Author Topic: I want to drop Norivir from my Truvada combo (Read 10423 times)

blowncircuit · « **on:** September 20, 2009, 11:02:25 pm »

I have been on the standard Truvada/Reyataz/Norivir combo for about a year and a half and my viral load has been undetectable for about a year and my T cells are over 600. In short it seems to be working well for me. However the one major side effect I have had with these drugs has been the damn bloating and gas. At times it can be downright ridiculous. I swear I wake up with a six pack and go to bed with a belly. The other big hassle is the whole refridgeration issue with Norivir as I travel alot.

A friend of mine is on the same combo sans the Norivir and he does not have as many bloat/gas issues. He also is undetectable with over 900 t cells. He takes twice the amount of Reyataz to make up for the Norivir.

I am in the process of changing doctors due to insurance changes and would like some feedback from anyone that has any input about this, prior to my first visit with the new doc.

Thanks in advance for any input!

sdguyloveslife · « **Reply #1 on:** September 21, 2009, 02:53:56 am »

I'm on a Norvir boosted combo as well, but I take Prezista (instead of Reyataz).

Hmm, I may be mistaken, but from my understanding, it's the Truvada (specifically the tenofovir component) that gives you the gas and not the Norvir.

Also, the refrigeration of Norvir is not absolutely necessary. If the bottle gets too warm, the gelatin capsules will actually melt and stick together. If this happens at normal room temperature, you can just tap the bottle against a hard surface and the capsules will separate quite easily. If you look on the side of the Norvir bottle you will see the following statement:

Refrigeration by patient is recommended but not required if used within 30 days and stored below 77 F (25 C).

So, even if you're traveling, your Norvir will be fine in your carry on luggage, or in your medication case.

I haven't had much of a gas or bloating problem with this combo, but I imagine that an anti-gas supplement into your diet might help? Perhaps some others will help here...

markaj · « **Reply #2 on:** September 21, 2009, 03:35:55 am »

I personally wouldn't be keen on taking 300mg Reyataz and Truvada without Norvir as a booster, although I'm aware of some patients taking 400mg (2 x 200mg capsules) of Reyataz without the Norvir, I don't know about taking twice the dose of Reyataz?

In your situation, it you're really not happy with the Norvir, I'd most probably talk to my doctor about ditching the Norvir and Truvada and take Epzicom and Reyataz instead.

I too experience gas which I attribute to Truvada, especially if I take it on an empty stomach. I never had a problem with Norvir to be honest, although I didn't take it for long.

mecch · « **Reply #3 on:** September 21, 2009, 05:05:39 am »

Are these all home grown solutions? Does your friend have any medical advice about his double dose of Reyataz?
WHy dont you ask your doctors to figure out a way to reduce the gas. It might be a antigas pills. There are perscription ones and also natural enzymes.
Change of diet maybe.
Or maybe change of HAART.
But don't go messing with the therapeutic doses.

Also yeah Norvir can go without refrigeration and also I've heard it will have a new formulation soon.

Miss Philicia · « **Reply #4 on:** September 21, 2009, 11:22:18 am »

I agree with what markaj and sdguy stated -- the gas and bloating is most likely from truvada. And I also agree with what sdguy stated about the Norvir/travel/fridge issue. If you read the med label you'll see that one only refrigerates Norvir if you have in excess of a 30-day supply and the room temperature is abnormally hot. The only issue with travel is that this should preclude placing your medication in your checked luggage, but then when one travels one shouldn't do this with any of your medication as it can get lost easily by the airline.

I'd also caution against listening to the anecdotes of one friend who has HIV. I have a friend like this who likes to tell me all sorts of personal medical theories of what I should and shouldn't do (or at least he used to until I told him his beauty school certification was not as good as a doctor's medical degree). He may be doing fine (in his mind and in yours) with his creative med protocol, but take 100 other patients in a controlled study that did this and you'll find that this would not be the case. Now, of course you're welcome to do whatever you like with your own body and nobody can stop you, but I'd just ask you to consider that little fact when making up your mind.

