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Author Topic: Being late for Atripla  (Read 10217 times)

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Offline DanMo

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  • Posts: 235
  • Finally undetectable! ;D
Being late for Atripla
« on: December 01, 2011, 08:49:50 am »
Hey all:

I woke up at 7 AM and immediately realized I forgot to take my pill last night.

I usually take it around 1 AM... I can't believe I forgot, but I'm especially busy since finals is next week. Is this a problem especially considering that my VL is still not UD?

- Dan
“I tried to drown my sorrows, but the bastards learned how to swim, and now I am overwhelmed by this decent and good feeling.” —Frida Kahlo

11 Feb 2011 - Preliminary positive
07 Mar 11 - Inconclusive WB
14 Mar 11 - Diagnosed positive
05 Apr 11 - 355 (21%) / VL: 186,054
27 Apr 11 - 390 (20%) / VL: 285,095
06 Jun 11 - 298 (19%) / VL:  78,380
01 Aug 11 - > STARTED ATRIPLA <
30 Aug 11 - 699 (31%) / VL: 1,938
03 Nov 11 -                / VL: 645
27 Dec 11 - 559 (35%) / VL: 1,189
11 Jan 12 -                 / VL: <20
09 Apr 12 - 686 (40%) / VL: UD
11 Jul 12 - 793 (37%) / VL: 25

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: Being late for Atripla
« Reply #1 on: December 01, 2011, 11:04:32 am »
Everybody misses occasionally.  But Atripla is pretty forgiving.  

Just take the missed dose when you can. And don't make a habit of it.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline ejwilliamson90

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Re: Being late for Atripla
« Reply #2 on: December 01, 2011, 07:56:48 pm »
You have a 12 hour window on the medication. So if you normally take it at 1am you can take it as late as 1pm then take your next dose at 1 am again. You're totally fine i do that on occasion if i forget before bed its no sweat. As long as you take your medication 95% of the time correctly within your 12 hour window you are okay. I forgot my first dose in 5 months!! and I missed it by 6 hours in the 12 hour time frame. and the doctor said it was no sweat since it had only happened once. Good luck!!!!!! Keep up on the regimen... We're lucky to be on such an easy going medicine compared to some of the others!
04/14/11  HIV- + Diagnosis
05/15/11 Initial CD4/VL reading: 89/ 550,000
05/15/11 - Genotype Test revealed no mutations
06/01/11 -Started Atripla
07/01/11- CD4/VL 125/900
09/26/11- CD4/VL 183/90
10/20/11- CD4/VL  172/72
11/15/11- CD4/VL 185/82
12/20/11- CD4/VL 186/<20!!!!!!!!!!!!!! FINALLY UD!
02/10/12 -CD4/VL 175/70
02/14/12- New Regimen: Norvir, Prezista, Isentress, Truvada
03/05/12 - CD4/VL 203/30 :
04/06/2012: cd4 228 vl <20
05/26/2012 cd4/vl 253/80
07/25/2012 cd4/vl 249/<20
09/10/2012 cd4/ vl 294/<20
Medications:
Prevacid 30, Ativan 2mg 4x/day,Testim 50mg daily, Certavite Multivitamin with Antioxidants, Quinapril 40mg, Fish Oil 3/day, 1000mg Garlic, 2-4 G Carafate, Paxil 20mg, Dapsone 100mg, Norvir, Prezista, Truvada, Isentress.
PRN: Marinol, Baclofen, Ultrum, Patanase, Lidoderm

Offline buginme2

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Re: Being late for Atripla
« Reply #3 on: December 01, 2011, 08:06:51 pm »
Agreed, If you forget that you missed your dose then take it.  If you are closer to the time of your next dose than the one you missed skip it and continue on.  You must< take a minimum of 95% of your medication so missing one dose is not going to be a set back. 

Heres a story.  A few months back I was getting headaches every day.  I had a migrain headache every day for about 10 days in a row.  I thought to myself "I'm not going to take my medication tonight" hoping it would make my headache go away.  Odd enough, my headache went away and I didnt skip my medication.

On my next doctors appointment I told him how I had thought about skipping my medication one day due to getting all these headaches.  I expected a reaction of some sort.  He didnt tell me to skip my meds but, he definately didnt have the reaction I expected.  He basically said it was OK if I missed a day every now and then as long as 95% of the time I took it ontime.  It happens.

