POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: justanotherncguy on December 12, 2009, 04:26:07 am
-
I've been on Atripla since october, i ended up moving and had a break in cell phone service etc, stressful times. I ran out of meds and wont be able to get any until monday when they arrive, how concerned should I be not taking the meds for 4 nights ?
-
There's not much of a way to answer your question. "Concern" yes I guess, but what's done is done right? When you have your next lab work done it will tell if it was a fuck up or not, so I'd just wait and worry about it then and not be bothered in the interim, as that doesn't really do you much good.
Just don't keep doing it -- none of the excuses you laid out are worth a hill of beans. You should build up a reserve of a month's worth of meds by getting your refills each month slightly on the early side. Try to do that from now on, OK?
-
Based on studies the most leeway one would have with Atripla is two days off (the FOTO study, Five Days On, Two Days Off). Keep in mind this applies to people who were already virally suppressed before they tried it.
If you are not yet undetectable I recommend you do everything possible to get a hold of some Atripla.
Is there any way you can get at least two Atriplas from either your doctor or a friend or even go online and ask if anyone has any? If you can get even two, space them out, taking them every other day for those four days that you are out. Getting a hold of four would be even better.
For future reference, and especially if one is already undetectable: When running low on Atripla if you absolutely have no other choice and know you will run out and not have it for several days, it's preferable to take the last few tablets every other day rather than run out and not take it for several days in a row. This is not ideal but it's definitely better than going several days without it if one has no alternatives.
Also, as Miss P says always try to refill Rx as soon as you are able to every month so you can build an emergency supply. I have about 3 months of extra meds right now.
-
I think your best plan is to contact your HIV doctor before you take another dose of Atripla when the pills arrive on Monday. Efivirenz/Sustiva has a longer half life in the body than Truvada which can sometimes create resistance issues to all other drugs in the same class if stopped. When I threw the towel in with Atripla (for good) I had to still take Truvada on its own for 10 days, so it's definitely worth checking things out with a doctor to err on the side of caution.
-
Frankly it seems rather reckless to be off your HAART so soon after starting.
You gotta commit to this and you gotta talk to your doc about both - 1) so see if you f*cked up your atripla effectiveness this weekend. 2) to figure out a way to be sure you have a reliable access to your Combo no matter how f*cked up your life is.
Remember - effective HAART makes hiv+ life so much better.
-
Definitely if you have a friend on ATRIPLA see if you can borrow a few pills -- you can pay them back from the new bottle in just a few days.
-
Follow the sage advice of previous posts but 25 years as an "atypical" pozzie living with other non-disease-free people tells me HIV infection is a biological crap shoot. My genes + HIV + other known and unknown factors + HAART + Plan 9 from Outer Space = Unique, Designer Disease. I'm a human one-off Hookie Mookie made of virgin silkworm saliva encrusted with sparkling HIV diamonds, lightly dusted like a Cafe du Monde beignet with Trizivir dust twice a day... if I remember.
You may get an idea of the effect, if any, of your involuntary non-compliance with your next labs. You may see a problem later after a teensy clump of HIV which gained resistance increases over time. You may be hit by Halley's Comet tomorrow. As Assurbanipal suggested try to get some Atripla from someone if you can.
I definitely believe once you decide to HAART you gotta ride that bronco or jump off quick. In a weak moment in 1998 I allowed my doc to start me on Combivir & Viracept (?? I think...) but after 5 weeks of Vertigo (I kept dressing like Kim Novak and running to the top of bell towers) I stopped. Combivir contains 2 of the drugs in my current regimen so resistance doesn't seem to be an issue, luckily for me.
In 10/2004 I began a clinical trial of twice daily Trizivir, which is contrary to standard HAART initiation guidelines (all 3 drugs in Triz are NRTIs so I take no other class of drug as most people do -- yay for me) but came at a time when I had fewer options. I'm still on Trizzie and my v.l. has been undetectable since late 2004. My frigging CD4s aren't so great (plummeted from 350 in May to 179 in September) but I'll get blood drawn this week and expect no surprises. The real test is my overall health and that is fine. No problems like thrush or other bizarre infections to indicate suppressed immune response.
