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Author Topic: starting meds soon.....  (Read 5384 times)

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Offline jb1973

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  • Posts: 68
  • To thine ownself be true
starting meds soon.....
« on: July 11, 2012, 07:52:02 pm »
Hi all.  Well the time has come.  I've decided to start meds, eventhough my cdr >500.  Well, actually it was decided after my last doctor visit in May.  We discussed the pros and cons and other things and agreed that I would start my next visit which is coming up in august.  My doc has always been great about letting me make the decision and really has never forced the issue. I just decided that this constant fatigue is getting the better of me and it's time to give my body a rest from fighting the virus 24/7. 

Anyhoo, i've narrowed the choices down to isentress and truvada or complera.  I was wondering if anyone could give any insight on if one was better over the other?  I know complera has the dietery/calorie requirement and is only once a day.  The I/T has no calorie requirement but the isentress is twice a day.  And on that note, my doc had hinted that since my VL was on the low side, I could possibly only take the isentress once a day. 

Thanks in advance!!!


??Infected - 08-09??
3/3/11-tested POZ
3/18/11 - CD4-534 VL-6,600
6/24/11 - CD4-642 VL-10,800
10/11 - CD4-580 33% VL-9,900
1/12 - CD4-602 ?% VL-9,700
3/12 - CD4-552 27% VL=10,684
8/12 - cd4-550 24% VL=9.865
Started Isentress/Truvada
10/12- CD4-613 31% VL=UD

Offline buginme2

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Re: starting meds soon.....
« Reply #1 on: July 11, 2012, 08:09:20 pm »


Anyhoo, i've narrowed the choices down to isentress and truvada or complera.  I was wondering if anyone could give any insight on if one was better over the other? 

Neither one is better.  They will both do the job.

Personally, If you are only choosing between Isentress/Truvada and Complera I would start with the Complera.  There was a recent news article of how those who are on "one pill, once per day" treatments are able to adhere to their medication schedule better than those who take multiple pills, more than once per day.

http://www.aidsbeacon.com/news/2012/04/18/single-pill-treatment-is-associated-with-better-treatment-adherence-in-people-with-hiv-aids/

You can read the article in the above post however, the first paragraph sums it up.
""Results from a recent study suggest that people with HIV whose antiretroviral regimen is taken as a single pill per day have better treatment adherence and a lower risk of hospitalization compared with people whose regimens consist of three or more pills per day.""

I would not choose to take Isentress once per day, becuase Isentress was studied once per day and it didnt pass muster.  If you want to take a Integrase Inhibitor once per day wait till the Quad pill comes out.





Don't be fancy, just get dancey

Offline jb1973

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  • Posts: 68
  • To thine ownself be true
Re: starting meds soon.....
« Reply #2 on: July 22, 2012, 09:47:57 am »
Thanks for the reply bug and sorry for the delayed response.  I think maybe I already had the answer, but I guess I was wondering if one was better in the long term side effects? But no worries, like you said both will do the job.  Thanks again!
??Infected - 08-09??
3/3/11-tested POZ
3/18/11 - CD4-534 VL-6,600
6/24/11 - CD4-642 VL-10,800
10/11 - CD4-580 33% VL-9,900
1/12 - CD4-602 ?% VL-9,700
3/12 - CD4-552 27% VL=10,684
8/12 - cd4-550 24% VL=9.865
Started Isentress/Truvada
10/12- CD4-613 31% VL=UD

Offline Miss Philicia

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  • Posts: 24,793
  • celebrity poster, faker & poser
Re: starting meds soon.....
« Reply #3 on: July 22, 2012, 10:00:51 am »
The biggest difference I would say is that the edurant portion of complera is quite new, having only been FDA approved for one year, while isentress now has a five year approval so there is more confidence with this medication in knowing what side effects a large amount of patients have experienced.

Side effect wise edurant is seen as more tolerable than the sustiva portion of Atripla, but also a higher rate of virologic failure. I assume the difference isn't that large though. Edurant, in clinical trials, has 1/2 less patients than sustiva going off the regimen, so while good the CNS effect is still there.

Personally I would probably go with isentress, just because I would be more comfortable with the larger amount of data, but then I am also used to taking two doses a day of HIV meds.

