Changing meds time

[BM]

Last night I turned a wine tasting evening into a wine swallowing evening and was very ill this morning. As usual, I took my morning meds (ritonavir, atazanavir, raltegravir, tenofovir) with some cereal and went back to bed. About forty minutes later, I started vomiting and couldn't stop. Is it likely that I won't have absorbed my meds? I was staying at a friend's house and couldn't repeat the doses. I'm thinking about repeating my morning meds this evening and switching evening and morning permanently. Should this be OK?

[eric48]

As of today, my combo is twice daily (although taking nevirapine 2 pills at the same time is something that is currently underconsideration)

I'd wished  could take my meds in the morning. as of today, I must take my Kivexa (along with viramune) in the evening because I think I need more time to adjust to an excitation / stress  effect of Kivexa.

First I though you'd be twice daily any way because of the Isentress (raltegravir) in your combo.

You've been UD for a while so can move timing by allowing a 24+12 hours gap once, no big deal...

Whenever I have changed the timing, I moved up (reducing the gap)

In you situation, I'd take the meds as soon as I hit home and then 24 hours later, and so on for a few days, then decide what to do.

It is a good reminder that everyone should always have a spare dose at hand: I always keep a spare dose in my wallet, one in my key holder ans a few in car/bags/etc.

at any rate, the good idea is the wine party w/ friends !!!

Cheers

Eric

[BM]

Sorry, my hangover is still very active and I'm not thinking too clearly yet! I meant I'd switch the morning lot to the evening and the single raltegravir to the morning (opposite of how I have been taking my meds). Apart from anything else, it'd make my mornings a lot less effortful! Only potential problem is if I'm out and can't easily eat to take the atazanavir...

The party was great, if a slightly pretentious way to get wasted! :-)

[eric48]

If I could time it in the morning, I'd prefer... I'll give it an other chance in a few month.

The good thing about the morning is that once it is done you do not have to think about it at all for the entire day.

the lowdown is that hangovers are not allowed . Shit , I miss them !

Take care (on the driving)

Eric

[newt]

No you probably didn't absorb them, but the odd (one off) missed does ain't gonna make damn squit of a difference.

- mtt

[BM]

Thanks guys. :-)

[Matt39]

Thanks guys. :-)

You should be very careful with your alcohol intake whether or not it results in vomiting after taking your meds.
It's frankly bad on your numbers full stop.
You need to consider your liver since it will be under pressure without the alcohol, so you absolutely *need* a plan of action to protect it:
1. Regular light-moderate exercise
2. Liver de-toxifying measures in your diet - the ideal for you is liquid form 80% Silymarin Milk Thistle, taken 1ml in a little water with meals 2-3 times a day.
You could also consider Liquorice Root (tea infusion or tincture) 1-2 times a day but *not* if you have high blood pressure, in which case stick to Milk Thistle.

[BM]

I've been somewhat intolerant of alcohol since I started my meds so nights like the one I described are exceedingly rare.

I'm sure I read somewhere that milk thistle is contraindicated with my meds.

[Miss Philicia]

You should be very careful with your alcohol intake whether or not it results in vomiting after taking your meds.
It's frankly bad on your numbers full stop.
You need to consider your liver since it will be under pressure without the alcohol, so you absolutely *need* a plan of action to protect it:
1. Regular light-moderate exercise
2. Liver de-toxifying measures in your diet - the ideal for you is liquid form 80% Silymarin Milk Thistle, taken 1ml in a little water with meals 2-3 times a day.
You could also consider Liquorice Root (tea infusion or tincture) 1-2 times a day but *not* if you have high blood pressure, in which case stick to Milk Thistle.

How utterly fascinating.  Shall we presume that you can provide us with links to research that backs up these assertions?

[newt]

You should be very careful with your alcohol intake whether or not it results in vomiting after taking your meds. It's frankly bad on your numbers full stop.

People might go Google and find this (misleadingly headlined) article on HIV and Hepatits, report by reputable writer Liz Highleyman:

Frequent Alcohol Use Linked to Lower CD4 Cell Count and Higher HIV Viral Load
http://www.hivandhepatitis.com/recent/2010/0528_2010_b.html

A study on alcohol/drug users in Miami (perhaps a selection bias there) showed no significant difference except when people were on combo. The real point of this article, as with many other before, is therefore drunk people forget to take their meds. Duh!

Alcohol will not affect your viral load or CD4 count. Lots of alcohol can damage the liver tho, and being the organ that cleans many HIV meds from the blood it is important to look after it.

It is entirely plausible that taking HIV meds will reduce your tolerance to alcohol, since the meds are basically using up the pathways in the liver that clean out alcohol.

Personally, I find a glass of wine a good digestiv for me combo each dinner time.

- matt

[Matt39]

I've been somewhat intolerant of alcohol since I started my meds so nights like the one I described are exceedingly rare.

I'm sure I read somewhere that milk thistle is contraindicated with my meds.

It is not contra-indicated for either Tenofovir or Raltegravir (Viread/Isentress) for sure as far as my HIV Consultant (UK) is concerned and he is the head of my Clinic - one of the biggest in London. I doubt very much if it is contra-indicated for the PI Atazanavir either since I have two friends on that and they use Silymarin (Milk Thistle) and their HIV Consultants will be aware of that.

Having said that you can choose to use Liquorice Root instead, and that is recommended even for the 'HIV/Hep B and/or C' coinfected by our 'Baseline' organisation - run by only poz people. Though Liquorice Root, while excellent at detoxifying the Liver can elevate BP in people who are either on medication for it, or battling to keep it below borderline levels.

[Matt39]

Alcohol will not affect your viral load or CD4 count. Lots of alcohol can damage the liver tho, and being the organ that cleans many HIV meds from the blood it is important to look after it.

Alcohol puts stress on the immune system of *everyone* to one degree or another, the issue comes down to the individual concerned and the *level* of alcohol intake.

[Miss Philicia]

Alcohol puts stress on the immune system of *everyone* to one degree or another, the issue comes down to the individual concerned and the *level* of alcohol intake.

Except that's not what you originally wrote, now was it?