Boosted reyataz / truvada regimen - when do people take theirs?

[skecherkid]

I started my first ARV using a once-a-day therapy of reyataz with truvada and norvir.  The instructions say to take it once a day with "food" - and says preferably a full nutritious meal.  For me, a meal can be anything from a bowl of cereal and milk to a three course dinner, with levels in between.  I defaulted to taking my pills with dinner because that is the largest meal I eat each day.  But now I find that it is hard to keep my pill-taking time at the same time each evening because dinner time can vary quite a bit.  So I've been thinking - maybe take it with breakfast because I do that more consistently at the same time each morning.  But sometimes I sleep late.  So maybe lunch? 

The easiest solution would be to take the pills with a very light snack like maybe a protein shake or bar,  at the same time each afternoon.  But I don't know if that is enough food to eat with the pills. 

Has anyone had success keeping their intake at the same time each day - how do you manage it?

Thanks!

[newt]

for the Norvir boost, 4g of fat.

for the Reyataz, 9g << the amount of fat in the original studies

for the tenofovir in Truvada, anything cos an empty stomach often = farts that destroy cities. More is absorbed with a high fat meal but you don;t need all the more.

not much eh?

Personally, lunchtime, whenever that is with whatever that is. Seems to work.

matt (undetectable 4+ years..or is that 3? can't remember) the newt

[BlueMoon]

I originally took my pills with dinner, but switched to breakfast after a few weeks because it's more regular for me, and then you don't have to think about it for the rest of the day.

I was told "food" meant a meal of at least 300 calories.  Usually I have a good breakfast but if I'm short of time or food in the house then a couple of sausage Mcbiscuits will suffice, or even a large Hershey bar and a pastry from the On The Go if I'm really running late.  

If you want to stay on a dinner dosing schedule, you might want to keep a supply of microwave meals on hand.  Those Lean Cuisine and Healthy Choice dinners run about 250 to 350 calories apiece, which is enough to let you take your meds properly.  

If you want to dose with an afternoon snack then maybe pump up the snack a bit with a handful of nuts and some fruit (but not grapefruit).

[denb45]

Truvavda I take it in the AM w/ Coffee Breakfast time, but the Norvir is taken twice a day, so, 200mg in the AM and 200Mg at night bedtime 400mg total norivr, and I have all of the side effects to go with it too, but, at bedtime I take the norivr w/ some Hershey's Milk Chocolate about 2 to 4 grams, not to much tho 

[Jacques]

Breakfeast and diner can vary a lot in my case but lunch time is relatively stable. So I decided to take my pills at lunch time with a moderate fatty meal and it works very well.

Jacques

[skecherkid]

Thanks all!  It's a great feeling to be able to learn from everyone's experiences.

[ad2san]

Hi,

I would like to catch up on this post ...

I started the combo beginning of May. A T+1M labor was nice VL 300 and CD4 459. I was taking the meds at 11:00 AM with a banana or so.
I had the follwoing problems though: dizziness, sweat ... and last but not least gas ! Having an afternoon meeting was so difficult (...).

So I progressively shifted the time for the meds (+1 hour every week) to 4:00 PM..
Then following problems appeared : I had to stand up at least 2 times a night (so time more) to pee ... as a result I woke up exhausted (not good). The gas problem remains. On top of it I have serious difficulty to get asleep (and then I wake up to go to the toilet and so on).

I tried to find out on the web at what time to take the combo is the best one. As I am close to dinner time, I am now shifting to 9:00 PM hoping it will help the falling asleep, pee, fart problems.

In your opinion, is this a better option? Any experience of the same kind?

I had also a lot of difficulties to find out how to change medication time and taking care of resistance ... Am I being cautious because "not experienced" I guess  ? Shifting carefully is somehow complicated ... especially when travelling.

Thanks in advance for your input.

[newt]

I wouldn't worry about the time shifting this combo, the drugs stay in your body a very long time

A banana is not enough food for this combo.

Specifically you need some fat, at least a glass of (proper) milk, but a sandwich or other snack with some fat in, or light meal is better. More food will most likely help with the gas probelm, which is from one of the drugs in Truvada  (tenofovir).

There is no best time, it depends on you.

