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Author Topic: Triumeq and heart concerns  (Read 1367 times)

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Offline jmupatrick

  • Member
  • Posts: 20
Triumeq and heart concerns
« on: October 11, 2017, 12:47:51 pm »
Hi everyone. New to the forum. New to HIV. New to Triumeq. I have been on Triumeq for about a week now. My doctor prescribed it saying that he has several patients on it, that all have responded well to it, and that none have complained of side effects. Prior to my HIV diagnosis, I struggled with and started meds for hypertension and ectopic heartbeats (pvc's). Also, my recent blood workup showed that I have slightly elevated cholesterol--a new fun problem to have. I also have pretty severe anxiety, that I wasn't treating regularly until my HIV diagnosis (now on a low dose of Celexa).

After starting Triumeq, I read about all of the possible associated cardiac risks, but there seems to be huge debate on whether or not there is, indeed, an associated risk. I've noticed that I feel a constant buzz, like I've had 25 cups of coffee, and like I have constant heartburn. Also, after some strenuous activity yesterday, my heart rate shot up and wouldn't come down for a long while, even after taking a beta blocker. All of my poz friends have had symptoms when starting meds that eventually went away, but I am concerned. I'm also concerned that I have a HUGE hypochondriac and anxious mess, and that I'm making my symptoms worse in my head than they actually are. I will most definitely talk to my doc about what I am experiencing, but I'm wondering if anyone else has experiences this too, or if anyone out there with similar heart issues (high bp, cholesterol, ectopic beats) taking Triumeq just fine?
August 2017 - Infection
8/31/17 - Seroconversion
9/22/17 - Diagnosis
10/6/17 - CD4=442, 25%; VL=343,959; started Triumeq
11/3/17 - CD4=762, 39%; VL=50 (holy cow, it's working!!)
1/3/18 - CD4=676, 35%; VL=UD (WOOHOO!!)
3/18/18 - CD4=681, 39%; VL=UD
6/1/18 - CD4=796, 40%; VL = UD

Offline JimDublin

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Re: Triumeq and heart concerns
« Reply #1 on: October 11, 2017, 01:18:10 pm »
Hi

Welcome to the forum.

How are you getting on with your HIV, I mean what were you latest labs like? VL/CD4.

Triumeq buzz thing i found settled after a while, i also changed to taking it in the morning. Are you taking the Triumeq with food? You might want to switch to taking it on a empty stomach to reduce the impact as you adjust to the meds, unless you have been directed otherwise.

On the heart risk its the Abacavir component but I don't think there is a huge debate anymore at all, maybe a few years ago regarding abacavir but that has really been settled with all newer studies have shown its relatively safe.

Let me put it like this your doctor is aware of the other medication you are taking and any conditions you have right? I am sure they have taken this into account and also checked for hypersensitivity but if you are unsure ask them to clarify about this concern you have. 

My own personal take on it is, I don't have a preexisting conditions that would disqualify me taking it and so increasing any tiny risk that remains to what is still a tiny risk is not worth me stressing about.  :) In fact stressing about it would probably be a bigger risk, also when taking about the heart the basics are very true. So cutting out other risk factors in life that have a bigger impact tends to be the real focus, such as smoking as example. 

We have dozens of threads on abacavir and the heart however I would take anything before 2012/2013 on the topic with a big pinch of salt given that it would be outdated by now. 

Here happens to be one I commented in a while back
https://forums.poz.com/index.php?topic=64175.msg713603

Anyhow trust your doctor and continue to work with them.
Take it easy

Jim

https://www.poz.com/article/hiv-abacavir-heart-17023-5792
https://www.poz.com/article/hiv-abacavir-heart-20134-4073
https://www.poz.com/drug/triumeq

https://www.poz.com/basics/hiv-basics/hiv-heart
https://www.drugs.com/sfx/abacavir-side-effects.html

https://www.google.ie/search?q=poz.com+abacavir+heart&ie=utf-8&oe=utf-8&gws_rd=cr&ei=f5bnV774BeuPgAayi7qADQ
« Last Edit: October 11, 2017, 01:23:30 pm by JimDublin »
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Offline Mightysure

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  • Posts: 383
Re: Triumeq and heart concerns
« Reply #2 on: October 11, 2017, 04:44:07 pm »
If your pharmacist knew about your heart issue, s/he would've informed you or your doctor of the potential contraindication. HIV meds take some adjusting.  And anxiety is so tricky. It can mimick heart issues.

Offline PozLawyer

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Re: Triumeq and heart concerns
« Reply #3 on: October 12, 2017, 01:37:20 am »
Hi everyone. New to the forum. New to HIV. New to Triumeq. I have been on Triumeq for about a week now. My doctor prescribed it saying that he has several patients on it, that all have responded well to it, and that none have complained of side effects. Prior to my HIV diagnosis, I struggled with and started meds for hypertension and ectopic heartbeats (pvc's). Also, my recent blood workup showed that I have slightly elevated cholesterol--a new fun problem to have. I also have pretty severe anxiety, that I wasn't treating regularly until my HIV diagnosis (now on a low dose of Celexa).

