Change from Combivir to TenVir-EM. Please help.

[ZeroFive]

I’m currently on Combivir + Nevirapine (2 times a day for each).

Recently the hospital pharmacy change my combivir to TenVir-Em, due to combivir out of stock. And I have problem contacting my doctor, but I believe the hospital pharmacy & hospital doctor know what they are doing in replacing Combivir to TenVir-Em.

I did some research here, and found out TenVir-Em is the best replacement for combivir, however my concern is still on side effects. As far as taking Combivir + Nevirapine for almost 4 years now, I have no major side effect such as rashes. I do have fatigue issue, easily tired, my doctor told me it could be combivir, but due to my condition with health anxiety, he still said that my fatigue might be coming from stress & anxiety. I also experience Gas & Bloating (sometimes, not all the time), which the doctor told it could be from the food I ate.

The pharmacy told me TenVir-Em is 1 tablet a day pill. Which should be good for most of us who are on medication.

I’m going to start TenVir-Em soon. My combivir last tablets will finished on 4th March. Please advice me on starting this medication, because my Nevirapine is still 2 times a day.

Option A.
4th March Saturday
Morning - Take Combivir + Nevirapine
Night - Take Combivir (last tablet) + Nevirapine

5th March Sunday
Morning- Take only Nevirapine ONLY (no more combivir)
Night - Take TenVir EM for the first time + Nevirapine


Option B.
4th March Saturday
Morning - Take Combivir + Nevirapine
Night - Take TenVir EM for the first time + Nevirapine (stop combivir last tablet)

5th March Sunday
Morning - Take only Nevirapine
Night - Take TenVir Em + Nevirapine

Which option should I use?

And also, please advice on side effects, I’m kinda freak out about it.

I’m 850 Miles away from my hospital for work.
Last CD4 taken October 2016 was 337. (Up & Down since 2012, highest was 537 back in 2015)
Last Viral Load test April 2016 was U/D since 2013 after starting treatment.

[Jim Allen]

Look it does sound like you have yourself all wound up and concerned / braced and focused on the side effects when the concern at this level is not needed, You should not be expecting any major side effects at all from this change/switch.

Take the pills as directed.

Jim 

[CaveyUK]

I would always recommend you get guidance from your doctor rather than the internet for stuff like this, but I will give you my opinion....

Option B won't work, as Combivir contains 3TC and Tenvir-EM (which many know as Truvada) contains FTC. Both 3TC and FTC are similar drugs but should not be taken at the same time, so a morning dose of one and an evening dose of the other should not be taken. So scratch that option completely.

Option A is the one I would personally go for. The first day would be your last day on your old regimen, and the second day would be the first day on your new one. Keeps everything simple.

Given you are Undetectable, it may be worth asking your doctor if you can go onto once-daily dosing of Neverapine, as this would reduce complexity in your life further if you can take 2 or 3 pills once a day, rather than some in the morning and evening.
http://i-base.info/guides/3543

So check with your doc if you are anxious, but I'd go with Option A

And good news on switching away from Combivir. As with *any* meds switch, watch out for any side effects and let your doctor know if anything troubles you. It's highly unlikely you will have any adverse effects so no point in worrying about them.