As much as I've tried to stay ahead and have extra Triz it hasn't worked out. My Medicare prescription program seems to measure refill eligibility in hours and on several occasions I've spent $200 or $300 for 4 or 6 pills to tide me over until the *&$^! gave the pharmacy the OK. Last month I got 90 pills (60 is 1 month's supply) and paid 2 copays but didn't realize it until I got home. Tomorrow I plan to argue until everyone is blue in the face that they owe me the other 30 pills and I shouldn't have to make another copay but if I must I must.
Excuse my rambling... do your best not to miss doses, young man!! Life can throw one curve ball after another but cell phones are a distant 2nd to your meds on the scale of priorities.
-
I didn't take a break on purpose, the meds didn't arrive today either, i'll be calling my doctor in the am. As far as being off the atripla, i actually feel better than i was on it. I feel better mentally and physically i've gained 7lbs i'm only 15 more pounds toward my target weight. My sex drive has came back cause i didn't have one while i was on it. I definately want to get back on meds for sure! I got caught up with moving and losing my cell service for a few days etc. Typical life problems, and i thought i had more pills than i did.
Anyways i'm calling the doc tomorrow!
-
I didn't take a break on purpose, the meds didn't arrive today either, i'll be calling my doctor in the am. As far as being off the atripla, i actually feel better than i was on it. I feel better mentally and physically i've gained 7lbs i'm only 15 more pounds toward my target weight. My sex drive has came back cause i didn't have one while i was on it. I definately want to get back on meds for sure! I got caught up with moving and losing my cell service for a few days etc. Typical life problems, and i thought i had more pills than i did.
Anyways i'm calling the doc tomorrow!
7 lbs in a few days? and Sex drive instantly back? Something is rotten in denmark. In any event, in my humble strangers opinion, you are showing great ambivalence about being on HAART for the long run. Read your paragraph again. It is filled with contradictions.
Be careful, you are playing with fire. You don't want to screw up your HAART options on such whims.
-
Follow the sage advice of previous posts but 25 years as an "atypical" pozzie living with other non-disease-free people tells me HIV infection is a biological crap shoot. My genes + HIV + other known and unknown factors + HAART + Plan 9 from Outer Space = Unique, Designer Disease. I'm a human one-off Hookie Mookie made of virgin silkworm saliva encrusted with sparkling HIV diamonds, lightly dusted like a Cafe du Monde beignet with Trizivir dust twice a day... if I remember...
[attachment deleted by admin]
-
7 lbs in a few days? and Sex drive instantly back? Something is rotten in denmark. In any event, in my humble strangers opinion, you are showing great ambivalence about being on HAART for the long run. Read your paragraph again. It is filled with contradictions.
Be careful, you are playing with fire. You don't want to screw up your HAART options on such whims.
I have to agree with the good advice that has already been given. As has been stated, it's a bit like playing Russian Roulette to miss your meds for so many days in a row. As far as the sudden return of your sex drive and weight, sounds like it's more likely due to placebo effect than anything else? If Atripla is an issue for you (which it very well may be), why not have a discussion with your doctor about switching meds once you're undetectable? There's a great discussion going on right now about Isentress.
Anyhow, stay healthy and good luck!
-
I recently had to stop my meds due to liver toxicity. I had a conversation with two different HIV doctors about this very subject, although not about Atripla.
The net result of it is that they both said that there are treatment breaks for a variety of reasons. It's more important not to haphazardly miss doses.... i.e Miss Monday, and then again Thursday, and then Friday because you were tweaking.
Missing because your life is fucked up or you are sick etc... or your insurance is sick of you.... lol is another story.
The most important thing, more important than anything that *anyone* here is says is to talk to your doctor and follow his or her advice. Chances are that if you don't make a regular habit of taking holidays from your meds you will be fine. However, as other experienced folks have pointed out, you only get one shot at some of the drugs. If you screw it up you will go from a med that has few side effects to one that may not be as much fun to take.
There are a few things to keep in mind, because you may not be able to build up a reserve if you are getting meds for free.
1) Most ASOs have a "med-loaner" program where they will help you out if you run out for a few days. Most pharmacies will do the same thing. Ask next time you are at your ASO and find out what you need to do to utilize it.