After starting Triumeq, I read about all of the possible associated cardiac risks, but there seems to be huge debate on whether or not there is, indeed, an associated risk. I've noticed that I feel a constant buzz, like I've had 25 cups of coffee, and like I have constant heartburn. Also, after some strenuous activity yesterday, my heart rate shot up and wouldn't come down for a long while, even after taking a beta blocker. All of my poz friends have had symptoms when starting meds that eventually went away, but I am concerned. I'm also concerned that I have a HUGE hypochondriac and anxious mess, and that I'm making my symptoms worse in my head than they actually are. I will most definitely talk to my doc about what I am experiencing, but I'm wondering if anyone else has experiences this too, or if anyone out there with similar heart issues (high bp, cholesterol, ectopic beats) taking Triumeq just fine?

There is some debate, and the evidence is weak, but some docs take the "better safe than sorry" approach.  That was my doctor's attitude.  If your VL is undetectable and you are otherwise well, your own morbidity/mortality will resemble the general population, for which cardiac issues are a huge problem especially as you age.  I am 35 with family history of cardiac problems so we switched from Triumeq to Descovy+Tivicay in order to replace the abacavir.  It's still one dosing per day, just in two pills instead of one.

Up to you (and what your insurance or country will cover--I didn't see you mention whether you are in USA or elsewhere).

The Tivicay component in Triumeq has a potential side effect of insomnia, but like JimDublin said it typically goes away, and if you take it in the morning it will hopefully be less intrusive.  Switching away from Triumeq to Descovy+Tivicay probably will not alleviate that side effect.  You'd probably need a different regimen altogether if it really is intolerable, which hopefully it won't be.  Raltegravir (Isentress) is another integrase inhibitor that is effective and will soon be available in 1x/day formulation.
PozLawyer Blog at https://pozlawyer.com or http://optimisticdespiteitall.com (same site)
Follow me on Twitter at @PozLawyer https://twitter.com/PozLawyer.
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Diagnosed August 2014
Tivicay + Descovy, VL UD, CD4 fluctuates b/w 400-600
Married, serodiscordant.  Husband is negative.
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Offline mecch

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  • Posts: 13,451
  • red pill? or blue pill?
Re: Triumeq and heart concerns
« Reply #4 on: October 12, 2017, 03:45:36 pm »
 jmupatrick - welcome here

You are a week on HIV meds.  Starting any combination is going to make some people feel a bit drugged and out of whack for awhile.

It is way too soon to tell if your body plays nice with this combo, or not.

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline jmupatrick

  • Member
  • Posts: 20
Re: Triumeq and heart concerns
« Reply #5 on: October 13, 2017, 12:12:06 pm »
Thanks, everyone. I'm one week in on Triumeq now, and I've decided to stick it out for now. My doctor says the choice is mine if and when I want to try a different regimen, but like I mentioned in my previous post, I am AWESOME at making things up in my head and believing them, and I want to make sure that the symptoms I am experiencing aren't just my anxiety, or amplified by my anxiety. As I read from someone in another post, these meds are keeping me alive. That's the most important thing.

Regarding what I'm feeling, I still feel the morning buzz, but it seems to be diminishing each day. I hope it goes away altogether. I've found that I CAN'T mix Triumeq with coffee, which sucks, because I really love a good iced coffee! For me, the caffeine amplifies troubles I have with irregular heartbeat, and just makes my anxiety unbearable. I've also found that is is best if I take Triumeq alone. I take my Triumeq in the morning and have moved my beta blocker and anxiety meds to the evening. I don't have any digestion or sleep problems to speak of. Maybe a little more tiredness than usual, but I'm not undetectable yet, so that could just be the war that is going on inside of me to clobber this virus.

Continuing to monitor how I feel without driving myself bananas.  :o
August 2017 - Infection
8/31/17 - Seroconversion
9/22/17 - Diagnosis
10/6/17 - CD4=442, 25%; VL=343,959; started Triumeq
11/3/17 - CD4=762, 39%; VL=50 (holy cow, it's working!!)
1/3/18 - CD4=676, 35%; VL=UD (WOOHOO!!)
3/18/18 - CD4=681, 39%; VL=UD
6/1/18 - CD4=796, 40%; VL = UD

Offline JimDublin

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  • Twitter @JimAllenDublin
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Re: Triumeq and heart concerns
« Reply #6 on: October 13, 2017, 12:33:42 pm »
Hi

Well look glad to hear you are going to stick it out to be honest.

I agree with Mecch comment, it does takes time for the body to adjust and to settle into the new medication.

Give it a few weeks to settle and keep us posted.

Jim
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

 


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