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Author Topic: Stop Atripla after first day  (Read 2130 times)

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Offline Mattnben10

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Stop Atripla after first day
« on: April 20, 2014, 12:52:22 PM »
I was discharged from the hospital with a supply of Atripla to begin treatment. Because my adap application is pending, they were nice enough to find a two week supply of Atripla for me. However, no one explained the side effects or anything.

At home, that night at 10pm (Thursday 4/17/14), I took my first dose of Atripla. About an hour or so later, I went to sleep.

At around 5 am the next morning (Friday 4/18/14), I awoke partially from some sort of nightmare. People were in my bedroom pointing and laughing. This faded away. My head was all fuzzy, I had a headache, I felt extremely exhausted, but had trouble falling back asleep.

All day Friday, I was miserable. I felt like I was stuck in my body, clawing to get out. It seemed like extreme withdraw from a narcotic of some sort. My mind was not itself. I was paranoid and depressed.

This freaked me out. So, after one dose of Atripla, I decided not to take my second dose.

The following day, Saturday 4/19/14, not much had changed. I still felt these side effects. I read through the forum and was contemplating just taking my second pill and continuing treatment until the side effects subsided. However, I would feel more comfortable talking to a specialist before hand. As it is Easter weekend, it's impossible to get a hold of anybody that has answers.

So, now it is Sunday and I am still feeling really weird.

Why am I still feeling these side effects when I only had one pill of Atripla??

If I decide to resume treatment with Atripla, is it bad that 3-4 days passed from when I took my first (and only) pill?

Has anyone else stopped after only one pill? What was your experience? Did you resume taking the pills?

Any help, answers, or support would be greatly appreciated!

Online Jeff G

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Re: Stop Atripla after first day
« Reply #1 on: April 20, 2014, 01:22:19 PM »
Welcome to the forums . I think you should be on the phone with your doctor about this at the first possible opportunity you have . I do not ever want to tell a person to stop taking meds before consulting with a doctor first . I have no way of knowing how acutely sick you are and if its absolutely necessary that you be on treatment immediately, since you were just released from the hospital I assume there is great need for treatment .

The central nervous system or CNS complications can be severe with this drug, it can cause life threatening feelings of hopelessness and thoughts of wanting to harm yourself as well as the sleep disturbances you are having .   

Its in your favor that you have only taken one dose of the med, you will not suffer any problems with resistance issues in this case . Only you know the status of your health and can determine if you can afford to wait a few days to talk to a doctor about a new combo .
I would think that in most cases a few days isn't a big deal but you are better off to determine that than I . 

Here is a thread devoted to Atripla/ Sustiva to read . http://forums.poz.com/index.php?topic=47901.0

Offline Mattnben10

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Re: Stop Atripla after first day
« Reply #2 on: April 20, 2014, 02:09:40 PM »
My numbers are very low. I was cleared of any opportunistic infections and was prescribed Atripla. They gave me enough of the drug to last me to when my adap kicks in.

So, I'm supposed to be taking it. I just got scared of the side effects and didn't continue taking it. Now I am debating if I should just start again and tough it out until the side effects subside. I just have fear that they will never subside.

Online Jeff G

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Re: Stop Atripla after first day
« Reply #3 on: April 20, 2014, 02:23:32 PM »
Its a tough spot to be and I feel for you . Most doctors recommend giving any medication with side effects time to resolve by giving it a go for several weeks or months . Its your and his decision to make if you can stick it out that long .

Atripla is a wonderful drug for many with little or no side effects for many who take it , it saved my life when I needed it and although I suffered many side effects from it and I took it for years not realizing it was the cause of most of my depression and CNS issues . Its your body so if the bad side effects continue do not let your doctor talk you into staying on a med that makes you miserable because there are many more combos without the problems Atripla can potentially cause . 

What ever you decide just be open to going to the emergency room if you are feeling overwhelmed until you get this sorted out . I'm sorry you are having to deal with this on a holiday weekend . 

