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Author Topic: Reyataz,Norvir, Kivexa [abacavir/3TC, Epzicom].  (Read 8251 times)

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Offline Mondo

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  • Posts: 6
Reyataz,Norvir, Kivexa [abacavir/3TC, Epzicom].
« on: June 14, 2009, 10:08:57 pm »
Hi all

Is there anyone here at the forum taking the following cocktail?
I'm taking Reyataz,Norvir, Kivexa [abacavir/3TC, Epzicom].
I would be interested to know how you are going with it and any problems or side effects that you may have.

Cheers

Mondo
« Last Edit: June 15, 2009, 05:49:12 pm by Mondo »
Just because I知 paranoid doesn稚 mean I知 not being followed.

Offline risred1

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Re: Reyataz[atazanavir], Norvir [ritonavir] and Epzicom [Kivexa ].
« Reply #1 on: June 14, 2009, 10:44:11 pm »
1st question is, why are you boosting reyataz when unboosted is an option with Epzicom.

I'm on reyataz, norvir, truvada.

not exactly your combo...

what effects are you having, or are you anticipating?
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline Mondo

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Re: Reyataz[atazanavir], Norvir [ritonavir] and Epzicom [Kivexa ].
« Reply #2 on: June 14, 2009, 11:09:48 pm »
Thanks for your reply.

I can't give you an answer to your question as i am fairly new to meds and I'm taking what my doc prescribed. I do not have a very good grasp on the ins and out of meds yet.

I have experienced a bit of diarrhea and stomach upset mainly nausea. Other than that, I have some very vivid dreams early in the morning that make it difficult to shake off and get out of bed. After 11 months on meds I feel very fortunate that I feel physically well.

Cheers

Mondo
Just because I知 paranoid doesn稚 mean I知 not being followed.

Offline Inchlingblue

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Re: Reyataz[atazanavir], Norvir [ritonavir] and Epzicom [Kivexa ].
« Reply #3 on: June 15, 2009, 02:30:14 am »
My partner is on that combo and he's doing great. He started with a very high viral load about 7 months ago (800,000!) and his CD4s were approximately 250 or so. He was losing weight, extremely fatigued and was basically deteriorating. He is now undetectable and has 600+ CD4s and looks and feels great with all his old energy back.

Initially he was prescribed Reyataz/Epzicom without the Norvir but he had to change doctors due to insurance issues and the new doctor added the Norvir (about 2 months into treatment). It was probably a good idea because of his high viral load. Epzicom has higher instances of treatment failure (than say, Truvada) when starting with a very high viral load.

As mentioned above he's doing great now, only 7 months later. He has no side effects to speak of. It's possible that he may be able to drop the Norvir at this point, he will be discussing it with his doctor. As you may know Reyataz is boosted with Norvir many times and in fact, when combined with Truvada, guidelines state that it must be boosted with Norvir. But with Epzicom it's not absolutely necessary to boost it so if it's a viable option to drop the Norvir without impact on suppression then it would seem like something worth doing.

What were you numbers when starting treatment vs. now?
« Last Edit: June 15, 2009, 02:35:39 am by Inchlingblue »

Offline risred1

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Re: Reyataz[atazanavir], Norvir [ritonavir] and Epzicom [Kivexa ].
« Reply #4 on: June 15, 2009, 09:21:42 am »
Of course with all things related to our health, your should discuss with your doctor to make sure or at least inquire about potential interactions with thing you might do to mitigate side effects.

As I'm on at least the PI you use and PI's are often implicated with Diarrhea, there are things you can try to manage digestive effects.

The big three, well in my mind at least are:

Psyillium Husks Fiber Drink or Capsule. Most folks think of Fiber as a way to deal with constipation. However, I think it may be a stronger anti diarrhea treatment than many would suspect. i don't know if your in the US, but i get a large canister of orange flavored powered psyillium fiber from costco and put a teaspoon in about 8-10 ounces of cold water every morning. In that drink I also add.

Glutamine. Glutamine has long been used to help control PI based Diarrhea. Glutamine is an amino acid.

DATA:     Glutamine, HIV meds, and diarrhea: Clinical studies have demonstrated that people with protease-inhibitor-caused diarrhea find relief using 30-40 grams per day: start with about 15 grams per day and increase the dose until the diarrhea is controlled. For those using the powder form, each kitchen teaspoon is about 5 grams. A daily maintenance dose is one teaspoon a day. Take three times per day before/after or at the very beginning of meals for it to work effectively.
CAUTIONS:    Those with liver or kidney problems should exercise caution in the use of supplemental L-glutamine. (Source Newyorkbuyersclub.org http://www.newyorkbuyersclub.org/resources/all-about-supplements/index.html)

This is not meant to be an add for NYBC.... NYBC is a ASO 501-3c Non profit organization. As with all supplements, you have to be careful with claims of the product. But a fair amount is know about Glutamine. I buy glutamine in bulk ( one kilo at a time) and have a scoop that is close to 5 grams, which is about a teaspoon.)