Do you have one of those Monday-Sunday pill containers?  They really do work and remind me to take my meds.  If you don't, you can pick one up for just a couple dollars at Walgreens. 

Good Luck
Don't be fancy, just get dancey

Offline ejwilliamson90

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Re: Being late for Atripla
« Reply #4 on: December 01, 2011, 08:12:00 pm »
Agreed! I use a 4 part pill planner, mon-fri. It's fantastic it gives you such a great visual, do it if you aren't already!
04/14/11  HIV- + Diagnosis
05/15/11 Initial CD4/VL reading: 89/ 550,000
05/15/11 - Genotype Test revealed no mutations
06/01/11 -Started Atripla
07/01/11- CD4/VL 125/900
09/26/11- CD4/VL 183/90
10/20/11- CD4/VL  172/72
11/15/11- CD4/VL 185/82
12/20/11- CD4/VL 186/<20!!!!!!!!!!!!!! FINALLY UD!
02/10/12 -CD4/VL 175/70
02/14/12- New Regimen: Norvir, Prezista, Isentress, Truvada
03/05/12 - CD4/VL 203/30 :
04/06/2012: cd4 228 vl <20
05/26/2012 cd4/vl 253/80
07/25/2012 cd4/vl 249/<20
09/10/2012 cd4/ vl 294/<20
Medications:
Prevacid 30, Ativan 2mg 4x/day,Testim 50mg daily, Certavite Multivitamin with Antioxidants, Quinapril 40mg, Fish Oil 3/day, 1000mg Garlic, 2-4 G Carafate, Paxil 20mg, Dapsone 100mg, Norvir, Prezista, Truvada, Isentress.
PRN: Marinol, Baclofen, Ultrum, Patanase, Lidoderm

Offline DanMo

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  • Finally undetectable! ;D
Re: Being late for Atripla
« Reply #5 on: December 03, 2011, 05:23:18 pm »
Hey guys! Thanks for your advice!

Yes I do have one of those pill containers (and I don't use it), but I don't think that's the problem. When I forgot to take my pill, I knew I had to take it, but I got caught up in finishing a paper for school. And then I went to bed after having finished it. I probably would have forgotten to take the pill even if I was using the pill container.

When I woke up at 7 AM, I woke up with a start thinking I forgot to take my pill. I couldn't remember if I took it or not, and using the pill container would have helped in that regard. What I had to do was count the number of pills in the bottle and use my calendar to count. Fortunately, it was a brand new bottle and I marked on my calendar when I began the new bottle :D (I had 28 pills and should have had only 27 pills, thus confirming that I did indeed forget to take it).

I did end up taking my pill at 7 AM that morning. I thought I was going to spend all day at work in a daze, but surprisingly, I was barely dizzy at all. I think my body's used to the drugs.

I do have a question that I've been having doubts about: how important is it to take the pill at exactly the same time every day? What I'm doing right now is I have my phone set to go off at midnight and I take the pill sometime after midnight, right before going to sleep. But I don't go to sleep at the same time every night. I would say I take the pill +/- 4 hours.

Sometimes I take it exactly at midnight, sometimes at 1, 2, or 3... just depends what I'm doing that night.

So, is this a good practice? Or should I be more strict?

- Dan
« Last Edit: December 03, 2011, 06:11:27 pm by DanMo »
“I tried to drown my sorrows, but the bastards learned how to swim, and now I am overwhelmed by this decent and good feeling.” —Frida Kahlo

11 Feb 2011 - Preliminary positive
07 Mar 11 - Inconclusive WB
14 Mar 11 - Diagnosed positive
05 Apr 11 - 355 (21%) / VL: 186,054
27 Apr 11 - 390 (20%) / VL: 285,095
06 Jun 11 - 298 (19%) / VL:  78,380
01 Aug 11 - > STARTED ATRIPLA <
30 Aug 11 - 699 (31%) / VL: 1,938
03 Nov 11 -                / VL: 645
27 Dec 11 - 559 (35%) / VL: 1,189
11 Jan 12 -                 / VL: <20
09 Apr 12 - 686 (40%) / VL: UD
11 Jul 12 - 793 (37%) / VL: 25

Offline bufguy

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  • Posts: 214
Re: Being late for Atripla
« Reply #6 on: December 03, 2011, 05:36:18 pm »
Atripla has a very long half life...especially the effavienz component. You were smart to have taken it as soon as you discovered it. In fact a small study called FOTO, five on two off, had some patients take atripla monday thru Friday and then take Saturday and Sunday off. Their performance was very similar to those that took it for seven days....Now don't go missing doses because of that. The study was very small, so some docs think its inconclusive....The point is there is some forgiveness in atripla...take it every day and use that forgiveness for those missed lapses.
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 .
11/29/18 vl un CD4 1080/39% CD8  .86

Offline Since2005

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Re: Being late for Atripla
« Reply #7 on: December 03, 2011, 06:13:27 pm »
Sometimes I take it exactly at midnight, sometimes at 1, 2, or 3... just depends what I'm doing that night.

