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Author Topic: Skipping a Dose  (Read 1372 times)

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Offline Matthew_74

  • Member
  • Posts: 4
Skipping a Dose
« on: April 12, 2012, 01:12:51 PM »
My doctor told me to skip a dose of Atripla in order to get on a different schedule. I was taking it at night, but wanted to switch it to the AM, he said to skip tonights does, and take it at 9 AM everyday.

Opinions, Advice? Could this do any damage or cause the HIV to be resistant to the Atripla?

Offline ad2san

  • Member
  • Posts: 187
Re: Skipping a Dose
« Reply #1 on: April 12, 2012, 01:37:24 PM »
Hello Matthew, trust your doc   ;)
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%
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%
Aug 2014 CD4 639 UD 25%

Offline Hellraiser

  • Member
  • Posts: 4,136
  • Semi-misanthropic
Re: Skipping a Dose
« Reply #2 on: April 12, 2012, 03:39:59 PM »
My doctor told me to skip a dose of Atripla in order to get on a different schedule. I was taking it at night, but wanted to switch it to the AM, he said to skip tonights does, and take it at 9 AM everyday.

Opinions, Advice? Could this do any damage or cause the HIV to be resistant to the Atripla?

Once you are undetectable, you can do a lot of things with the timing of atripla.  If a medical professional told you to skip a dose and take it in the morning then follow his instructions.

Offline LoboDog

  • Member
  • Posts: 78
Re: Skipping a Dose
« Reply #3 on: April 12, 2012, 11:51:34 PM »
I read someplace that 90% adherence to your meds is satisfactory. I skip a dose every 2 weeks or so (just so that I have stock pile if my life goes to hell in a handbasket). I've been undetectable for over 3 years now...

But as ad2stan said, trust your doc

Offline leatherman

  • Member
  • Posts: 6,154
  • Google and HIV meds are Your Friends
Re: Skipping a Dose
« Reply #4 on: April 13, 2012, 01:23:20 AM »
I read someplace that 90% adherence to your meds is satisfactory.
studies say 95%. efficiacy begins to fail after that and resistance begins to become a factor

Successful long-term treatment of HIV/AIDS requires at least 95% adherence to HAART in order to prevent emergence of drug-resistant HIV variants that lead to regimen failure and limit options for future therapy--
http://www.ncbi.nlm.nih.gov/pubmed/12737640

Effect of adherence to HAART on virologic outcome and on the selection of resistance-conferring mutations in NNRTI- or PI-treated patients.--http://www.ncbi.nlm.nih.gov/pubmed/17956829

google 95 adherence to haart
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline buginme2

  • Member
  • Posts: 2,844
Re: Skipping a Dose
« Reply #5 on: April 13, 2012, 02:39:25 AM »
I skip a dose every 2 weeks or so

Skipping one dose every two weeks would be a 92% adherence rate (your missing about 24 doses per year).  Reduce that to 18 and your at 95%.  However, me thinks Atripla may be a bit more forgiving than some other treatment options.  Just a thought though.

Offline J.R.E.

  • Member
  • Posts: 7,126
  • Joined Dec-2003 Living positive, since 1985.
Re: Skipping a Dose
« Reply #6 on: April 13, 2012, 08:06:02 AM »
Sounds like the right way to transition a timing change of your medication.  Your doctor didn't want you to take a dose ( at lets say)  11:00 pm, and then another dose at 9:00 AM the following morning.  If I was on Atripla, that's the way I would want to do it.

There's no problem---Ray
« Last Edit: April 13, 2012, 08:08:13 AM by J.R.E. »
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg 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


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline bufguy

  • Member
  • Posts: 161
Re: Skipping a Dose
« Reply #7 on: April 13, 2012, 09:43:48 AM »
The FOTO study, Five On Two Off, studied undetectable patients who took Atripla Monday through Friday then didn't take it Saturday and Sunday. The study showed no statistical difference in those on the 7 day regimen and those on the 5 on, 2 off. The effavirenz component has a very long half life.
I discussed this study with my doc and he said he would never recommend the FOTO regimen because it leaves little room for error, as in missing additional doses. What it does show is how forgiving Atripa is to missing a dose here and there.

Like everyone says trust your doc. Atripla is a very well studied regimen!
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .9

Offline leatherman

  • Member
  • Posts: 6,154
  • Google and HIV meds are Your Friends
Re: Skipping a Dose
« Reply #8 on: April 13, 2012, 09:48:36 AM »
However, me thinks Atripla may be a bit more forgiving than some other treatment options.  Just a thought though.
quite possible as the FOTO study (http://www.natap.org/2009/IAS/IAS_63.htm) has shown that Atripla can be taken 5 days on, 2 days off a week. there was even some evidence gathered in this study that showed accidentally skipping a third daily dose in a row did not compromise treatment - but this was not a regular occurrence and was not studied.

Of course changing to any other dosing schedule than once-a-day, as prescribed by YOUR doctor, is improper, risky, and needs to be discussed with your doctor to get his/her approval. However missing an occasional dose of HAART is NOT the end of the world and not a concern for resistance.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

 


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