Offline eric48

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Re: Stop Atripla after first day
« Reply #4 on: April 20, 2014, 03:29:08 PM »

First Welcome here... At least we are open during the holiday

I will make my post short, because it is very late here and I need some sleep. I'll give numbers out of memory

I hope this post reaches you in time

That is a catch 22

Problem with sleep/nigthmares after a single dose of Efavirenz (the component of Atripla that gives you these problems) is well documented


Problem with single dose (followed by no treatment) with the OTHER NNRTI Nevirapine is well documented, since it is used in poor country to protect the baby at delivery

Problem with single dose (followed by no treatment) with the NNRTI (Efavirenz) that is part of Atripla is NOT well documented, for one and only one reason: Efavirenz is NEVER given to pregnant women at delivery


Resistance occurs at the crossroads of unfavorable profile of diffusion of the drug (aka Pharmacokinetics) in the body and (low) barrier to resistance

Nevirapine and Efavirenz share the same UNFAVORABLE profile of diffusion of the drug (aka Pharmacokinetics)

Efavirenz has a higher barrier to resistance which is slightly favorable

Single dose resistance occurs in 70 % of delivering mothers


Single dose resistance to Efavirenz may occur. Admittedly with a lower risk, but not a low risk. In the absence of data, I would tune down the 70% to 50%

Admittedly 'cold turkey' stop of Atripla in suppressed patients (Smart Study) lead to a 12 % risk of resistance only...
This is not high , but now that low either. More over this is  valid for patients who are UD at time of stop

If delivering mothers stop Nevirapine after one dose, the clinical guidance is that they should not restart after at least 6 months

If you stop Efavirenz (in Atripla) after one dose, the clinical guidance is unknown to me, but I would think it is the same


Best case scenario: you keep taking the Atripla and make sure to have someone with you for the night(s) until you see a Doctor

I would not recommend scenario: stop taking the meds

I would certainly advise against: stop meds and resume after 3-4 days

Note: due to the long stay of Atripla in your body, even after the first dose, resuming after one (and ONLY one) missed dose might be OK

We have a poster in this forum who was given Atripla for 4 days while in hospital (and did not know it...) => resistance

I appreciate this is putting a lot of pressure on you and I would advise seeking any help you can find.

That being said, stopping Atripla NOW is risky. Unless you are being told by a specialized doctor (note: no doc on this Forum)

Once you are UD:  much lesser risk.

With the information you provided, I would hope you find help and be able to pursue treatment with no interuption at this time

In a few days, you will most likely start to feel better and we can discuss this again.

If this post is a somewhat difficult or unclear to you, please forgive me, I am exhausted after one hard day and need sllep. Keep asking questions if you need... others will be more than happy to help you

Wishing you well

NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

Offline buginme2

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Re: Stop Atripla after first day
« Reply #5 on: April 21, 2014, 12:58:16 AM »
The first night Atripla really sucks, I had hallucinations the first night also and it was pretty trippy.

The second night..99% better. 

The third night...even better.

After a couple weeks..very minor issues.

This is very common with Atripla.  I wish someone told you about this before you stopped your meds.  Stopping meds can be bad. 

Offline IndianPoz

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Re: Stop Atripla after first day
« Reply #6 on: April 22, 2014, 12:51:57 AM »
I started on Atripla on April 7, 2014.

The first night was tough with lots of dizziness at night & in the morning for several hours after waking up. These symptoms have eased up quite a bit now after two weeks. I still feel it in the mornings, but largely I'm fine with it now.

My doctor recommended taking it at bedtime with lots of water. That helped.

I, too, was thinking of giving up after the first dose & looking for an alternative. However, I stuck with it. I'm now waiting to see if my numbers improve. I'll know in about two weeks.