So, is this a good practice? Or should I be more strict?

- Dan

I thought ej answered your question already if I am reading it correctly

You have a 12 hour window on the medication. So if you normally take it at 1am you can take it as late as 1pm then take your next dose at 1 am again. You're totally fine i do that on occasion if i forget before bed its no sweat. As long as you take your medication 95% of the time correctly within your 12 hour window you are okay.

Offline DanMo

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  • Finally undetectable! ;D
Re: Being late for Atripla
« Reply #8 on: December 03, 2011, 06:35:56 pm »
I thought ej answered your question already if I am reading it correctly

I saw his post, but I wanted more clarification.

What I'm trying to point out is that I never take my pill at exactly the same time every night. He mentions "you can take it as late as 1pm then take your next dose at 1 am again."

The thing is: I don't normally take my pill at exactly the same time EVERY night. So, I don't know how this plays into the 95% adherence...

That's why I wanted to know if taking the pill sometime between 00:00 and 04:00 is a good practice, or should I be more strict about it? (For example, I took my pill at 03:30 this morning). Is this what he means by that 12 hour window? Or is this just a guideline for when you miss a dose and not something to make a habit of.

When people talk about adherence, does it mean skipping doses? Because in that case, I haven't skipped a dose yet.

I apologize but I just want to make sure I understand all this correctly.
“I tried to drown my sorrows, but the bastards learned how to swim, and now I am overwhelmed by this decent and good feeling.” —Frida Kahlo

11 Feb 2011 - Preliminary positive
07 Mar 11 - Inconclusive WB
14 Mar 11 - Diagnosed positive
05 Apr 11 - 355 (21%) / VL: 186,054
27 Apr 11 - 390 (20%) / VL: 285,095
06 Jun 11 - 298 (19%) / VL:  78,380
01 Aug 11 - > STARTED ATRIPLA <
30 Aug 11 - 699 (31%) / VL: 1,938
03 Nov 11 -                / VL: 645
27 Dec 11 - 559 (35%) / VL: 1,189
11 Jan 12 -                 / VL: <20
09 Apr 12 - 686 (40%) / VL: UD
11 Jul 12 - 793 (37%) / VL: 25

Offline Since2005

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Re: Being late for Atripla
« Reply #9 on: December 03, 2011, 07:12:46 pm »
You have a 12-hour window on the medication. As long as you take your medication 95% of the time correctly within your 12-hour window you are okay.

This is what I understand reading from others etc. Atripla is pretty forgiving and having 12-hour window on the medication will allow someone like me who always forgets things. Now, I understand that as long as someone takes his/her meds within 12 hours of the  “regular/exact” time then that particular person will be adherent to the meds 100% of the time unless, of course, do miss his/her dose. Having that 12-hour window is really refreshing to know about Atripla.

I myself may have to go on meds soon. So, I have a good interest about the info specially hands on info about this med. Atripla is on top of my list if/when I start meds ( though I just read from Growler that he had some issues with depression and being on Atripla.. but I guess doc will figure it out)

Hey Dan, no apologies, the more you understand the better you could take care of yourself. Thanks for starting this thread. I am learning a lot and it sure helps.

Edited to add – Thanks EJ for bringing that up, 12-hour window about Atripla, I came to know recently. That’s an accurate information right ( not that I am questioning…questioning..).. My comments above about adherence are my understanding reading from others, not a statement. So, please do correct me if my understanding is not accurate. Now that I am thinking more.. I am with Dan.. reconfirmation/clarification will be helpful.
« Last Edit: December 03, 2011, 09:08:57 pm by Since2005 »

Offline MiniPozToyota

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Re: Being late for Atripla
« Reply #10 on: December 03, 2011, 08:42:24 pm »
I have a app on my iPhone that tells me to take it everynight at 10:30pm and it makes you check a little box saying you have taken it.
April 2010- tested neg.
April 1 2011 -  CD4 346 VL 46856 22%
July 27 2011- Started Atripla
(Meds are good) needed more space to update been UD now for three years. Current down below
Jun 5 2014 - CD4 704 VL UD % 44.0

Offline newt

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Re: Being late for Atripla
« Reply #11 on: December 04, 2011, 12:28:32 pm »
Quote
You have a 12 hour window on the medication

I am interested to know where idea this comes from.