I didn't need to do the 30-40 grams, I started with 10 when i started my combo 3 weeks ago as a preventative. It wasn't long before I had a bit of constipation, so I backed off to my usual 5 gram once daily dose. If you diarrhea as you describe is a bit, then big doses may not be necessary. There are certainly PI's that can produce tremendous gastric upset, and i think this dosing, 30/40 grams a day is to address those needs.

And lastly, I take my pills with a Yogurt smoothie drink, either a product called Activa made by Dannon, or now, Stoney Brook Frams Smoothie. (That is a great drink) Yogurt has, Probiotics.... ok Bacteria that is intestinal friendly. We need bacteria to digest properly. If you ever take antibiotics, you know that they can potentially reduce the bacteria in your intestines. Anyway, there's all this stuff now about probiotics, but I'll just say that, it may help make things work a bit better.

This is part of my daily med taking routing. Small breakfast as Reyataz requires an acid stomach to be absorbed properly. (I have a couple pieces of toast and peanut butter, or an english muffin.)

You can of course simply take Imodium to try to control the diarrhea. And many would attest to that or lomotil. I have and will use Imodium occasionally as the need arises. It can stop the diarrhea, but lets say its a quick fix that may not change the environment that the diarrhea is occurring. That's why I'm using this concept.

Fiber, Glutamine, Yogurt.

Imodium as needed.

The mind stomach connection is strong. When your digestive track isn't right, I've notice all sorts of overall impact on our mental outlook. When I have a headache, it isn't long before my stomach is bothering me. (Alka Seltzer has been around for a long time treating this connection.) And of course if your feeling nausea, your mind can't ignore it.

So the "big" three can help improve digestive function. But for nausea, there are numerous treatments you can choose from medicines a doctor can provide to folk cures like...

Ginger. Ginger has long been known as a food flavoring, but it is also used in treating Nausea.  I used to eat pickled ginger, the kind you'd get at a sushi restaurant when feeling a bit nauseated. But now, I have freezed dried Ginger in capsules. Which honestly doesn't work as well, but its really convenient. Because its dried, a sufficient amount of water is required. And you might notice some gas effects.

Its not that I favor "holistic, or natural", type cures over medicines. Not at all. As far a nausea, find a thing that works for you, and I think that starts with your doctor. We need to be careful we are not impeding the meds. And there are herbs that may in fact interfere with our meds working properly. Because of this I've stopped taking Ginseng supplements which i was using to combat fatigue prior to taking meds. But now that I'm feeling a whole lot better, I don't need the Ginseng, so why worry about interaction?

So, be cautious, but also look into these things and check with your doctor, who might be able to help clarify your options from a medical standpoint. But I've also found that for many things, we have to learn for ourselves what chooses we have, and what we are willing to do.

Me having this morning routine of what I eat and use with my meds works well for me as I take my meds in the morning. PI's have a bit more overhead in that regard, in my mind, than say Atripla users, which I don't believe have a take with food requirement.
 





« Last Edit: June 15, 2009, 09:26:20 am by risred1 »
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline Tryin2bhappy

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  • Posts: 8
Re: Reyataz[atazanavir], Norvir [ritonavir] and Epzicom [Kivexa ].
« Reply #5 on: June 15, 2009, 10:24:39 am »
I'm actually on that combo right now, for the past 2 years and I'm feeling great and my numbers are also great. I'm undetectable and my CD4 is 700+. When I first started on the meds I had a bit of nausea and upset stomach but I think it was due to not eating enough food with the meds.  After that my health is great so I think the meds are good...

Offline Mondo

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  • Posts: 6
Re: Reyataz,Norvir, Kivexa [abacavir/3TC, Epzicom].
« Reply #6 on: June 15, 2009, 06:02:53 pm »
Thanks for the comms I really appreciate you taking the time to read and reply to my post.

You will notice that I have altered the meds list . This is what happens when drugs are marketed under different names in different parts of the world. The fault is mine and I apologise for the confusion.

I started on the meds when my VL was 1000 and CD4 was 350. I did however have some low kidney function results so my Doc started me on the meds earlier than usual but he said by only six months or so.

Thanks again

Mondo
Just because I知 paranoid doesn稚 mean I知 not being followed.

 


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