Is it must to take meds on exact time everyday

[pinkadam]

Hi folks

Happy New Year

Is it must to take drugs exactly on same time every day.
Iam on sustiva and truvada one pill each perday. I take them every evening. I take these medicines between 6:00PM to 11:00PM. I dont take them exactly same time every day. My doctor thinks its okay to do it. But some people differ his opinion.

What are the pros and cons of taking medicine not at the same time every day.

Thanks ahead for your valuble opinion

pink

[cubbybear]

Some medications require you to be pretty diligent as to taking them at the same time every day.  With the meds you are on, (the same as I am) they both have exceedingly long half lives and will remain in your system long enough that a window that large should not be too much of a problem, however it is good to keep steady levels of the drugs in your system.  My ID Doc said as long as I take my meds each night it doesnt matter what time, and for 3 months I was a bit slack and took them between 9pm and 3am.  Remained undetectable the entire time, and still am today, though I take my meds usually within an hour or so of my scheduled time now.  Some meds, that need to be taken 2 or more times a day you can not afford to do that with, as they do not remain in your system long enough, but Sustiva and Truvada have very long half lives.

I would recommend however taking your meds as near as possible to the same time when ever possible, but there is that window of leeway with your meds, just don't miss a dose, or get too lazy. Adherence is the key.

Cheers
Matt

[aztecan]

The once-a-day dose meds are a bit more forgiving than some of the others. In other words, they remain in the body/bloodstream for a longer period and, therefore, it isn't necessary to take them at the exact moment each day.

That said, it usually is best to take them at a regular time each day, say within an hour or two.

Some meds, like the Crixivan I take three times a day, are much less forgiving. Crix has a 20-30 minute window, meaning I can miss my time by about 20-30 minutes, but no more.

I think your doc probably is right. Being as anal as I am though, I would probably set a specific hour and then try to stick to it. But, that's just me.

HUGS,

Mark

[antibody]

i haven't had a problem taking my meds at the same time. since my diagnosis i have become very domesticated so i am always home. I have been trying to take care of myself for about 3 years before going on my first combo. my lover is great about asking if i took my pills. i take Atripla every night within a 3 hour window. I don't really worry how long it's been since I've eaten. i am able to eat so much more since being on treatment i don't want to skip anything if i feel hungry. i do notice more of the dizzy effects but i trade that for hopefully adding a few pounds.

[J.R.E.]

I take my meds at 8:00 Am and 8:00Pm.  I always try to take them on time, but I may vary as much as 30 minutes plus or minus. Once you've been doing something for a while, it gets pretty routine, time wise.


Ray

[Tucsonwoody]

Probably more than you want to know but here is some more info from a website where you can look up excrutiating detail about stuff like half-lifes
I'm not even sure I understand all or even half of this..yet, but learning more everyday.   

"Elimination: Efavirenz has a terminal half-life of 52-76 hours after single doses and 40 55 hours after multiple doses. A one-month mass balance/excretion study was conducted using 400 mg per day with a 14C-labeled dose administered on Day 8. Approximately 14-34% of the radiolabel was recovered in the urine and 16-61% was recovered in the feces. Nearly all of the urinary excretion of the radiolabeled drug was in the form of metabolites. Efavirenz accounted for the majority of the total radioactivity measured in feces."

http://www.rxlist.com/cgi/generic/efaviren_cp.htm

[Miss Philicia]

I consider taking them within an hour window still technically "on time."  I think you'll find that the more you adhere to as strict as schedule as possible the less likely you will be to totally forget a dose.

[koi1]

I take my meds at 9:30 which is when I go to sleep. I agree that having a set time makes it routine and automatic, and helps with adherence. I have not stayed out late since I started taking them. But I suppose you can take it a few hours later without any consequences. The literature says that a routine is definitely the best thing for adherence and even a missed dose will not have serious consequences, however many missed doses are the reasons people develop mutations and then drug resistance.

rob

[marc11864]

I went to an HIV event here in Phoenix the past weekend called Live-Link-Learn. It was provided by the Phoenix EMA Ryan White Planning Council and offered various discussions and forums including,

• The Importance of Medical care and Medications by my ANP Brian Arey

and another during lunch called

• Sticking With Your HIV Medications: How am I gonna do it by Brian Coppedge

Of note Brian Coppedge works for Bristol-Myers Squibb, the company that puts out Sustiva and both of the above gentleman are both out, gay and HIV positive men.

In My ANPs presentation, he touched upon the adherence questions with a number of slides culled from HIV resources that he uses to help treat me. I am of course on Kaletra and Truvada. Ninety-five percent adherence is the standard for acceptable safe compliance with no discernable mutation occurring in users with an undetectable viral load. As small a drop as eighty-five percent, has been found to cause mutations in up to fifty percent of people with HIV who are on a therapy. As an example, it was suggested that if you miss a maximum of one dose every fourteen days you are still in compliance with your regimen. We were cautioned of course not to purposely miss one dose every fourteen days. I have asked Brian on many occasions myself what is an acceptable measure of compliance as relating to being even a few (read 2 - 4) hours late on a dose post-full-missed-dosage and he indicated that it should not be of "panic-level" concern regarding mutation providing you are in compliance otherwise. As others pointed out earlier, the "half-lives" of many of these drugs are quite long.

In Brian Coppedge's presentation he concurred with my ANP regarding dosing with Atripla or Sustiva and Truvada for much the same reason. He would not offer information regarding other *non-BMS HIV medications as he was not as familiar with them however he did ask other Pharmacological and Medical representatives within the audience to offer their insight on the acceptable adherence levels of other combinations. In most all cases, the new classes of drugs especially PIs with a Norvir boost, have these levels of therapeutic management.

I would say if you aren't sure however, it is always a good idea to speak with your doctor or if you are seeing a non-HIV specialist, ask to see one for clarification on these or other therapies.

One other side note is that you should check in with your local HIV agency(ies), to see if they have any similar events as I found much of the discussions very helpful and encouraging to PWAs and HIV. 

* BMS = Bristol-Myers Squibb