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

Offline Ann

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Re: Being late for Atripla
« Reply #12 on: December 04, 2011, 12:47:14 pm »
Sorry I'm a bit late in moving this thread - I only just realised it was in Living instead of Treatment.

These types of threads should be in the Treatment forum because if someone comes here with the same question, that's the logical forum to look in first for the answer. :)
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline buginme2

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Re: Being late for Atripla
« Reply #13 on: December 04, 2011, 02:28:57 pm »
Hi Dan, instead of focusing on a specific time to take your medication, maybe you should try taking it at a particular event during your day.  Such as, take you pill when you headed to bed, or when you brush your teeth at night, or something else you do in the evening every day. 

The specific time isnt all that important.  There will be times when you travel across the country and youll deal with time changes.  There will be times when your out late one night.  Its ok to just take it at your bedtime, whatever time that is.  Its more important to be adherent. 

Hope that helps.
Don't be fancy, just get dancey

Offline DanMo

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  • Finally undetectable! ;D
Re: Being late for Atripla
« Reply #14 on: December 06, 2011, 12:26:43 am »
I am interested to know where idea this comes from.

- matt


What would you say is a more appropriate time frame?

For example, here are the times of the past four days (including today) that I've taken my pill.

3 Dec 03:27
4 Dec 01:38
5 Dec 02:29
6 Dec 00:14

- Dan
“I tried to drown my sorrows, but the bastards learned how to swim, and now I am overwhelmed by this decent and good feeling.” —Frida Kahlo

11 Feb 2011 - Preliminary positive
07 Mar 11 - Inconclusive WB
14 Mar 11 - Diagnosed positive
05 Apr 11 - 355 (21%) / VL: 186,054
27 Apr 11 - 390 (20%) / VL: 285,095
06 Jun 11 - 298 (19%) / VL:  78,380
01 Aug 11 - > STARTED ATRIPLA <
30 Aug 11 - 699 (31%) / VL: 1,938
03 Nov 11 -                / VL: 645
27 Dec 11 - 559 (35%) / VL: 1,189
11 Jan 12 -                 / VL: <20
09 Apr 12 - 686 (40%) / VL: UD
11 Jul 12 - 793 (37%) / VL: 25

Offline DanMo

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  • Finally undetectable! ;D
Re: Being late for Atripla
« Reply #15 on: December 06, 2011, 12:27:16 am »
Hi Dan, instead of focusing on a specific time to take your medication, maybe you should try taking it at a particular event during your day.  Such as, take you pill when you headed to bed, or when you brush your teeth at night, or something else you do in the evening every day. 

The specific time isnt all that important.  There will be times when you travel across the country and youll deal with time changes.  There will be times when your out late one night.  Its ok to just take it at your bedtime, whatever time that is.  Its more important to be adherent. 

Hope that helps.


Hey buginme2,

Thanks for your advice.

I know I'm probably coming across as a pedant in this thread. My daily activity has been when I go to sleep. It's just that it varies as much as 4 hours most days. I was curious to find out from other people if the irregularity of taking my pill is a good habit or not.

- Dan
“I tried to drown my sorrows, but the bastards learned how to swim, and now I am overwhelmed by this decent and good feeling.” —Frida Kahlo

11 Feb 2011 - Preliminary positive
07 Mar 11 - Inconclusive WB
14 Mar 11 - Diagnosed positive
05 Apr 11 - 355 (21%) / VL: 186,054
27 Apr 11 - 390 (20%) / VL: 285,095
06 Jun 11 - 298 (19%) / VL:  78,380
01 Aug 11 - > STARTED ATRIPLA <
30 Aug 11 - 699 (31%) / VL: 1,938
03 Nov 11 -                / VL: 645
27 Dec 11 - 559 (35%) / VL: 1,189
11 Jan 12 -                 / VL: <20
09 Apr 12 - 686 (40%) / VL: UD
11 Jul 12 - 793 (37%) / VL: 25

Offline Ann

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Re: Being late for Atripla
« Reply #16 on: December 06, 2011, 11:42:04 am »

I did end up taking my pill at 7 AM that morning. I thought I was going to spend all day at work in a daze, but surprisingly, I was barely dizzy at all. I think my body's used to the drugs.