That said, gas/bloating is totally uncomfy, and I've had this issue a lot. I would recommend that you look into what I take for this, and while it does mean more pills each day and another prescription, I've found it totally works.

http://www.DigestiveCare.com/Information/?t=prod

I take Pancrecarb MS-8 twice daily and it effective controls the issue for me, and I've now taken it for four years.

BM · « **Reply #5 on:** September 21, 2009, 01:09:27 pm »

The standard dose of Reyataz without Norvir is 400mg once a day with food. If you're wanting to drop the Norvir, discuss it with your doctor: it is not recommended to take unboosted Reyataz if you've taken previous PI-based drug combinations. A formulation of Norvir that doesn't require refrigeration is expected soon; also, another company is looking into producing a booster that has none of the gastro-intestinal problems of Norvir (and none of the anti-HIV activity either).

I'd like to echo the opinions of others who've commented on your gas problems. It is most likely the Truvada component of your regimen that is to blame. My friend recently started Truvada/Sustiva and is experiencing many of the bloating problems you mention.

Miss Philicia · « **Reply #6 on:** September 21, 2009, 02:03:22 pm »

Quote from: BM on September 21, 2009, 01:09:27 pm

another company is looking into producing a booster that has none of the gastro-intestinal problems of Norvir (and none of the anti-HIV activity either).

GS-9350, and just today this appeared in relation to it working with Reyataz

http://www.aidsmap.com/en/news/B470830A-3221-4614-9FC7-49AC0D27E4E9.asp

antibody · « **Reply #7 on:** September 21, 2009, 07:06:35 pm »

I am talking to my Doctor about dropping the Norvir and going up tp 400mg on the Reyataz. There was a recent study where this is possible if you have remained undetectable for at least a year.
http://www.aidsmeds.com/articles/hiv_reyataz_atazanavir_1667_16988.shtml
I would prefer this route than to try some new booster just because they made one. I want to take less medications in the long run.

BM · « **Reply #8 on:** September 22, 2009, 07:09:03 pm »

But it's not recommended to drop Norvir at all if your combination also contains Truvada (tenofovir/emtricitabine) or Viread (tenofovir). This is because tenofovir causes blood levels of (unboosted) Reyataz to fall dramatically, even at the 400mg dose. The Norvir stops this from happening.

Robert · « **Reply #9 on:** September 22, 2009, 08:28:25 pm »

hi blowncircuit.

I also had been having issues with Norvir and talked it over with my Dr at my last check-up in July. Since Dec, 2003 I've been taking Truvada, Reyetaz, Norvir. Together we dropped the Norvir and the Truvada, increased the Reyataz from 300mg to 400mg (2 200 mg tablets) and added Epzicom (Epzicom must be combined with at least one other HIV drug, usually a protease inhibitor (PI) (the Reyataz) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) and is a combination of Abacavir and Lamivudine.)

It's still too early to report about the numbers but I am happy to say the bloatedness and the gas have all but disappeared. I might also add my constipation has gone by the wayside too. I've always suspected it was from the Norvir and apparently it's so.

Norvir is one of the two drugs in Kaletra. I despise Kaletra and, as far as I'm concerned, that's reason enough to drop the Norvir.

Like I said, it's too early to tell but talk it over with your Dr. Even though your combo is working (my numbers were very similar to yours) if you don't like, do something about it.

robert

antibody · « **Reply #10 on:** September 22, 2009, 11:47:04 pm »

It is possible I might switch out the Truvada for Epzicom so I could drop the Norvir.

J.R.E. · « **Reply #11 on:** September 23, 2009, 08:17:19 am »

Gilead is working on a new PK booster , that shows promise ;

http://www.poz.com/articles/hiv_gs9350_norvir_761_17294.shtml

But, I am also on Viread, and have the issues with gas. I am not on Norvir.

