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Author Topic: Time for a change of regimen.  (Read 3918 times)

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Offline midnightchatter

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Time for a change of regimen.
« on: February 01, 2016, 04:35:37 pm »
Hello Everyone,

I'm back for a little support so please be gentle. :-)

I've been on atripla for 10 years but I've finally decided to make a change, The side effects were just too much for me. I feel like i haven't slept properly in years. Mad mood swings restless legs and horrific night terrors and a total loss of libido to name just a few.

My Doc has recommended Eviplera or complera as its known outside the uk.
My question to you all is this ..... I always took my atripla late at night 1am due to my work schedule. My new meds will require me to have them with a small meal so I've decided to take it in the morning with my breakfast.

I'm just a little scared about what to expect. I'm planning on starting first thing tomorrow.

So what kind of experiences have you guys and gals experienced??

Wish me luck.

Stay Healthy x

Offline CaveyUK

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Re: Time for a change of regimen.
« Reply #1 on: February 01, 2016, 04:41:23 pm »
Is there any reason your doc is recommending staying with a drug in the same class as Atripla, rather than moving to an integrase inhibitor such as Tivicay or Triumeq?

Only ask because the mood-altering side effects of the integrase class seems to be far lower than the NNRTI drugs. From what I can tell anyway.

May be worth asking?
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Offline midnightchatter

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Re: Time for a change of regimen.
« Reply #2 on: February 01, 2016, 05:12:26 pm »
Hi Cavey, As far as im aware there were only 2 other choices of meds available to me eviplera and stribild. My main focus was getting away from the efavirenz. I gave it 10 years but it seriously kicks my butt.

Im just hoping i manage to stay undetectable and that hopefully my cd4 may climb a little from 400 but i'm not holding out on that too much.


Offline CaveyUK

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Re: Time for a change of regimen.
« Reply #3 on: February 01, 2016, 06:04:26 pm »
Just looking at the side effect profile for Eviplera :

Side effects: as with the individual drugs in this formulation. These include depressive disorders (depressed mood, depression, mood altered, negative thoughts, suicide attempt, suicidal ideation), rash, nausea, liver problems.

http://i-base.info/guides/5912

As you mentioned mood problems being a problem, and Eviplera contains Rilprivirine which is the same class as Efinvirenz (in Atripla), it seemed a curious choice thats all.

Not trying to second-guess you doctor who may have very valid reasons for using this combo, but I would certainly ask the question if it were me just to be sure.

Stribild contains an integrase inhibitor (Elivitegravir) which is a different class of drugs, and from all reports I've seen tends to be pretty well tolerated with few mood or CNS effects.
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Offline CaveyUK

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Re: Time for a change of regimen.
« Reply #4 on: February 01, 2016, 06:07:00 pm »
I should add that I'm not an expert. Just an information junkie who is currently immersed in the minute details around ARV's due to my recent start on treatment :)
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Offline harleymc

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Re: Time for a change of regimen.
« Reply #5 on: February 02, 2016, 10:30:42 pm »
Hi I've been on Complera with Raltegravir for about 3 years.  It's a breakfast pill for me too, if I miss the breakfast dose, I have a chance to catch up at lunch or dinner.

I have had depression and anxiety disorder for 40 years, it didn't get any worse going onto complera.
I've done some work with a counsellor, exercise regularly and have a micro dose script for 7.5 mg of Mirtazapine which has been helping my mood considerably. Al in all I'm not having any troubles whatsoever with Complera.

Offline terrymoore

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Re: Time for a change of regimen.
« Reply #6 on: February 07, 2016, 08:21:45 pm »
I have just started Atripla, and although i initially convinced myself that i am not having any side affects,this weekend there were signs of mood-swings/depression etc - something i NEVER experienced before. I am still waiting to see if this is the drug or just a lack of sleep and pressure from work. I raise this here since my doc raised Complera as the alternative. I am interested to know how the switch goes so please let me know.

Offline Expat1

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Re: Time for a change of regimen.
« Reply #7 on: February 09, 2016, 05:52:02 pm »
Terry I experienced an initial dizziness with Atripla.  I did not like the tedious dreams.  But as time went on, I started getting moody.  I woruld be 'abrupt' with friends for no apparent reason. 

