Thailand - switch from Complera to Dovato (generics)

[Mindless]

So, I promised to someone here on the forum that I would update about my planned switch and here I am.

Eventually, I switched 2 weeks ago. I had been taking generic Complera for almost 3 years, before that used generic Atripla about 1 year.

Thanks to the forum I got to know that generic Dolutegravir was eventually available at TRCARC in Bkk and talked to my ID doc who eventually agreed to the switch. So, in writing this I also mean to give back to the great people that helped me.

Generic DTG 50 mg (by Milan) costs 720 bath, whereas generic Lamivudine 300 mg (by GPO) is 210 bath, therefore the cost for a 30 days supply is 930 bath, which is not much different to what I paid for Complera (generic) and still a super good/acc accessible price (thank you Thailand for this).

Reasons for the switch: food requirement, less meds (2 instead of 3) and see if some side effects would get better (insomnia and bowels issues).

Luckily I didn’t get any very bad reaction from the switch but for the first week had increased insomnia, vivid/bad dreams and fatigue. During this second week it seems like these effects are slowly subsiding. I hope this improving trend continues, if not I’m considering to take the pill in the morning to see if the sleep benefits.

Not having to take the pills with food is great and my taking timing is way more consistent than before. It’s actually very good to know that if I can’t have a full meal I can still take the meds. In the past this gave me more than one headache.

Now I have to wait my first lab test in about 5/6 weeks (my doc suggested the timeframe) to see if the meds are working. Fingers crossed 🤞🤞🤞

The following is a link to the TRACARC price list: https://th.trcarc.org/en/anonymous-clinic/arv

I have been told that also Biktarvy (original) is now available at Red Cross, prive should be in the range of 2,500 bath/bottle but I forgot to check.

I will post if I have any updates.

Hugs

Edit: I just checked and Biktarvy (original) is now present in the TRCARC price list at 2,250 bath/bottle. Great price as well.

[bocker3]

I've been taking Dovato for a year now -- I take it in the morning and have had no sleep issues at all. 
I like the convenience of just taking it when I get up -- no worries about eating or not eating (I used to take both Atripla and Reyataz, so one without and one with - every day).
I'm very glad that I finally made the switch after 14 yrs.

Good luck!!

Mike

[Mindless]

Hi Mike,

thanks for the feedback. BTW, you take it before/after your breakfast? I'd like to try the morning to see if the sleep improves. A part from that I'm happy with the switch.

Hugs

[daveR]

Hi Mindless.
Thanks for the detailed update. I am currently taking the same regime as you just gave. The food requirements are something I want to get away from. I discussed it with my ID Doctor and she reverted back to older regimes which I turned down. In April I will discuss generic Dovato, those prices are reasonable and a day trip to Bangkok to collect them would not be an inconvenience.

Thanks for the great info.
Dave

[Mindless]

Hi Mindless.
Thanks for the detailed update. I am currently taking the same regime as you just gave. The food requirements are something I want to get away from. I discussed it with my ID Doctor and she reverted back to older regimes which I turned down. In April I will discuss generic Dovato, those prices are reasonable and a day trip to Bangkok to collect them would not be an inconvenience.

Thanks for the great info.
Dave

Hi Dave, you're welcome. FYI, TRCARC has a shipping option for the meds, you can check on their website. Basically, they can ship you the meds, so you don't have to travel. I never used and so I don't know how it works in detail. Maybe a Thai friend could help you with that (the website is mostly in Thai language)

Hugs

[bocker3]

Hi Mike,

thanks for the feedback. BTW, you take it before/after your breakfast? I'd like to try the morning to see if the sleep improves. A part from that I'm happy with the switch.

Hugs

Sometimes before breakfast, sometimes after.  That's the beauty of this, for me.  After 14 years of taking my Reyataz in the morning, after breakfast and my Atripla a few hours after dinner, I love that there is no worry now.
Mike

[TGun]

so ive been on biktarvy and genvoya for awhile and suffered some weight gain that i can't get under control (about 20 lbs)   is the dovato giving you the same side effects???

[Mindless]

Sometimes before breakfast, sometimes after.  That's the beauty of this, for me.  After 14 years of taking my Reyataz in the morning, after breakfast and my Atripla a few hours after dinner, I love that there is no worry now.
Mike

I’ve been taking Complera for just less than 3 years, I can only imagine what could be go through 2 different food requirements for 14 😅. Good that you made the switch!

