Ran Out of Atripla

[NycJoe]

Hey hope everyone is doing well today.  Have a question for you.  I have been on Atripla for 8 years.  I miss on average 2 pills a year.  For the first time EVER, I ran out of them on Saturday (new mail order doesnt send auto refills as I have always had and I thought for some reason I had one more bottle), so I missed Sat pill, then found one to take last night in my drawer luckily.  So the new script is suppose to arrive tomorrow.  Do I spend $70 to take a pill tonight as an emergency refill or do you think I am ok skipping 2 days in a week?  My doc has yet to get back to me.  Thanks for your input! 

Joe

[darryaz]

Unless your CD-4 is at AIDS level two missed pills won't be the end of the world.   

Spend that $70 on shoes.

[leatherman]

numerous studies have shown that at least 95% adherence for most HIV meds results in successful treatment, so missing 2 doses a year is nothing to fret about.

btw, there have been studies with Atripla for those who have reached UD, taking 5 days on and two days off (FOTO) where patients have remained successfully treated and saved a lot of money. http://www.crine.org/index.php?id=224 has a great list to a lot of references on this topic

[darryaz]

Thanks for that link Leatherman.

I like the idea of FOTO.  I'm going to print out the info you referenced and show them to my doc the next time I see him.

Your link only addresses effectiveness (unless I missed something - honestly I looked over it very quickly - will read more completely soon).  It would be interesting to know whether FOTO yields any positive result on side effects (since you'd be reducing your total dosage by 29% if I calculated correctly) .  Are you aware of any information on that?  Just curious since there is so much discussion of Sustiva side effects on here.

[mecch]

Also throw this into the mix to discuss with your doctor... If you are worried about side effects related to sustiva, in particular, maybe a combo change? 

8 years of great adherence, bravo.

[darryaz]

Also throw this into the mix to discuss with your doctor... If you are worried about side effects related to sustiva, in particular, maybe a combo change? 

I personally don't have any side effects.  Just thought it would be an interesting addition to all the discussion that's been going on.  It's my opinion that Atripla is very much a viable option.

[leatherman]

Your link only addresses effectiveness (unless I missed something - honestly I looked over it very quickly - will read more completely soon).  It would be interesting to know whether FOTO yields any positive result on side effects (since you'd be reducing your total dosage by 29% if I calculated correctly) .  Are you aware of any information on that?  Just curious since there is so much discussion of Sustiva side effects on here.

Google is your friend! 
I knew about the FOTO studies but not all the details. I was nicely surprised to have google show me that page with so many links. I really only linked to prove I knew what I was talking about although I guess I should have also linked to some of the studies verifying the 95% adherence rate. LOL I would imagine some of that FOTO study info should also discuss side effects.

I personally don't have any side effects.  Just thought it would be an interesting addition to all the discussion that's been going on.  It's my opinion that Atripla is very much a viable option.

yes, it would be interesting to know if someone who had been dealing with side effects at the full daily dosage had fewer side effects on FOTO. That would really make FOTO something every Atripla-user should talk to their doctors about.

Atripla, like so many other ARVs (heck, like HIV itself) always seem to effect so many people so differently. For some people Atripla is a great med and for others a horrible ordeal. As a well-studied med that has low side effects rate, and is only 1-pill once-a-day, Atripla is a great one to start people out with.

I never took Atripla because I was on Sustiva back in the late 90s. For the nine months that I took it (waiting on some other med to come to market), I threw up every day (literally every single solitary day!) and never lost the dizzness/"drunk" feeling. I had to quit my job. I had to quit driving. Eventually one day, after staying in bed hours trying to shake that feeling, when I left my bedroom and fell down the flight of stairs, I stopped taking Sustiva for quality of life reasons. Thankfully (LOL) that led to resistance, and now I have an excuse to never be bothered by that med again.

and because Atripla is NOT my medication, I leave it to others to do the research (google!!) to find out about side effect rates on the FOTO plan. 

[darryaz]

It just doesn't pay to be lazy around here, does it?!   

As far as I can tell, the study only addressed effectiveness, not side effects.