Dan, if you don't seem to have a problem with taking your Atripla in the morning, maybe that would be a better, more consistent time? Quite a few people take it in the morning - David in NC being one of them. If you took it in the morning, that would be at least five days a week where you'd be taking it at roughly the same time. Having a lie-in at the weekend shouldn't be a problem either.
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline hoykahoy

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Re: Being late for Atripla
« Reply #17 on: January 02, 2012, 01:55:44 pm »
I am interested to know where idea this comes from.

- matt


i too have missed an hour or two or three but i dont stick on a specified accurate time. as a doctorate student, my face is glued manipulating sas or spss data up to 3 in the morning. it however did bother me if i should stick on a specified because an hiv coordinator, not even a rn, pa, or md, said that it will lead to a resistance. but this dr has answered me, it doesnt mention about the 12 hrs span though:

      
MISSING A DOSE OF ATRIPLA
Jul 29, 2010

I am on atripla for the past two months. I always drink my tablet at the same time everyday, but one day I missed my tablet for about 15minutes. Does it mean that the drug will become resistant. I am worried about it. Should I go to my HIV doctor and check if this is the case. please help

Response from Dr. Frascino

Hi,

Relax Max. Atripla has a very long half-life and consequently does not have to be taken exactly at the same time every day. You can be off by hours in either direction without any cause for concern. This will not increase your chance of developing drug resistance. You do not need to check with your doctor regarding this incident. See below for similar questions.

Dr. Bob


cited: http://www.thebody.com/Forums/AIDS/Fatigue/Q209973.html?ic=2003
« Last Edit: January 02, 2012, 02:02:27 pm by hoykahoy »

Offline ejwilliamson90

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Re: Being late for Atripla
« Reply #18 on: January 15, 2012, 12:57:57 am »
That's the fantastic thing about Atripla, There are nights, like New Years I knew I was going to be drinking a lot and didn't want to take it at midnight when I'd be drunk more than likely.....lol So I waited till 8 am. My usual time i take it is 10 pm. But I will vary in the same week anywhere between 9pm and 1 am. Just depending on when I ate last and when I'm going to bed. You have a really flexible, powerful drug. Don't worry! Hey and after posting this on here I missed a dose completely!!!!!!! It was my first time even after all the knowledge on the missing I was freaking out cause it was 6 pm and my 12 hour time had elapsed by like 8 hours so there was no making up that dose.... so I just took it at bed time.... And I thought for sure that my VL would be higher on my next reading when in fact it was my lowest one yet... i went to <20!!! I had been teetering around 100. Obviously I'm not saying that missing doses helps your VL, but I've learned it's not going to kill you. its just better to have a schedule. Like I keep a paper cup by my bed and my pill planner so when i'm watching tv or on my laptop or phone. and about to go to bed, I can reach for my meds, take a gulp, turn off my lamp and go night night. It works for me! Just keep on keeping on!
04/14/11  HIV- + Diagnosis
05/15/11 Initial CD4/VL reading: 89/ 550,000
05/15/11 - Genotype Test revealed no mutations
06/01/11 -Started Atripla
07/01/11- CD4/VL 125/900
09/26/11- CD4/VL 183/90
10/20/11- CD4/VL  172/72
11/15/11- CD4/VL 185/82
12/20/11- CD4/VL 186/<20!!!!!!!!!!!!!! FINALLY UD!
02/10/12 -CD4/VL 175/70
02/14/12- New Regimen: Norvir, Prezista, Isentress, Truvada
03/05/12 - CD4/VL 203/30 :
04/06/2012: cd4 228 vl <20
05/26/2012 cd4/vl 253/80
07/25/2012 cd4/vl 249/<20
09/10/2012 cd4/ vl 294/<20
Medications:
Prevacid 30, Ativan 2mg 4x/day,Testim 50mg daily, Certavite Multivitamin with Antioxidants, Quinapril 40mg, Fish Oil 3/day, 1000mg Garlic, 2-4 G Carafate, Paxil 20mg, Dapsone 100mg, Norvir, Prezista, Truvada, Isentress.
PRN: Marinol, Baclofen, Ultrum, Patanase, Lidoderm

 


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