago and don't have the results.  A regular xray didn't reveal anything that looked degenerative.  My back has been messed up in the past for a few weeks, but never like this.  I can hardly put weight on my left leg, it's  a bit numb and so is my left hip.  I can hardly get out of bed and am only comfortable when lying down.  When I can get up I can only be up long enough to walk to the bathroom or to the kitchen to get something quickly and it's back to bed.


I am having pain in lower back, but mostly in the left hip and pain in my right leg.  I am guessing that this is all related.  I will go to an endocrinologist for further analysis of my labs.  I am also getting a sensitivity test to see if Epzicom could work for me.     
« Last Edit: April 07, 2012, 07:19:02 PM by cityboy »

Offline sfpvguy41

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  • Posts: 114
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #4 on: April 09, 2012, 02:15:19 AM »
I was on the same regimen since 2005, diagnosed with osteoporis in feb 2011.  I switched to Epzicom after a failed experiment with Isentress.  Epzicom not only is better for the bones, but you can get off Norvir, which I did (I take 400mg Reyataz wtih Epzicom only now)  It is SO much better, to get off the Norvir.  My doc thought maybe flonase I take for allergies (corticosteriod) compounded by Norvir plus Truvada could have done it...

Good news is bone density test in Feb showed improvement of 7% (that's big) in a year. Unfortunately it'll take 5 years of improvement at this rate to be out of danger zone.  No problems to speak of bone-wise until a few weeks ago back problems, but I think they are unrelated. 

Take calcium supplements, check your Vit D, and Strontium supplements at night (12 hours off the calcium) has worked wonders for me.  Write me if you want more details.
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 cityboy

  • Member
  • Posts: 143
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #5 on: April 09, 2012, 09:38:41 AM »
I was on the same regimen since 2005, diagnosed with osteoporis in feb 2011.  I switched to Epzicom after a failed experiment with Isentress.  Epzicom not only is better for the bones, but you can get off Norvir, which I did (I take 400mg Reyataz wtih Epzicom only now)  It is SO much better, to get off the Norvir.  My doc thought maybe flonase I take for allergies (corticosteriod) compounded by Norvir plus Truvada could have done it...

Good news is bone density test in Feb showed improvement of 7% (that's big) in a year. Unfortunately it'll take 5 years of improvement at this rate to be out of danger zone.  No problems to speak of bone-wise until a few weeks ago back problems, but I think they are unrelated. 

Take calcium supplements, check your Vit D, and Strontium supplements at night (12 hours off the calcium) has worked wonders for me.  Write me if you want more details.

That's great news how you improved!

I am taking these meds since 2007 and think if I do not change I will go from borderline osteoporosis to full osteoporosis too.

I was using something similar to Flonase - Veramyst, but used half the dose and now I will not use it since it can effect bone density. I use Rainbow Light Allergy Rescue which is natural instead.   I have also stopped taking Zantac and use Mastic Gum and priobotics as well as diet change to control acid. 

I was thinking of taking Strontium too. My Vit D was checked and is fine. Can you tell me the dosage, and brands/types of the supplements you mentioned that you are taking and how you take them...spread them apart?

I also see that Magnesium, Vit K2 and Boron help to build bone density.  Do you take any of these?

My back and hips have been bothering me, but it could be more related to my working out at the gym a lot more now.  Do you work out too?  My doctor told me it can help me to have better bone density.

I am not understanding now why Truvada is prescribed if osteoporosis is a side effect when you can use Epzicom.  I don't get it???

« Last Edit: April 09, 2012, 10:01:38 AM by cityboy »

Offline buginme2

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  • Posts: 2,762
  • Certified Life Coach
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #6 on: April 10, 2012, 02:53:49 PM »



I am not understanding now why Truvada is prescribed if osteoporosis is a side effect when you can use Epzicom.  I don't get it???

Because Truvada has a better efficacy profile than Epzicom.  AND Epzicom has been shown to increase the rate of heart disease in some studies.
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Online Miss Philicia

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  • Posts: 23,582
  • celebrity poster, faker & poser
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #7 on: April 10, 2012, 04:57:24 PM »

I am not understanding now why Truvada is prescribed if osteoporosis is a side effect when you can use Epzicom.  I don't get it???