2) You can usually get a prescription for a few days from your doctor if you call and explain what is going on. Don't take "leave him a message" from the staff either. Explain that it isn't an emergency but it is urgent and it has important consequences for your treatment. Above all be polite. Nobody likes a demanding jerk on the phone.
3) Friends will normally loan pills if they think they will get them back or they have a stockpile.
Above all, relax. Stress is just as toxic as anything else. HIV is a cross country race, not a dash across the street. So if you stumble you haven't lost as long as you keep running. Get your stride back, prioritize what matters, and take care of yourself.
-
So the update....the monday i thought my meds didn't come in, they did, so i started back so i was off of them for 5 days. You guys saying playing with fire? get a grip, i didn't do it on purpose and dont plan on it to happen again. as far as the weight gain and sex drive back, i think thats its because my body is used to the medicine. I think maybe my meds have helped my body get to the point of health to where it needs to be.
All i know is that everyones body is different so who knows until i get to the doc again and have tests done.
I'm happy to be gaining weight for once, have my appetite back and my sex drive!
-
As far as being off the atripla, i actually feel better than i was on it. I feel better mentally and physically i've gained 7lbs i'm only 15 more pounds toward my target weight. My sex drive has came back cause i didn't have one while i was on it.
This statement does not match your theory in your new post. You new theory is that you had a sex drive in your 5-day treatment pause because the treatment made your body healthy. come again? There's also the seven lb gain in a few days. Huh?
-
THIN IS IN!
-
good to hear you're back on track and understand you didn't do it on purpose...id definitely use this as a learning experience though.
Your comment about your sex drive coming back and appetite, you have a clearer head and all that. Maybe you should talk to your doc about the side effects of the Sustiva component? I experienced the same thing while taking Atripla and just dealt with it. Switched my meds and all that went away...I loved the convenience of Atripla and the wonders it did to bring me undetectable within 30 days but your post may suggest that you are experiencing some (maybe not so hard to deal with) side effects.
Take it with a grain of salt as I am not a doctor I am speaking of MY experience and yours sounded familiar.
Can't hurt to have a discussion about it with your doc and best of luck to you.
-
The answer of Dr Young for a 2 days (unwanted) break
http://www.thebody.com/Forums/AIDS/Meds/Current/Q205799.html?ic=700101
Now, missing a single dose is still not an option.
I would definitely try my best to get back on meds asap.
-
I say Yay for you for feeling better..everyone thinks that we are the Big Drug Companies rats and that we should eat our pills like a good boy should..well, i take my pills just as I am suppose to..but feel like Sh#t so when a person feels better it is important...maybe the Big Drug companies dont care if you feel like crap or not?!! glad you are back on your pills and good luck with your health.
So the update....the monday i thought my meds didn't come in, they did, so i started back so i was off of them for 5 days. You guys saying playing with fire? get a grip, i didn't do it on purpose and dont plan on it to happen again. as far as the weight gain and sex drive back, i think thats its because my body is used to the medicine. I think maybe my meds have helped my body get to the point of health to where it needs to be.
All i know is that everyones body is different so who knows until i get to the doc again and have tests done.
I'm happy to be gaining weight for once, have my appetite back and my sex drive!
-
I say Yay for you for feeling better..everyone thinks that we are the Big Drug Companies rats and that we should eat our pills like a good boy should..well, i take my pills just as I am suppose to..but feel like Sh#t so when a person feels better it is important...maybe the Big Drug companies dint care if you feel like crap or not?!! glad you are back on your pills and good luck with your health.
Really? Everyone thinks we are the Big Drug Companies rats???? I don't, nor does everyone I know!
I get pissed when I hear this kind of statement because I have seen dozens of slow painful deaths of friends and loved ones. I know the emptiness of loss and the anger and frustration of "if they only hung on a little longer" for these WONDER DRUGS.
Do you really believe there is a Big Drug Company collective conscious and that it is focused on the way we feel? Instead of feeling like shit maybe you would like to feel dead.
Sorry for the rant but really, please.
Remembering all those who were not as fortunate as us and giving thanks everyday to the scientists, chemists, doctors, volunteers and the BIG Drug Companies for saving my life and the lives of others,
Richard