Changed med from Atripla to Dovato

[metekrop]

Hello

After taking Atripla for nearly 12years, my doctor changed my med to Dovato.  Atripla has been very good for me so far. The reason why he wanted to change my med is that Atripla may in the long run give rise to kidney disease and bone problems. Is there anyone here who is taking Dovato?  How do you find Dovato? Advantages, disadvantages etc?

Thanks

[bocker3]

I did the same switch almost 2 years ago (though I also was taking Reyataz w/ the Atripla).  I have had no side effects from Dovato.
The big change for me - no more food worries.  I had to have food with the Reyataz, but no food with the Sustiva portion of Atripla.  That meant taking pills in morning and evening.
Now - one pill when I get up.

VERY happy with the switch

Mike

[Matths]

Hi good morning, I have been taking Dovato for 2 years (slightly longer) now. I was diagnosed a little over 2 years ago and started on Triumeq which I took for a month, and then, when Dovato became available, my doctor switched me over to it. Dovato is the same combo as the 3-drug combo in Triumeq, only without the Abacavir component, and therefore is a 2-drug combo.

I don’t want to lecture you on the clinical trials that supported its use for acute, maintenance and switch therapy for people on other ART treatments. Altogether, the science seems very strong and clearly demonstrated that Dovato is a treatment combo with excellent efficacy and good tolerability. The one caveat that I was made aware of by my doctor is that because it’s a 2-drug combo it’s very important to have good compliance to avoid resistance, ie don’t skip doses!

In my case, I have since starting it not skipped a single dose. I take it in the morning first thing when I start my day. On this schedule I haven’t experienced the sleep problems some people report (I believe mostly when they take it at night). I have been undetectable <20 since I started, minimal weight gain (I believe based on my laziness more than a drug effect), no changes in any body functions (liver, kidney, blood sugar, lipids etc). Therefore, I’m very happy with this combo and intend to stay on it. Another good part is that having health insurance and the ViiV co-pay program, I have $0 costs out of my pocket for this medicine. For me, as stated, it works great. Hope this helps, best Matt

[CircularNatural]

I'm on "generic Dovato" from another lab here in Argentina called Zevuvir L Pack ( essentially, they grab a Dolutegravir pill and pack it side by side to a Lamivudine pill - coming in blister packs. So far, it's been 45 days on it, and feel no side effects.
Havent had my first blood check up still.
The key here is adherence. I write dates on en pill pack with a permanent marker on the blister pack so I don't skip doses.
Hope everything goes well in your treatment.
Best regards!

[metekrop]

Thank you friends for your input.

Appreciated.

[Bucklandbury]

I am thinking about asking my ID in December when I see her again to let me switch as well. Assuming I am still undetectable, that will be a little over six months as such, so I cannot see why she wouldn't allow it. I have never missed a single Biktarvy dose, so adherence for me will not be an issue barring some heinous turn of events between now and then.

I go back and forth on the fewer ingredients aspect. My thinking on this is the constituent meds are all different, so one cannot compare apples to oranges that way. Maybe I missing the logic of that marketing pitch?

Come to think of it... I am not sure why I got started on Biktarvy in the first place?!

I did notice a few side effects were (potentially) slightly higher with Dovato - like anxiety. But it wasn't much more.

Another aspect I wrangle with is to stick with what works. If it's not broken, then don't fix it?!

I need to think on it more, I guess.

[Matths]

Hi Bucklandbury, lots of good thoughts and reasonable questions in your post.

I think the “sales pitch” that ViiV is pursuing with promoting 2-drug treatments is simply based on the fact that once you are diagnosed you need to stay on ART for the remainder of your life. For most of us this will be for a very long time. And if there is a way to limit the exposure to necessary medication and still achieve a favorable treatment outcome, this approach makes a lot of sense. Thus, I believe it’s more than just a sales pitch, it’s a new way of thinking how to best treat HIV now that there are medications available that allow such approach.

I can’t provide any insight as to why you were started on Biktarvy but it’s a very potent medicine and clinical trial results are very convincing in the acute treatment and for maintenance. Still, some of the ingredients in that combo may not be for everyone but this statement probably applies to most patients. That’s why consulting with your doctor is a good idea and discussing available treatment options too.

I would agree with your statement you made that why switching when you achieve what you wanted. However, if your lab results or weight gain or any other side effects call for re-thinking this initial treatment decision, I believe it’s reasonable to do so. For me personally being on Dovato, being U<20, and having no side effects, I have no reason to contemplate a switch to anything else. Hope this is helpful, best Matt

[Bucklandbury]

And if there is a way to limit the exposure to necessary medication and still achieve a favorable treatment outcome, this approach makes a lot of sense. Thus, I believe it’s more than just a sales pitch, it’s a new way of thinking how to best treat HIV now that there are medications available that allow such approach.

So in a hypothetical... let's say I have two different pill combos. One has two ingredients, one of which ends up being toxic after some time goes by... the other pill combo has three constituent ingredients... all of which end up being OK.

Which combo would you choose?

[Matths]

Certainly the combo that brings me to undetectable AND does not go with side effects that could cause any harm. Could be any single or combo medicine. But nowadays there are so many options available that taking a medicine that provides exactly that is achievable, but it’s based upon careful review of a patient’s history and ongoing care.

That’s why I pointed out repeatedly, for me Dovato works. But it may not be the best option for everyone. Best Matt