1) Truvada is seen as the most lipo-friendly NRTI

2) The majority of patients are on Truvada, so even if a small amount experience osteo issues it's contextually minor (except for a patient like you of course)

2) but above all of this the link is far from decisive -- I posted this in another thread you were in about the same subject last week but maybe you didn't see it

http://www.aidsmeds.com/articles/Bones_4878.shtml
"Iíve slept with enough men to know that Iím not gay"

Offline cityboy

  • Member
  • Posts: 143
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #8 on: April 17, 2012, 11:57:19 PM »
1) Truvada is seen as the most lipo-friendly NRTI

2) The majority of patients are on Truvada, so even if a small amount experience osteo issues it's contextually minor (except for a patient like you of course)

2) but above all of this the link is far from decisive -- I posted this in another thread you were in about the same subject last week but maybe you didn't see it

http://www.aidsmeds.com/articles/Bones_4878.shtml

Thanks for the link.


Offline cityboy

  • Member
  • Posts: 143
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #9 on: April 17, 2012, 11:58:43 PM »
Because Truvada has a better efficacy profile than Epzicom.  AND Epzicom has been shown to increase the rate of heart disease in some studies.

A little crazy, I get to choose between a heart attack or brittle bones. 

Online Miss Philicia

  • Member
  • Posts: 23,582
  • celebrity poster, faker & poser
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #10 on: April 18, 2012, 12:48:29 AM »
A little crazy, I get to choose between a heart attack or brittle bones. 

Well, it's not like anyone expects to be given aspirin for HIV.
"Iíve slept with enough men to know that Iím not gay"

Offline eric48

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  • Posts: 1,020
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #11 on: April 18, 2012, 05:28:07 PM »
Hi,

Only the DADS longitudinal study is reporting a 'possible' increased risk . Other studies (including one by FDA combining all the results from dual blinded clinical studies, the true benchmark of clinical decision) do not report this.

It is usually reported, that according to the DADS, the additional risk is a baseline multiplier of 1.9 (smoking is a multiplier of 2 to 3). BUT, if you read the original paper here (and not second or third hand comments):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688660/?tool=pubmed

and very precisely this:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688660/figure/F1/

you will see that the 'possible' multiplier risk is NOT across the board.

on section B of the above picture, you will see that for the people who have a baseline 'higher' risk, the multiplier is significantly high, but almost negligible for the ones with a low or moderate baseline risk. (for whom that multiplier should be 1.1 and not 1.9...). That intriguing finding has been confirmed in follow ups by the same study group.

If your baseline risk is either low or moderate, I see no reason to overworry about this.
Once again, the jury is still pretty much out on this matter as a whole, but certainly not if you belong to the low or moderate risk

If you have any concerns, you may discuss it with your doctor.

Cheers!


Eric

Offline Assurbanipal

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  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #12 on: April 18, 2012, 09:43:24 PM »
Hi

I found I had osteporosis after breaking a wrist 6 months after starting meds.  I  switched over to Epzicom (also trying and failing Isentress as part of the switch) and like Epzicom.

I tried Fosamax, but had an odd (and rare) reaction to it and was put on Actonel instead -- I'm on Boniva now mainly because my drug plan has a better deal with the manufacturer.  I would suggest that you start Fosamax as a weekly dose at first, just to make sure nothing goes wrong -- you can then move to monthly (which is much more convenient).  Fosamax is cheapest (generic) and has the most data around it.

I've had good response to Boniva, with 6% to 12% increases in bone mineral density so far.  I've not had any negative reactions to it or Actonel.

Gory details in this thread http://forums.poz.com/index.php?topic=23815.msg350408#msg350408  (and links to other sources of osteoporosis information)

Good luck -- I must say that while I am conscious of the fact that I might have a somewhat higher risk of spine fracture and take it into account in thinking about which physical activities to undertake, it is generally pretty invisible to me and doesn't really impinge on quality of life at all.  I hope you have the same result.

Assurbanipal

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline sfpvguy41

  • Member
  • Posts: 114
Re: Truvada and Borderline Osteoporosis..Epzicom Substitute?
« Reply #13 on: May 08, 2012, 01:04:44 AM »
Quote
I've had good response to Boniva, with 6% to 12% increases in bone mineral density so far.  I've not had any negative reactions to it or Actonel

hi, hey glad to hear that. I had about a 7% improvement after a year swapping to epzicom for truvada, dropping norvir, adding major vit d, calcium, strontium and weekly generic fosamax.  Same range, I hope it will keep up as I need five years at this rate to be out of danger.

Good luck to you!
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.

 


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