Me I take it lunchtime mostly, but if my schedule suits breakfast more 9say at weeked) I'll take it then. this is just a personal thing, lunchtime is most consistent slot for regularity. Hmmm...but when I'm on holiday i do it dinner time....

- matt

[denb45]

I wouldn't worry about the time shifting this combo, the drugs stay in your body a very long time

A banana is not enough food for this combo.

Specifically you need some fat, at least a glass of (proper) milk, but a sandwich or other snack with some fat in, or light meal is better. More food will most likely help with the gas probelm, which is from one of the drugs in Truvada  (tenofovir).

There is no best time, it depends on you.

Me I take it lunchtime mostly, but if my schedule suits breakfast more 9say at weeked) I'll take it then. this is just a personal thing, lunchtime is most consistent slot for regularity. Hmmm...but when I'm on holiday i do it dinner time....

- matt

I take all my Meds every 12 hrs..........this works for me, and is also a habit as well after, so many yrs. of Meds

[ad2san]

Hi there,

Concerning the shifting the time, do you think that I could for example shift tonite and take the meds starting from today at 09:00 PM instead of 05:00 PM ?

I kind of guess that it would not matter that much in the over direction since the concentration in the blood would be then superior ... but delaying ??

@newt, if I take the combo around 09:00 PM it would be always within 1 hour after diner, it would do the trick for Gas stuff.

Thanks

[risred1]

I take my combo in the morning with breakfast.

Full Nutritious meal is vague.

If you look at the guidelines published on Aids Meds, it says Light meal.

The point is that the stomach needs to be producing acid for the Reyataz to work best.

I eat about a 500-600 calorie breakfast, which usual is some kind of bread,

for example an english Muffin, with Peanut Butter (2tbs), and 1/2 of a 10oz Yogurt smootie, 115 calories. (Stoney Brook Farms, strawberry smoothie.)

I discussed with the doctor and his opinion is that is fine.

I also may have some coffee, and if I'm pressed, take my fiber/glutamine drink with supps at the same time as well.

Morning is best for me, which is why I went with PI based instead of Atripla at bedtime.

[Inchlingblue]

If you look at the guidelines published on Aids Meds, it says Light meal.

I agree it's vague but it doesn't say "light meal," at least not under the guidelines for Reyataz.

from aidsmeds:

Reyataz should be taken with food, preferably a complete nutritious meal, to ensure proper absorption of the drug into the bloodstream.

http://www.aidsmeds.com/archive/Reyataz_1563.shtml

[Miss Philicia]

I agree it's vague but it doesn't say "light meal," at least not under the guidelines for Reyataz.

from aidsmeds:

Reyataz should be taken with food, preferably a complete nutritious meal, to ensure proper absorption of the drug into the bloodstream.

http://www.aidsmeds.com/archive/Reyataz_1563.shtml

Perhaps it's not up to date, as the actual Reyataz web site says that a light snack suffices

http://www.reyataz.com/hiv-medication.aspx

And a  6/18/09 FDA update states that the insert has results of a food effect study of a light meal vs. high fat meal:

http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/HIVandAIDSActivities/ucm124020.htm

[bocker3]

I take my Reyataz with breakfast -- usually cereal and fruit (banana, blueberries, etc).  I take my Atripla in the evening.  I tried doing them all together at night, but hated to "have to eat" a snack before bed, so switched to breakfast.
I've been told all along by my doctor (as well as the Reyataz website) that a meal or snack was sufficient.

I always thought that it was not the FOOD, per se, that was important but that it was the stomach acid -- perhaps I'm wrong, but I thought this was why acid blockers are a no-no close to dosing time.  Food just insures that there is stomach acid there.......

Mike

[risred1]

http://www.aidsmeds.com/articles/DrugChart_10632.shtml

In this drug description from AIDS MEDS it says "light meal", which is inconsistent with the other posting about the guidelines.

Whatever... the point is that it is actually, in my opinion, insufficient as terms depend on our interpretation.

What is a "complete Nutritious Meal"? What is a "light meal"? your interpretation can be clearly different from mine.

What I draw from this is that there is "allowed" variability of opinion. All we apparently have to do is insure  our stomachs are acid enough for the reyataz to work.

What does that take? According to my doc, as long as the blood tests show effectiveness, manipulation of how we take Reyataz doesn't really need to be looked at. There are apparently ways to "tune" what and when you eat if that looks like an issue.

