SUSTIVA vs. VIRAMUNE (AND TRUVADA) ??

[mrtallguy]

I have been on the Sustiva and Truvada combo for 6 months and my sleep issues are getting progressively worse.  Responses from another posting lead me to believe that the Sustiva is the problem child for me and I am thinking of talking to my doc about switching to Viramune as my NNRTI....any thoughts about side effects...good or bad....on VIRAMUNE??

BE WELL!!

MRTALLGUY

[penguin]

Hey..

sustiva, just don't agree with some people.

Viramune, a non nuke like sustiva, sans the screwy head effects - can be bit tougher on the liver, & a small chance of causing a serious allergic reaction at the start of treatment. No food restrictions. Dose is 200mg once a day for the first 2 weeks then increased to 400mg/day if all goes well, usually split into 2 doses.
You can read more about it here

Does it have to be viramune though? There are other, PI based choices for a once daily combo..boosted reyataz or lexiva, kaletra..

Re the sleep, or not sleep, from your other post - mirtazapine can be a useful anti depressant, due to its sedative properties. If the primary issue is anxiety, then a low dose of zyprexa or summat similar might be more helpful than the sleeping tabs/tranquillisers you've been downing..just a thought.

kate

[J.R.E.]

Hello Mrtallguy,

You need to open up with your doctor, and discuss the sleep issues that you are having. I've been on Viramune since October of 03 ( first line of meds ), and had no problem with it. There are other options available to you.

From the drug Section :

"Taking Viramune is a two-step process. For the first two weeks (14 days) of treatment, the dose is one 200mg tablet once a day. Two weeks after starting treatment, the dose of Viramune is increased to one 200mg tablet twice a day. Following this schedule – which you should do under your doctor's guidance – can reduce the chance of developing a rash or other side effects.

"Liver problems have been reported in HIV-positive people treated with Viramune. The greatest risk of liver problems is during the first six weeks of treatment. Liver problems are more likely to occur in women (including pregnant women) with T-cell counts greater than 250 at the time of starting anti-HIV treatment for the first time. As for men, liver problems are more likely to occur if the T-cell count is above 400 at the time of starting anti-HIV treatment for the first time. HIV-positive people should work with their doctors very carefully if they have T-cell counts above these levels and are planning on starting therapy for the first time with a drug regimen that contains Viramune.


For complete info on this drug, click here :

https://www.poz.com/drug/viramune-viramune-xr



I can only share with you my experiences of being on viramune. So far...so good !! I have very little issues with sleeping. Of course I sleep in the day and work at night, but still I have very little issues.

No wild dreams, just the usual stuff. I have had most of my life!  How about reyataz,- norvir and truvada?

I believe that could be a possible combination for you. Talk to your doctor, and see what he may suggest to you. I wouldn't put it off. If you can't handle the Sustiva, check out your options.


Take care/ Let us know what you decide on-----Ray

[Pippet]

  I had a bad reaction to Viramune.  I developed a rash (from face to waist) along with a fever at day 10. It was unbearable by day 12. I will soon be trying Reyataz / Norvir with Truvada.

  I have a friend who swears by Truvada / Viramune combo.  He has had no side effects, to speak of, and his numbers have been great for years.  I was hoping for the same results...

  I am new to this, but one thing I have learned is that the combo that is right for one person may not be what's right for you.  All we can do is give it a shot, and hope for the best.

Be well, Pippet 

[mrtallguy]

Hey Kate, Ray, & Pippet....
THANKS for the feedback!  I was thinking about Viramune since it also is an NNRTI but since my CD4 is at 725 I don't think I will risk starting on that one now....it could be saved for a time if and when my CD4 drops to a lower level.  I want to get away from the sleep drugs so I'll be talking to my doc about trying a low dose anti-depressant to see how that goes....the Sustiva has done great things for my CD4 so I don't want to dump it pre-maturely....but if it is not for me then I will dump her and review options.  Pippet...you hit it on the head with your comment about what works for one may be a disaster for another!  Are we having fun yet?

Be Well,

Craig

[JasonintheOC]

I started Atripla last summer as soon as it was available.  It was my first crack at drug treatment and thought it would be really nice to have 1 pill once a day.

I had heard about the wild and vivid dreams that Sustiva tends to cause or the opposite, sleeplessness.

My experience with Sustiva ended with switching my meds to Truvada (2 of the 3 drugs in Atripla) and Viramune.

Sustiva created short episodes of panic, fear, and depression.  With incredible in-tenseness I would all of a sudden feel depression and sometimes feel so hopeless that I had suicidal thoughts.  These episodes lasted 5-10 minutes and happened several times a week.

I stayed with the medication through the 3rd month.  My numbers dramatically improved after month 1.  My viral load went from 100,000 to less than 50 and my CD4 count rose from 350 to 450.  I figured that I would eventually get used to the medication and the mental side effects would subside.  I also really wanted to stick with a one pill once a day regimen.  The episodes didn't let up and I didn't want to put up with them any longer.

I've been using the Truvada and Viramune combo now for a couple months and have no known side effects.  I've gotten over having to take 3 pills (2 Viramune, 1 Truvada) instead of 1.

I'm definitely in the Viramune camp!

[mrtallguy]

Hey Jason...
Thanks for the reply! And WELCOME to the AM forum!  It is great that you found this venue to find and share information....I joined a few weeks ago and have found the members here to be quite amazing in their desire to share and help eachother.  Of course, as with any endeavor, what you GET from this group will be in direct preportion to what you GIVE this group.  So stop back and let us know about your progress, trials, and tribulations.  We are all in this together....there is strength in numbers!

I have learned through this site that Sustiva does not have to be taken in the recommended 600mg "insanity" dose....it also is available in 200mg capsules so I will start with those tomorrow.  I will try one in the AM, one an hour after lunch and one at bedtime...hopefully a smaller hit will not affect the sleep.  If this approach does not work it is good to know that the Viramune is a good alternative.

Be Well!

Craig