Is the one-dose-day an huge issue with you?
« Last Edit: July 22, 2012, 10:02:42 am by Miss Philicia »
"I’ve slept with enough men to know that I’m not gay"

Offline jb1973

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  • Posts: 68
  • To thine ownself be true
Re: starting meds soon.....
« Reply #4 on: July 22, 2012, 06:50:21 pm »
Once a day dosing isn't that big of a deal. I could do twice a day with no problem. You make good points regarding the newness of edurant. I guess I'm more concerned about long term side effects more s than anything else.
But, I guess with the caloric requirements for complera was one of the reasons I was leaning towards the I/T.  I was just concerned with having to eat it with a meal.  Yea, I know, I eat everyday, but, I was thinking if I took it with dinner, what happens when I eat one night at 6 and the next night at ten?
??Infected - 08-09??
3/3/11-tested POZ
3/18/11 - CD4-534 VL-6,600
6/24/11 - CD4-642 VL-10,800
10/11 - CD4-580 33% VL-9,900
1/12 - CD4-602 ?% VL-9,700
3/12 - CD4-552 27% VL=10,684
8/12 - cd4-550 24% VL=9.865
Started Isentress/Truvada
10/12- CD4-613 31% VL=UD

Offline Miss Philicia

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  • Posts: 24,793
  • celebrity poster, faker & poser
Re: starting meds soon.....
« Reply #5 on: July 22, 2012, 07:45:45 pm »
I'm sure there would be a label on the bottle telling you 'YOU MUST TAKE THIS EXACTLY 24 HOURS APART OR YOU WILL DIE'

Seriously, it's not that complicated.
"I’ve slept with enough men to know that I’m not gay"

Offline jb1973

  • Member
  • Posts: 68
  • To thine ownself be true
Re: starting meds soon.....
« Reply #6 on: July 22, 2012, 07:49:49 pm »
I'm sure there would be a label on the bottle telling you 'YOU MUST TAKE THIS EXACTLY 24 HOURS APART OR YOU WILL DIE'

Seriously, it's not that complicated.


Bahahahahahaha.  Ok, but I thought the meds needed to be taken at the same time every day? Or is there more of a window?
??Infected - 08-09??
3/3/11-tested POZ
3/18/11 - CD4-534 VL-6,600
6/24/11 - CD4-642 VL-10,800
10/11 - CD4-580 33% VL-9,900
1/12 - CD4-602 ?% VL-9,700
3/12 - CD4-552 27% VL=10,684
8/12 - cd4-550 24% VL=9.865
Started Isentress/Truvada
10/12- CD4-613 31% VL=UD

Offline Jmarksto

  • Member
  • Posts: 667
Re: starting meds soon.....
« Reply #7 on: July 22, 2012, 08:07:39 pm »
jb:  Thanks for posting, I am in the same boat and had come down to a choice between the two options you have, although now am considering the Quad too.  A few things I am trying to figure out are:

1.) Does the quad have any dietary (with/without food) requirements?

2.) What is the cost difference (in the US)? It looks like I will have a 50% copay.

3.) Is there data on the percentage of people with each side effect, and severity of the side effect, by drug?  The research indicates that fewer people stop the Quad due to side effects, although my doctor indicted that because the population selected for the trials need to meet certain criteria the data from the trial may not represent the true rates of side effects in the general population.

Thanks,
JM
03/15/12 Negative
06/15/12 Positive
07/11/12 CD4 790          VL 4,000
08/06/12 CD4 816/38%   VL 49,300
08/20/12 Started Complera
11/06/12 CD4   819/41% VL 38
02/11/13 CD4   935/41% VL UD
06/06/13 CD4   816/41% VL UD
10/28/13 CD4 1131/45% VL 25
02/25/14 CD4   792/37% VL UD
07/09/14 CD4 1004/39% VL UD
11/03/14 CD4   711/34% VL UD
03/13/15 CD4   833/36% VL UD
04/??/15 Truvada & Tivicay
06/01/15 CD4 1100/50% VL UD
10/16/15 CD4   826/43% VL UD
??/??/2017 Descov & Tivicay
2017 VL UD, CD4 stable around 850
2018 VL UD, CD4 stable around 850