[antibody]

whenever i eat my first meal. it does vary on occasion sometimes i work an earlier shift and might take it 3 hours early one day. Sometimes it's a big meal sometimes it's just a granola bar just to get it out of the way. I don't really worry about it and I have always been undetectable.

[newt]

This food thing fucks me off

For one, a light snack and nutirious meal is in the ey of the beholder.  You have to go back to the original studies to find out what this means. For tenofovir (therefore truvada) it was a full-on eat-what-you-like burger buffet by the looks of things, for Reyataz it was, more or less, the average contents of a milk-based protein drink.

The important thing with Reyataz is some food for acid stomach (excuse for cola or coffeee but orange juice is heathy eh?) and some fat (esp for the norvir booster) (excuse for ice cream), for tenfovir, some food, preferably more, or else you fart til kingdom comes, plus food = better drug quantities into the body.

- matt

[risred1]

You know, that is great information....

I had no idea, and of course I'm not told that these different meds really have different profiles for the type of meal you should be looking at.

So according to what you wrote...

I have carbs in the bread, peanut butter for fat, and about 115 calories of Yogurt Drink.

All that is missing is the 1/3 lb. burger grilled, topped with cheese, bacon, fried onions, lettuce, a ripe tomato with mayo on the bottom roll, peppered of course, and a nice brown mustard...

then run about 10 miles!

 

[Dennis]

I personally have never worried about this. Originally, the first few years, I was taking my meds at bedtime, which would vary between 10pm and 1am; way past my last meal of the day. I just recently switched, and now take them in the morning. Sometimes with breakfast and sometimes without. Depends how rushed I am to get out the door. More often than not, it's just with a cup of coffee and a few rugula. I've Been undetectable except for a few months in 2008 when I was not taking my meds. As soon as I restarted, I was undetectable within the month.

[weasel]

I have always   ( 4 years ) ,  taken my meds with breakfast .

 I eat  yummy stuff , pizza , lasagna , leftover intipasta . spaghetti & meat balls

  ham and cheese sandwich , Chicken devan'.

  I have stayed with morning meal , very easy for me , the side effects wear off in a couple

  of hours and i am ready to go , or not 

  Anyway  Morning works well , and I eat like a hog in heaven !

                                              be good ,  take your pills when it is good for you .

                                                                                      Carl

                                                       

[subaruturbo]

I started on that combination about a little less than two months ago. I take them between 12:30pm and 1:00pm in the afternoon seems to work for me. Thats when I eat the biggest meal and sometimes the only meal I eat. I have to watch what I eat fast food is not a good thing. I get alot of indegestion and gas from the combo if I get sick its in the wee hours of the morning because the medications didn't properly digest. Now doing a lot better. pepto and rolaids are my friends. Gas what the heck I laugh when I rip a few off no need to be shy. three pills once a day very nice taken alot of combo therapies. one month went from 15 cd4s to 136 vl from 127k to less than 75. Even found out am I pre-diabetic now on metformin twice day. Smoke like a chimney too, giving up very soon. terrible when you hack in the morning. my main concern is weight loss went from 130lbs to 114lbs not good but feeling great. As far as taking meds golden rule don't skip doses and take on time everyday. when you take them should fit your lifestyle. Night owl here up all night and all day.

[jay195]

I take my meds reyataz norvir and truvada after breakfast. I have a toasted soya bread bun with fresh garlic lightly rubbed in to it then fresh tomato pulp put on top of that and to finish off a light coatimg of olive oil and a wee touch of salt. I live in Spain and this is a typical Spanish brekkie. This  is accompanied by a mug of green tea. This is also the time when I take my fish oil capsules .Then off to the gym for my spinning class.No side affects.
                                                        Jay
                                                                                                                     

[Rayray]

I have been on the same combo as you for two years now you can see from my numbers that I'm telling the truth when i say I Have only been drinking a cup of coffee in the am with my pills and feel fine no side effects as stated with the gas and other problems.And My ID says keep doing whatever it is I'm doing b/c its working been undetectable for over a year now and feeling better then ever before,I'm not saying this works for everyone but for me it works everyday at 8:30am take the pills and go on about my day. all blood work comes back better everytime I go in so something is working.