I feel exhausted ever since the switch, not all days but almost every other. Not sure if this is from the Dovato itself or from the disturbed sleep. I think I’ll switch to the morning to see how that works. BTW, how does it work when you have things like blood tests or other procedures that need fasting in the morning? I have several medical issues I’m keeping monitored besides hiv, so I have periodic blood tests and other stuff to do. Taking the meds at night, that wasn’t an issue but in the morning? How do you manage?

Thanks

[Matths]

Hi, I have been on Dovato for 1.5 years now. I take it in the morning. Given there are no food requirements it doesn’t matter whether you take it with or without good. Therefore, if you had a procedure that requires fasting you can still take Dovato, get your fasting blood draw and have breakfast after. Best Matt

[Mindless]

so ive been on biktarvy and genvoya for awhile and suffered some weight gain that i can't get under control (about 20 lbs)   is the dovato giving you the same side effects???

Hi TGun, as you see I’ve been taking it only for a couple of weeks, so I can’t help you. Hope someone else can answer you. Anyways, both Bictegravir and Dolutegravir belong to the same class (integrase inhibitor), which has be linked to weight gain in some people. But as Isaid, someone more experienced may give you a better feedback.

Hugs

[Mindless]

Hi, I have been on Dovato for 1.5 years now. I take it in the morning. Given there are no food requirements it doesn’t matter whether you take it with or without good. Therefore, if you had a procedure that requires fasting you can still take Dovato, get your fasting blood draw and have breakfast after. Best Matt

Thanks Matths, feedback much appreciated. How about the time window you consider? With Complera my doc suggested a +/- 2 hours, not sure if it’s the same with Dovato.

Hugs

[bocker3]

I always schedule my blood draws early in the morning -- I was so used to taking my meds after I had my blood draw, because I needed the food with the Reyataz, that I've been doing the same with the Dovato -- taking it after.  I suppose there is no reason I can't just take them before -- with water only, of course.

As for the window to take it -- I've pretty much used the "anytime during the day" method for 14 years.  I rarely vary more than a couple hours either way, but when I travel (remember when we could actually travel places......  I miss that) I've gone as long as 36 hrs and as short as 12 hours due to time changes.
For me -- as long as I take it "daily", I'm comfortable.  Oh, and I have not had so much as a tiny blip in 14 yrs, so.......  Just an anecdote, but that is what I do.

Mike

[Matths]

I take the medicine always at 7am when I get up. Maybe I’m a little obsessed but I have only a time change when switching at daylight savings time. Otherwise, it’s part of my morning routine. Medicine with a sip of water, and ready to start my day. From a pharmacokinetics perspective you can easily accommodate a time window of 2 hours plus minus and I can pull the publications showing half life time of both drugs that make Dovato etc etc. I adhere to that also on days when I get the VL checked, or other parameters like lipids, liver, kidney function etc. it’s a very easy drug in my opinion that doesn’t impact your daily routines and that was one reason besides the good data from clinical trials that made me choose Dovato over other choices that my doc and I discussed at the time. Best Matt

[Mindless]

Mike, Matths,

Thank you, both of you. Really, I mean it. Getting first hand, thoughtful advice from experienced guys like you is invaluable.

Hugs

[Mindless]

@Mike

Yeah, I do remember the time when we travelled to other countries through the sky on those cylinders of steel with wings. That was when I still had customers to visit and new ones to make or when I went on vacation, back home or to some exotic places: new places, new faces... God, I miss that.

[Mindless]

Update

For anyone interested: I got my first VL test at week 6 after the meds switch and it’s UD!  I’m so grateful for this.

Taking the meds without need for food is really great for me. I switched to morning and take it as soon as I wake up and then go about my day.

Initial side effects have subsided but I still have occasional trouble with the sleep, anyways I had it also with Complera before.

All in all, I’m satisfied with the switch and planning to continue with the new meds. I will check my blood labs at my usual biannual check in a few months.

Hugs

[daveR]

Thanks for the update. I hope it all continues to go well for you. I will discuss the switch in April at my next appointment.

Dave

[Mindless]

Thanks for the update. I hope it all continues to go well for you. I will discuss the switch in April at my next appointment.

Dave

Thanks and best of luck to you too! Chok Dee krap! 🙏🏻