Atripla / Food / Side Effects - dangerous or inconvenient?

[SteveS]

Sorry - I realize there has been a lot of discussion on Atripla and food - but I cannot find an answer to my specific question.

My work schedule is very crazy and non-consistent. Thus, I often only get to eat a late night dinner - which is the same time I take my Atripla.

I realize the issue is that taking the Atripla with food raises the absorption of the med, and can cause higher side-effects.

What I am NOT clear on is if those are the side effects that are DANGEROUS, or just the ones that are inconvenient.

In other words - is it raising the side effects of things like kidney toxicity and bone weakening? Or only the stuff of weird dreams and feeling hung over in the morning? If it is just the second, then I don't care about pressing through those the 2 or 3 times a week I have to take it with dinner. But if it is increasing my long term serious toxicity issues, then I will just go to bed hungry and grab a quick snack at work earlier (that is not easy for me to do due to my type of work, but nevertheless, I will not die from hunger.)

Hope this makes sense and thanks much.

[jkinatl2]

Depends on your definition of inconvenient.

I felt my intense suicidal ideations were quite inconvenient, especially considering I was in no way depressed at the time I was taking Sustiva, a component of Atripla.

If your side effects intrude upon your daily life, then by all means this is a huge deal. But 2 or three times a week ought not be an issue, provided it does not, over time, become one.

Thats the thing about the CNS side effects. Unlike bone density and kidney toxicity, they cannot be measured accurately by anyone but yourself.

[SteveS]

OK - that is helpful.

What I think you are saying is that it is not the things like kidneys / bones/ etc.

The only side effects I have noticed that I attribute to "CNS" (when I DO eat late at night) are

- the weird dreams (which I actually quite like and do not leave me worn out)
- mild muscle twitches in different places - mostly my eyes or hands. They are very mild and not noticeable to anyone, just an "internal" twitch - but I feel them on the days I have eaten with the med.

So - I think you are saying that if this is all it is at this point, and I am OK with that, that it is not damaging anything permanently by taking it with food.

Thanks!

[mecch]

So far I don't agree with the reasoning in this thread.  I think you should ask an experienced HIV doc and/or a pharmacist your question. 
If the hypothesis is that Atripla + heavy food equals more absorption thus higher level of drug in the body, it would stand to reason that this would heighten the risk of any danger this drug could pose.
Just because someone would not get more of one side effect such as dreams, does not rule out that the increased dosage could be increasing the risk of something that might be less immediate but still undesirable.

Why don't you simply change the time you take your Atripla to a time you don't need to take a huge meal, if you are concerned.

[jkinatl2]

So far I don't agree with the reasoning in this thread.  I think you should ask an experienced HIV doc and/or a pharmacist your question. 
If the hypothesis is that Atripla + heavy food equals more absorption thus higher level of drug in the body, it would stand to reason that this would heighten the risk of any danger this drug could pose.
Just because someone would not get more of one side effect such as dreams, does not rule out that the increased dosage could be increasing the risk of something that might be less immediate but still undesirable.

Why don't you simply change the time you take your Atripla to a time you don't need to take a huge meal, if you are concerned.

Would that not be something routine blood monitoring would divulge? Especially if the patient were to tell his doctor his schedule.

Were it every single day, I would embrace your apprehension. But two to three days a week seem to be best left to the informaed pervue of the physician, so long as he knows the deal. We probably should not raise unnecessary alarms concerning side effects that might or might not even exist, correct?

[mecch]

Yes I agree jkinatl2. 
Also my suggestion - just change the dosing time. The OP didn't say the meal coincides with the dosing just a few times a week.
Why not change the dosing time to earlier, before the late dinner. 

(If the answer is, that following the dose, there is some kind of noticeable effect, so one prefers it before bed, then the solution should be getting off the Atripla completely.)