Hope this helps.
3/29/2014: ELISA +ve
4/7/2014: WB confirm; CD4-201(20%);VL-17065;started Trustiva/Teevir(Atripla)
8/2/2014: CD4-385(31%); VL < 20 copies/ml

Offline Reggie

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Re: Stop Atripla after first day
« Reply #7 on: April 23, 2014, 02:47:32 AM »
I too had very severe side effects the first days, into weeks but slowly and surely got better. Now into my 5th month the side effects that persist are to do with a bit less and interupted sleep and the dreaming which although not nightmares are vivid. Saying this the drug has brought my VL from over a million to 400 at my 10 week blood test and cd4's improved from 79 to 357. I am being patient as even the sleep is slowly improving and not sure that other regimes also have side effects and what they will be. I am looking into the possibility of possibly changing to Stribild but for now will try my best to deal with the side effects as the drug does its job against the hiv.I hope you improve and SURE after a week you wil feel much better then the first days.

Offline eric48

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Re: Stop Atripla after first day
« Reply #8 on: April 23, 2014, 09:06:36 AM »
correction: the 70% was in one paper... Yet in other reports the risk is more like 20%
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

Offline zach

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  • not fade away
Re: Stop Atripla after first day
« Reply #9 on: April 23, 2014, 11:29:05 AM »
seriously, don't do that. things will settle down. and if they don't, don't do it that way, talk to your doctor. dangerous game you play
gonna go up to the mountain, for to find a little peace
looking over the valley, for the beauty i see
out across the hills, forevermore

Offline Mattnben10

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Re: Stop Atripla after first day
« Reply #10 on: April 25, 2014, 05:22:45 PM »
Thanks for all the feedback. My doctor switched me to Truvada, Norvir, and Reyataz combo. I stopped Atripla after one day. Today is my first day on the new combo. I will update with my experience. So far, no major side effects and seems much easier than Atripla

Offline mikeyb39

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Re: Stop Atripla after first day
« Reply #11 on: April 25, 2014, 07:33:37 PM »
That's great news Mattn.  Glad you got into a doctor fairly quick
11/02/2010  cd4-251, vl-591000
12/09/2010  started Atripla
02/18/2011  cd4-425, vl-800
06/10/2011  cd4-447, vl-70
10/10/2011  cd4-666, vl-80
01/05/2012  swiched med (prezista,norvir ,isentress, )
02/10/2012  cd4-733, vl-UD  Viread removed
06/10/2012  cd4-614, vl-UD
12/14/2012  cd4-764, vl-UD
09/01/2013  cd4-785, vl-UD
03/06/2014. cd4- 1078, VL-UD
09/05/2014  cd4-850 , VL-UD

Offline eric48

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Re: Stop Atripla after first day
« Reply #12 on: April 26, 2014, 12:48:37 PM »


NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

Offline Mattnben10

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Re: Stop Atripla after first day
« Reply #13 on: April 27, 2014, 01:11:06 PM »
It's day 3 on this new Truvada combo. So far, I am very pleased as there are no extreme side effects like the Atripla had. I am overly groggy and having trouble staying awake through TV shows and movies. But I would rather be sleepy than have terrible insomnia.

 Also, after the first dose, my knees are giving out. I fell over 7 times while showering and drying off yesterday. I am only 35 years old, but my cd4 count is only 25. I experienced this same weakness a few weeks ago while in the hospital. I hope this all gets better.

Finally, I have been experiencing hair loss in the past couple of months. Anyone else have hair loss? How do I treat that?

Offline newt

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Re: Stop Atripla after first day
« Reply #14 on: April 28, 2014, 04:04:39 PM »
Hair los might be from the FTC in Atrpila and tends to pass, ie the hair comes back. If not, you are alive, sexy and bald.

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

Offline Mattnben10

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Re: Stop Atripla after first day
« Reply #15 on: May 16, 2014, 08:14:25 PM »

Switched to Stribild on May 1. As of May 14, my cd4 has increased from 25 to 217! Great news.


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