The doc wanted me to take Atripla for 1 year.  After 11 months it was enough for me. And I switched to the Recovir EM  (generic Truvada) and Edurant.  Happy I mad the change.  No more mood swings.   Now 14 months on RecovirEM/Edurant.  Undetectable.  CD count 1060.

I take it with the first meal of the day. 

The issues my doctor was concerned about are that Edurant is a little weaker than Efavirenz.  And if you become resistance to it, it can possibly also cause some resistance to the recovir EM. 

In regards to the option of an integrase inhibitor vs nnrti.  The integrase inhibitors are about 25X the cost of nnrti drugs here in Thailand.  Also I wish to preserve that class for the future if necessary.

I am 60.  I might be more leery if I was 25 and had to contemplate 50+ years of arvs.  In which case, the issues of resistance might be more critical.

OP: Recovir and Edurant (two pills) are the exact same ingredients as Complera.

Offline terrymoore

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Re: Time for a change of regimen.
« Reply #8 on: February 10, 2016, 01:44:02 am »
A quick update  - since my last post 3 days ago i still feel "weird" - foggy, not "sharp", moody (impatient, snappy), even a bit confused. Minor hiccups in planing seem to become huge unsolvable puzzles (like changing travel arrangements for business trips - a common occurrence for me in my work). I have come to the conclusion that this Atripla is to blame and not for me. I have made an appointment to see the doc tomorrow. I will let you know how that goes. Thanks to all! (oh, and OP sorry for the hi-jack!).

Offline BT65

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Re: Time for a change of regimen.
« Reply #9 on: February 10, 2016, 07:47:25 am »
Midnight, I have been on Stribild for a few years (with a couple other meds just because of resistance issues) and have had no issues with it whatsoever.  I took it alone for a couple years and had no issues then either. I don't believe the resistance issues was due to just taking Stribild, it was most likely because I missed taking it several times because the time I take it is when I am at work, so I just forgot about taking it.  Anyway, of course the decision is between you and your doctor, but you may want to check out all your options before making a decision. 

Atripla is well known for its psychiatric-related side effects.  I took Sustiva for quite a while (which is the med in Atripla responsible for those nasty effects) and finally told my doctor I could not take it.  That's when I was put on Stribild.

Good luck with your decision, and Terrymoore, please start your own thread if you wish to talk about your treatment. Thank you.

Betty
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Offline atlanta05

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Re: Time for a change of regimen.
« Reply #10 on: February 28, 2016, 01:16:02 pm »
I moved from Truvada+Sustiva (same ingredients as Altripa) to Stribild 6 months ago, and have had no trouble at all. The CNS effects of the Sestina were mild for me but they were still there. I don't miss that druggy feeling (minus any actual high!) in the evenings after taking it....

Offline terrymoore

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Re: Time for a change of regimen.
« Reply #11 on: February 28, 2016, 11:43:56 pm »
Hi Midnightchatter - how have you been?
Have you made the move to Eviplera/Complera?
After my last post,i saw the doc and made that switch - from Atripla to Complera.
It was a great choice! I still have not checked my numbers since the switch, so i do not know if the treatment is working, but i definitely feel A LOT better from a CNS point of view.
You mentioned that you would start taking the meds in the morning - how has the worked out for you?
I hope all is doing well mate!
CHeers

Offline JosephP

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Re: Time for a change of regimen.
« Reply #12 on: March 11, 2016, 11:08:34 pm »
Midnight, like many of us here when I was diagnosed the doctor put me on Atripla... I lasted less than two weeks... The side effects were so damaging and intrusive - horrifying dreams when I could sleep, insomnia the rest off the time, a feeling of drunkenness after taking dose- that my doctor was concerned and switched me to Stribild. Aside from an occasional headache, I haven't had any side effects.. However, as Expat says the integrase inhibitors are about 25times the cost of NNRTI drugs but only you -with your doctor- can make that decision!
Today January 20, 2020, I have taken 2378 pills of my ARV since first pill. This means 79 bottles of 30 pills of ARVs at an average of $3950 per bottle or $313,103 USD for my treatment. I have a compliance of 99.83% taking my meds and only .17% (or 4 pills) non-compliant. Of these four pills two I forgot completely, One I lost and one I didn't have with me while traveling! I became UD 3 months after treatment start   ***We are all dealing with this. And we will live long and productive lives!! AND, yes the Lord is my shepherd. Life is good... And thanks for the meds! ***

 


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