Missing doses

[inmontreal]

Im just curious, but how many doses does one person have to miss to have the meds stop working? I usually take my meds at 10 am every morning and then at 10pm at night..On saturdays i take it about 12pm and the second dose around 3am..and sundays back to 10am and 10 pm.. but once in a blue moon ( like once every 3 or months) i accidently forget a morning dose..I know its bad..but exactly how dangerous is it? Im on Kaletra and 2 other meds (forgot the names..ones kinda bluish green diamond and the other is a blue ones)

[BlkRedBonenla]

I don't know the specific answer to your question, but twice since I've been on meds - atripla - have I forgotten to take my evening pill. I told the doctor this and she barely fluttered an eye. One would think with all the bells and whistles around HAART, she would have wagged her finger at me.

I guess like most medications the purpose is to keep them at certain levels in your bloodstream. Missing a day I doubt will kill you, but how mandy days/doses before the meds are OUT of your bloodstream I DO NOT KNOW.

[inmontreal]

thanks for your answer..i really appreciate it..i gues i should make it 10-10 everyday and stop fucking up with my doses..its a gamble im not ready to take!

[Cerrid]

Im just curious, but how many doses does one person have to miss to have the meds stop working?

I don't think the answer is a definite number of doses, it's all about probabilities. The more misses, the higher the risk of treatment failure. It is generally recommended to maintain an adherence of 95% (i.e. not more than 3 misses/per month for a twice-daily drug or not more than 1.5 misses/month for a once daily-drug).

Here's a picture showing the failure rate versus adherence to HAART as measured by Medication Event Monitoring System.



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[inmontreal]

ok i think im safe *touch wood*..i only missed one dose in about 3 or 4 months..i just have to work on my weekends..i just sleep in so thats why i wait an hour or 2 extra..and on saturday nights i go out..so sometimes the Kaletra makes me dizzy or get teh runs..so i wait till i get home before going to sleep..and i think i should stop that habit..

[inmontreal]

im curious though..is there anyone out there who lost adherance due to missed doses or because you took meds at differnt times?

[trellium]

Hiya Inmontreal - fellow trial participant!

If I remember correctly you're taking Kaletra (twice daily) + Viread + Epivir 
How many doses does one person have to miss to have the meds stop working?

That really depends on each individual and there really isn't any definite cut-off numbers here. 
For 2 years my ex-roomie in San Francisco was in a somewhat passive-suicidal/depression mode and only took 1/2 of his daily prescribed Trizivirs, and yet he still managed to maintain VL<50 for those 2 crazy years.
(I would NOT recommend anyone trying that crazy stunt!!!)

Missing a dose every now and then (>80% adherence) seems to be "ok" with Kaletra-based regimes according to a study reported in IAC 2006. 

95% adherence rule" may not apply to lopinavir/ritonavir (LPV/r) based HAART regimens
http://www.hivandhepatitis.com/2006icr/16aids/docs/Shuter.pdf

Kaletra Regimens 'Forgiving' of Missed Doses
http://www.poz.com/articles/761_11875.shtml

[inmontreal]

thanks man..you ALWAYS know what to say to put my hypocondriac mind at peace!