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Author Topic: My first combo - Epivir(lamuvidine) + Viramune(nevirapine) + tenofovir. Advice  (Read 1085 times)

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Offline Pek

  • Member
  • Posts: 23
Hi,
I just came back from the Dr. The appointment was a kind of weird for me because he was changing the combo many times depending on  my answers to his questions. I was scared. I said I want the best to fight against the disease. He said to me that all the combos have the same result( or close to) but due to  my lifestyle (I am 30 and I dont have a regular time neither to sleep neither to wake up) he thinks the best  prescription is the one mentioned below. I need to trust. Thats the combo:
2 lamuvidine of 150mg per day
2 nevirapine of 200 mg per day
1 tenofovir of 300 mg per day
I will appreciate if someone tells me about side effects, results and all u can help me.
Its my first time taking meds against HIV. My labs results was CD4 281 and viral load 9,500. I had my poz 3 weeks ago.
thanks a lot

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Not so fast...

Viramune is OK 2x 200mg once daily (I take it like this) ONLY after
A- your VL is below 50
AND
B - you have been on treatment for more than 6 months already

(and your Doc is OK with that)

Before that, it is 2 times per day. no exceptions!

With Viramune XR, it is approved once daily after a heads up of 2 weeks with 200 mg ONLY once per day

Pharmacokinetics of Viramune (200mg x2 / once daily) is such that you may not want to play too much with the time frame

The first 6 months are important and messing around with your doctors precise recommendations, timing, dosing, adherence is a NO-NO (in my book)

For Lavimudine, I do not know, since I take it coformulated with Abacavir in Kivexa, which is approved once daily, but apparently this can be taken once daily:
http://www.aidsmeds.com/archive/Epivir_1579.shtml

Hope this helps

Eric

« Last Edit: August 17, 2012, 04:48:01 PM by eric48 »
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline alberche

  • Member
  • Posts: 212
  • a distancia del mundo incierto, saludo mi suerte
Dear Pek,

As an alternative to Nevirapine (Viramune) you may suggest your doctor to consider Etravirine (Intellence) which is from the same family of meds, it is a recently developed med (about 3 years ago), with much less side effects, and you can take the whole dose since the beginning.

The cons of Intellence is that it should be taken with a meal (a breakfast or a brunch or a sandwich and juice or similar). Even if the protocols say it has to be taken twice daily (200 grams each 12 hours - to fulfill a 400 grams daily dosage), "Etraswitch" and other clinical trials have shown that it can be also taken once daily, it means, all the 400 grs dosage in a single take.

As per regards to lamivudine and tenofovir, there is a combo in a single pill: Truvada, that contains tenofovir and emtricitabine, this last one, emtricitabine, is almost the same substance than lamivudine and acts in the same way. Maybe you also could comment this to your doctor.

Maybe it will become more easy for you to be taking Truvada (one single pill once a day) plus Intellence (4 pills altogether once a day with some food -or 2 pills in the 200 grs formulation-), taking then all your meds just only once a day.

At any case and with any of the HIV meds, it is very important to be consistent in taking them every day and respecting your pill time as much as possible. This clockworking is essential for meds to be effective and to avoid viral resistances.

Hugs,

 8)


love is blindness...  a wonderful song!

Offline Pek

  • Member
  • Posts: 23
Thanks for the help. I already started taking meds. Its the 5th day today. Im feeling well. Just a mid-nausea most of the time. I hope I dont have more side-effects later.

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Hi,

I do not remember too well (since I am aleady 2 years into treatment, this is a past story for me), but adverse side effects do not really occur in the very first few days.

On the other hand after month 2 or 3 you are in a safer zone.

Therefore , for the next few weeks do not stress you body too much, drink lots of water. any activity that tire you should be avoided (parties, etc.) , just to be on hte safer side.

Please be reminded that Viramune has a low barrier to resistance , therefore, until you reach month 6 or so, I think it is a good idea to stick to a precise timing and dosing. and of course, do not miss a dosing time. If you miss oneor 2 : no panick, but still 100 % adherence is key and very much so for the first 6 months or so.

Wishing you well eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

 


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