Switching from Triumeq to Dovato or Biktarvy

[walkingpoz]

Hi guys, I’ve been on Triumeq for almost 10 years and have no noticeable side effects (I do have occasional insomnia but I always thought this was due to anxiety or stress etc.) and have been undetectable ever since. Now my clinic wants to switch me to Dovato (this has been suggested to me for more than a year now but I always declined - because I used to take Isentress and had a few blips then and wasn’t sure if it would work as well in me as in someone who is treatment naive). The reason they wanna switch me away from Triumeq is because of the cardiovascular risks associated with the abacavir component. Now I’ve decided to switch away from Triumeq but I am indecisive about whether to switch to Dovato or Biktarvy. I’m leaning towards Biktarvy because personally I would feel more comfortable with a 3-drug regimen and emtricitabine has a longer half life than lamivudine.

Now switching to Dovato would be straightforward as the 2 components are already in my system. But how is it with Biktarvy with dolutegravir’s molecular structure being so similar to bictegravir’s, and lamivudine’s being so similar to emtricitabine’s? Would it still take a few days until steady-state plasma concentrations are achieved or do the similar chemical structures help in this case?

[Jim Allen]

Interesting topic.

Now my clinic wants to switch me to Dovato (this has been suggested to me for more than a year now but I always declined

Same here but for the past 18+ months. Dovato isn't a superior treatment, and as for the ABC, it's been known for years; I'm still not too worried, although as I am getting older, I am now looking to switch as well; no rush, though, and it will not be Dovato. 3TC's short half-life and the fear of defaulting to monotherapy down the line are among the reasons.

I’m leaning towards Biktarvy because personally I would feel more comfortable with a 3-drug regimen and emtricitabine has a longer half life than lamivudine.

I'm sticking with HAART as well. I've outlined in more detail the why and discussed it in two recent threads:

https://forums.poz.com/index.php?topic=77560.0
New HIV drugs with a higher resistance risk should be classed as inferior

https://forums.poz.com/index.php?topic=77510.0
Experts recommend statins for all people with HIV aged 40+

Biktarvy is a solid drug, although not for me. I was on Truvada in the past, great for millions, but didn't agree with me and although Biktarvy contains the updated version*, I'm still going to give it a miss. *(emtricitabine/tenofovir alafenamide)

If you don't mind me asking how has your clinic reacted to you rejecting duo therapy and wanting Biktarvy?

Now switching to Dovato would be straightforward as the 2 components are already in my system. But how is it with Biktarvy with dolutegravir’s molecular structure being so similar to bictegravir’s, and lamivudine’s being so similar to emtricitabine’s? Would it still take a few days until steady-state plasma concentrations are achieved or do the similar chemical structures help in this case?

So... if you are switching one day to the next, the concentrations of drugs should consistently stay within therapeutic limits. Is that the question? Have you asked your clinic this question, and what did they say?

[Jim Allen]

Anyhow, I hope you can switch to something you are happy with. Remember that you are the boss of your healthcare, and keep us posted on how you get on.

[Tonny2]

                 ojo.               I wish I were in n that dilema of swishing from one pill to a different pill. Due to my history of resistance I still had to take lots of pills a day. I’m still alive though… I think that three medications is better than two, but that’s just me. I like Jim can’t handle tenofovir, I’m Allergic to it… please keep us posted and good luck with your decision.

[walkingpoz]

Thanks for the replies.

The clinic is ok with me wanting to switch to Biktarvy and I shall switch once I’ve used up the remaining Triumeq pills, which I still have a lot of. Will keep you guys posted.

[Tonny2]

          ojo.              Hello there!… i’m glad that you decided for the medication. I am allergic to abacavir I remember that after taking it at night time I woke up, and I look like the pink panther. All pink, because of a bad rash, plus my skinny legs definitely I look like the pink panther… good luck