Offline leatherman

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  • Posts: 8,593
  • Google and HIV meds are Your Friends
Re: starting meds soon.....
« Reply #8 on: July 22, 2012, 08:18:43 pm »
3.) Is there data on the percentage of people with each side effect, and severity of the side effect, by drug?
this kind of information (well, ALL information about a drug including storage, dietary requirements, dosage, etc), is always available on the package insert of any medication. Just google up "package insert" and the name of the med

http://www.merck.com/product/usa/pi_circulars/i/isentress/isentress_pi.pdf
http://www.gilead.com/pdf/complera_pi.pdf
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline Jmarksto

  • Member
  • Posts: 667
Re: starting meds soon.....
« Reply #9 on: July 22, 2012, 08:28:59 pm »
Thanks much Leatherman, I didn't know where to find that.

Sincerely,
JM
03/15/12 Negative
06/15/12 Positive
07/11/12 CD4 790          VL 4,000
08/06/12 CD4 816/38%   VL 49,300
08/20/12 Started Complera
11/06/12 CD4   819/41% VL 38
02/11/13 CD4   935/41% VL UD
06/06/13 CD4   816/41% VL UD
10/28/13 CD4 1131/45% VL 25
02/25/14 CD4   792/37% VL UD
07/09/14 CD4 1004/39% VL UD
11/03/14 CD4   711/34% VL UD
03/13/15 CD4   833/36% VL UD
04/??/15 Truvada & Tivicay
06/01/15 CD4 1100/50% VL UD
10/16/15 CD4   826/43% VL UD
??/??/2017 Descov & Tivicay
2017 VL UD, CD4 stable around 850
2018 VL UD, CD4 stable around 850

Offline leatherman

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  • Member
  • Posts: 8,593
  • Google and HIV meds are Your Friends
Re: starting meds soon.....
« Reply #10 on: July 22, 2012, 09:29:13 pm »
Thanks much Leatherman, I didn't know where to find that.
don't mention it ;) that's what comes from nearly 20 yrs of meds. I've always loved reading the P.I.s even when I've had to read a sentence 3 or 4 times to understand it and the science behind it.

That's why at times it feels like I'm on an don't-worry-about-side-effects crusade with some of my advice on here. LOL Clearly package insert information tells me that usually >10% or >5% deal with side effects, yet sooo many people hem-n-haw about starting meds worrying about the side effects - side effects that they're probably not even going to experience. ;D See I'm not really a gambling man, so a 90% chance of NOT having a side effect is a gamble I'm sure willing to take. ;)

good luck and good results with whichever meds y'all decide to take. ;)
mikie
(who, short of a few minor rashes and fevers, has really only suffered from the side effect of barfing with his HIV meds)
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline jb1973

  • Member
  • Posts: 68
  • To thine ownself be true
Re: starting meds soon.....
« Reply #11 on: August 13, 2012, 01:21:22 pm »
So I've decided on Isentress and Truvada and have an appointment with my doctor on Friday to pick up my first prescription.  I was there on the 10th and had blood drawn and a lengthy discussion regarding which medication I wanted to try first.  My doctor wants to see me on the 17th to go over the I/T again.  During the discussion on firday, she still mentioned that I could take the isentress once a day vs. twice a day.  She felt that my VL was low enough that it wouldn't be an issue.  But, I know that it failed the once a day doseing trials last year.  The supression rate was something like 83% for those dosing once a day. 

I dont want to take it only once a day and then it not work and develop resistance.  Should I just tell her I prefer to take it twice a day, or, trust in her knowlege and take it once a day?

Is anyone else taking Isentress once a day? 
??Infected - 08-09??
3/3/11-tested POZ
3/18/11 - CD4-534 VL-6,600
6/24/11 - CD4-642 VL-10,800
10/11 - CD4-580 33% VL-9,900
1/12 - CD4-602 ?% VL-9,700
3/12 - CD4-552 27% VL=10,684
8/12 - cd4-550 24% VL=9.865
Started Isentress/Truvada
10/12- CD4-613 31% VL=UD

 


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