POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: jaguarpaw on August 20, 2010, 02:53:17 pm
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Hello.
I take Isentress/RAL + Truvada twice daily.
AM Dose 8:30am- RAL + TVD, then PM Dose 8:30pm- RAL.
I'd have to change my work/school/life schedule lately and I'd like to move my my dosing time to 11am/pm
But I dont want to take it late and go those three hours without meds.
Any thoughts?
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Ask your doc.
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I'm on the same combo and I was traveling a few months ago to a place with a 4 hour time difference. I asked Dr. Gallant and he said it's fine to just take it at the new time. A 3 or 4 or even 5-hour difference is not going to affect treatment.
This applies especially if you are already undetectable. I would be more exact if there is still a viral load.
When I first started on meds I was very exact about the time but now I take them within a 3-hour window of about 8 to 11.
If it makes you feel better you can also space it out slowly. Take it at 9, then the next day at 10 and the next at 11 but it's not really necessary especially if you are undetectable.
Here is a similar Q&A from Gallant:
http://www.hopkins-aids.edu/q_a/patient/antiretroviral_therapy/antiretroviral_agents/integrase_inhibitors/re__isentress_dosing_intervals.html?contentInstanceId=530370
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I have also had to change of pill times due to travelling and work.
As per my doctor's advise when you have to move to take pills later than you did before the best is doing it slowly, advancing one hour (or less if possible) each day, untill you get the new hour you are going to take them. For instance, if now you take your pills at 8:00 and need to take them at 12:00 try to advance 1 hour each day: at 9:00 first day, at 10:00 second day, at 11:00 third day and then at 12:00.
Another possibility, if you need to change from early in the morning to before going to sleep is going back instead of forwards. If now you are taking pills at 8:30, let's say, and you need to change to 22:00 hrs, you can do this: first day of change at 5:00, second day at 1:30, third day at 22:00. In this way, "going back" you ensure there's always enough med concentration in your bloodstream.
Following from the point before, if you have to take them earlier than now, then you can also go back. For instance, if you used to take your pills before at 13:00 and now you need to do it at 7:00, you can go back 2 hours each day: 11:00 first day, 9:00 second day and finaly 7:00.
Nevertheless, try these changes not to be frecquent, as you may risk to loose a bit the sense of discipline and the timely habits you reached until now; as, once you start making changes you my relativize or even not be so sure of the right hour to take your pills (or have the sensation this was not so important once the "tabu" is broken).
As a norm, my doctor says the "safety window" is no more than 4 hours for once a day meds, and no more than 2 hours for twice a day meds, over these intervals, there are risks of viral resistance if loosing or taking doses on retard episodes repeats more than 2 times in a month.
This can be even worst depending on meds you are taking. NNRTIs give you a bit more of margin, but PIs and NRTIs do not. Mind also your previous resistance historial (if any) and whether your infection is more or less controlled (VL undetectable, CD4 stable or increasing) or not (VL detectable and low CD4). All this can make even more important to be as regular as possible in time scheduling your pills.
Hugs :-)
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Seriously people...
If your viral load is supressed eg below 50 copies then stopping drugs will give 2-5 days before viral replication gets going.
Therefore, as a one off, or occasional off eg a holiday, just change.
A few hours difference on one occasion won't make diddly squit difference. The virus will still be asleep.
- matt
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i used to take my viraday just before heading to bed... but it caused me so much insomnia i had to move my dosing time... when i asked my doctor, she told me to take my next dose to about 3pm of that day, and then the one after that at 11 am the following day... so as long as you don't go significantly more than 24 hours in between doses, you should be fine