Ray

risred1 · « **Reply #12 on:** September 23, 2009, 10:38:31 am »

Robert,

I'm a little confused. Switching Truvada to Epzicom and doing 400 mg of Reyataz is within guidelines. But not with Truvada, which lowers Reyataz in the blood. Are you swapping out Truvada for the Epzicom?

Antibody,

In light of your herbal use...

I would be concerned that loosing the boosting properties of norvir may make you more vulnerable to the possible effects of marijuana on Reyataz... I know, to early to know for sure.

just putting in a couple of cents.

Robert · « **Reply #13 on:** September 23, 2009, 12:19:13 pm »

hi risred.

I have dropped both the Truvada and the Norvir. Now I am taking Reyataz (400mg) and the Epzicom only.

Well, I also take 150mg of Effexor/day (for depression), Levothriod (.2mg)/day (for thyroid) and an iron pill.

I'll update my numbers in Nov. after my next visit to the Docs.

robert

blowncircuit · « **Reply #14 on:** September 27, 2009, 02:44:16 pm »

Thanks to everyone for their responses. I did not consider it might be the Truvada that is giving me the gas/bloat issues. Good to know.
I'm also glad to know the Norivir is not as fragile as I make it out to be.

weasel · « **Reply #15 on:** September 27, 2009, 08:48:02 pm »

I find it odd ?

I have been on these same drugs for 5 years .

No bloating , no gas

?

NO yellow ??

It MAY be what you guys are eating !

just my thought

Carl

BM · « **Reply #16 on:** September 28, 2009, 12:46:04 pm »

Quote from: weasel on September 27, 2009, 08:48:02 pm

I find it odd ?

I have been on these same drugs for 5 years .

No bloating , no gas ?

NO yellow ??

It MAY be what you guys are eating !

just my thought

Carl

Or you're just one of the lucky ones who doesn't get these symptoms!

jay195 · « **Reply #17 on:** September 28, 2009, 03:47:16 pm »

Hi to everyone. I have been on the Truvada, Reyataz , Norvir combo for about nine months with no problems at all. Why does Norvir have to be kept in the fridge ? Jay xx

antibody · « **Reply #18 on:** September 28, 2009, 08:16:41 pm »

Yea I've had no gas, bloating, yellowing, diarrhea or any side effects for that matter other than constant fatigue (no idea if it's related to combo). My reason to drop the Norvir is for less pill count and to avoid any harm from long term use but I must say that this combo has been a breeze. I have had zero problems with this combo and have always been undetectable so I'm sure my reasons to want to drop Norvir is not the same as your reason.

NYCguy · « **Reply #19 on:** October 15, 2009, 05:32:01 pm »

just my 2 cents.. I've been on Reyataz/Truvada/Norvir for 2.5 years, been undetectable from the beginning and have had absolutely no problems other than a bit of the runs when I first started, or whenever I don't eat enough. My philosophy is if it ain't broke... but I've never experienced the bloating problem. I'm assuming that you are eating a respectable meal, because this combo must be taken with food to be effective. I always take mine in the morning, in case that makes a difference? Hell, on weekends I sometimes swish them down with a bloody Mary!

The norvir I try to keep in the fridge, but don't worry about it so much, especially when traveling, and it seems to be fine. Looking forward to the new formulation.

I would be very careful about dropping norvir from the combo if staying on Truvada. If you do this, make SURE it is with a doctor who really knows his stuff and has a lot of experience with other patients on the same combo. I personally don't know anyone doing this and tons are taking the boosted combo with success. So be careful.

NYCguy · « **Reply #20 on:** October 15, 2009, 05:33:09 pm »

also remember that 100mg of Norvir is a very low dose...the doses that caused all the problems in the 90s were, I believe, in the area of 8-10 times higher.

frankt · « **Reply #21 on:** October 19, 2009, 08:02:33 am »

the problem is most likely reyataz. the moment i cut out reyatax most of my internal problems subsided.prezista is a miracle drug

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Author Topic: I want to drop Norivir from my Truvada combo (Read 10423 times)