I also found a thread from 3 years ago about FOTO that had some interesting and insightful comments:
http://forums.poz.com/index.php?topic=33469.0

[leatherman]

As far as I can tell, the study only addressed effectiveness, not side effects.

Maybe if you're able to find the actual studies with the data, you can see what sort of side effect evidence they documented. I would think they collected some side effect data along with lab work; but who knows. LOL Maybe they were just too happy to realize a 2 days medication cost savings - along with lab data about patients being UD or having a VL - to probe any deeper.

I also found a thread from 3 years ago about FOTO that had some interesting and insightful comments:
http://forums.poz.com/index.php?topic=33469.0

woohoo! not only google; but the search here too is always a good function to use. It sure ain't you that's lazy. LOL

[oksikoko]

numerous studies have shown that at least 95% adherence for most HIV meds results in successful treatment, so missing 2 doses a year is nothing to fret about.

btw, there have been studies with Atripla for those who have reached UD, taking 5 days on and two days off (FOTO) where patients have remained successfully treated and saved a lot of money. http://www.crine.org/index.php?id=224 has a great list to a lot of references on this topic

I would just be afraid that such an irregular schedule (5 and 2? Have you given no thought to symmetry with this wacky plan?!) would lead to missed doses due to forgetfulness, but that's not really a valid reason to take more drugs than you actually need to be taking.

Don't birth control pills come in dispensers (including a sugar pill for off days) that make adherence really easy? Did I imagine that? Either way, why don't they do that with HIV drugs? In this hypothetical case, it would be five real pills and two sugar pills per 7 day-dispenser. It would have to be a weekly dispenser, since 30 days of my horse pill would be like chaining a weight to your ankle. But at least you'd know if you took it.

I almost forgot one this weekend, and took it about 8 hours late. Now I imagine new little viroids crawling all around inside me. Blah. I also imagine them cursing me for fucking with their life cycles. "Where's the integrase? Who's got some extra integrase around here? No reverse transcriptase either? What is this Soviet Russia?" they complain as they queue up in vain and die. Hahaha.

[darryaz]

I would just be afraid that such an irregular schedule would lead to missed doses due to forgetfulness

That occurred to me as well, but I think one of these might be the solution.

[darryaz]

woohoo! not only google; but the search here too is always a good function to use. It sure ain't you that's lazy. LOL

LOL.....  I'm still pretty lazy....... that thread showed up in my Google search results.

[oksikoko]

That occurred to me as well, but I think one of these might be the solution.

Ha. I have about 14 of those in all sorts of varieties and sizes. Have I mentioned I unintentionally completely fetishized (in the non-sexual sense) my pills.

I have several pointless photo series with images like:



and



Unemployment does strange things to a man.

[leatherman]

(5 and 2? Have you given no thought to symmetry with this wacky plan?!)

you take the Atripla Mon- Fri and not on the weekends.
Not so wacky of a plan and awesome symmetry

[darryaz]

I  have to admit your pills are much more colorful and prettier than Atripla.

[leatherman]

I have several pointless photo series with images like:

such talent!  pix like that always make me reminiscence on the days when I was taking 32 pills and tablespoons of meds a day. So many colors; so many disgusting tastes; so many side effects - and never enough room in the Morning-Lunch-Dinner-Evening daily pills boxes to actually store one day's worth of medications. Sigh ROFLMAO

however i bet i do have enough empty pill bottles to make some sort of artistic statement.

[bufguy]

I discussed FOTO with my Doc and he acknowledged the long half life of the components of Atripla. More forgiving than Stribild or Complera. He said the trouble with FOTO is that if one did follow this protocol, there is little or no forgiveness. That's what he like about Atripla, the fact that you can miss a dose or two every once in a while without the risk of failure.
He did tell me he had a patient who he reduced the Atripla to 6 days a week because of concerns with the effect the Truvada was having on their kidneys.
He still considers Atripla to be the "gold standard" of meds.

[newt]

He still considers Atripla to be the "gold standard" of meds.

Yes, this is common with docs, even though several other combos work as well, and the excess suicide rate on efavirenz is, well, excess. << bad outcome this.

-matt