POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: spoon on July 08, 2010, 03:31:55 pm
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Hello. I'm new to posting in the forums but am a year long reader. This board has been a great resource, so I thank you all. I tested poz in June of 09 with decent numbers (cd4 655, viral load 38,000), but decided to start meds last month (cd4 393, vl 220,000). I was given three choices and chose Atripla. The first week I had zero symptoms and was considering myself blessed, but on the 10th day the rash started. By the 14th day it was covering most of my body (not my face) and started itching. I saw my doctor today (day 15) and she is leaning toward me switching meds, with the options being a boosted Prezista or a boosted Reyataz. As these as both Protease Inhibitors, I'm a little scared to take them since lipo issues are a big concern of mine.
I've read through everything I can find on the Atripla rash and was hoping for some feedback from others who have been there. I guess I have 3 options: 1) stick it out with the rash, continue to take the Atripla, and see if it goes away in another week 2) stop taking the Atripla and restart once the rash goes away, or 3) switch to another regime.
Also, any feedback on lipo issues with any of these meds for treatment naive people?
Thanks :)
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You are well informed about everything, except the fear of lipo on these newer PI's. Generally they are low risk for lipo.
I think you got to stick it out to see, or change. I never heard of the "stopping and restarting the same drug" option.
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Thanks for writing. I got that option from the Atripla info page which I'm bolding below:
n controlled clinical trials, 26% (266/1008) of patients treated with 600 mg efavirenz experienced new-onset skin rash compared with 17% (111/635) of patients treated in control groups. Rash associated with bulering, moist desquamation, or ulceration occurred in 0.9% (9/1008) of patients treated with efavirenz. The incidence of Grade 4 rash (eg, erythema multiforme, Stevens-Johnson syndrome) in patients treated with efavirenz in all studies and expanded access was 0.1%. Rashes are usually mild-to-moderate maculopapular skin eruptions that occur within the first 2 weeks of initiating therapy with efavirenz (median time to onset of rash in adults was 11 days) and, in most patients continuing therapy with efavirenz, rash resolves within 1 month (median duration, 16 days). The discontinuation rate for rash in clinical trials was 1.7% (17/1008). ATRIPLA can be reinitiated in patients interrupting therapy because of rash. ATRIPLA should be discontinued in patients developing severe rash associated with bulering, desquamation, mucosal involvement, or fever. Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash.
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I got it at day 12.
Initially it started on my arms, then totally covered me over and wherever I didn't have the rash my skin was red like sunburn.
It lasted for about 2 weeks, then went away as quickly as it came. I also had elevated liver enzymes during that period.
It was worth holding out though because 9 months in I now don't get any side effects at all, and I am undetectable ;D
I wouldn't suddenly stop and then restart again though because of rash, that sounds a bit risky to me :-\
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I would stick with it the rash last awhile but dont scratch :)
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Stick at it!! I had the exact same problem - started on arms... then a few days later COVERED.
I know it's horrible - absolutely horrible.
I majorly freaked out and had about two weeks of misery thinking "is this what my life is going to be like now?".
That was 6 months ago - and right now, here in the UK, I am feeling great and am about to go for a run with the dog and feeling FANTASTIC.
My viral load is now undetectable and my CD4 is climing over 500 now ;-)
But for two weeks at the start I was in agony. It was totally grim...
But remember u are not alone - i found these forums when i was really upset - they were a great support.
TIP: Get some Hayleve (for hayfever) or whatever you have in the states that is equivalent. Any sort of antihistamine really. It can help somewhat to deal with the rash... won't go away.. but will help a bit.
It took two weeks for me. Some people have said longer, some less.
Be brave, and stick at - thinking of you
J
xxx
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An update: It's the next day and the rash started going away. Rash started on day 10 and is almost gone on day 16, kinda like clockwork from what others had said. Makes me wonder why my doctor was so ready to throw in the towel. But good news, and thanks for the support :)