I switched from Atripla to Viramune + Truvada

[StacheBC]

About 2 months ago I switched from Atripla (Sustiva + Truvada) to Viramune + Truvada.

The switch was easy... since I take my 2 viramune and 1 truvada in the evening just before going to bed. No additional side effects.

I did very well on Atripla (VL and mood wise), but at times I could notice that my mind wasn’t as sharp as it used to be.
My doctor was actually the one that suggested the switch.
2 Months down the line I’m glad I did make the switch. When I wake up I tend to feel more refreshed, it took a while but I think my mind/thinking is clearer... and although I thought Sustiva wasn’t affecting my mood... After the first month off of Sustiva I did notice that just felt more at ease, just happier.

So if my liver continues happy, Viramune+Truvada and I are the best of buds.

[Hellraiser]

Good to see you back here!

Anyway, is the resistance threshold for Viramune something to worry about?  With the XR version of this drug it's yet another weapon in the HAART arsenal I've been contemplating.

[northernguy]

Was that the only option to switch to here in BC, Stache?  I kind of get the impression it is.  Any concerns about the liver with your cd4 count?

[J.R.E.]

About 2 months ago I switched from Atripla (Sustiva + Truvada) to Viramune + Truvada.



So if my liver continues happy, Viramune+Truvada and I are the best of buds.

Hi,

Glad to hear that all's going well for you, with the switch.  I am still waiting for the single dose of Viramune to come out. The doc told me, as soon as it's available to the VA, that I will receive it.


Ray

[eric48]

... is the resistance threshold for Viramune something to worry about? ....

I am not being affirmative here, but, since I keep track of latest info concerning Viramune + Epzicom here:

http://forums.poz.com/index.php?topic=33062.0

and I have had a recent discussion with my doc about Viramune (not being the most popular in part because of the resistance threshold).

Viramune is not prescribed alone and the meds associated to it (usually Truvada or Epzicom) are very potent (compared to older meds).

Not only you may have noticed that the warning that Viramune should not be prescribed to males with CD4 above 400 and women with CD4 above 250 remains enforced for treatment naives BUT that it has officially been dropped for treatment experienced

Moreover, my doc, who is a member of those guidelines boards, told me that the other recommendation not to prescribe Viramune to treatment naives with VL above 100.000 is also going to be revisited and the threshold removed of lift up. (note: nothing official has been published yet...)

This to point out that while the 'resistance threshold' may be a concern, it is not as high a concern as it used to be.

Switching to Viramune is IMHO a quite smart option in several contexts (cost concerns, cholesterol concerns, etc)

I have commented it here :

http://forums.poz.com/index.php?topic=33062.msg465091#msg465091

and here:

http://forums.poz.com/index.php?topic=36800.0

to StacheBC :

Glad to see you seem content with the switch. One of the things you may see in a not to distant future is a raise of your HDL (the good one...). It would be nice if you could report it here if you observe it as well.

I feel very comfortable with Viramune (with I take once daily , off label, without problem so far)

I might have been a bit happier with Truvada than Epzicom, I do not know, and most likely will never know...

So you are not a true pill buddy of mine, but close enough, and I wish you well

Eric

side note: I am now able to take it in the morning (at the begining, I really had to take my combo in the evenings... but no more, and I find the morning more convinient, but, that, of course is a personnal choice)

[StacheBC]

Good to see you back here!

Anyway, is the resistance threshold for Viramune something to worry about?  With the XR version of this drug it's yet another weapon in the HAART arsenal I've been contemplating.

Thank you !!

My doctor tells me that they now have a better understanding of Viramune regarding effectiveness and resistance threshold... and although there are some trade offs of possible side affects when compared to Sustiva, Viramune is making a big come back as a first line alternative to the classic Sustiva+Truvada combo... principally in cases where patients have any sort of complaints or reason to suspect that Sustiva is affecting their head/thought in any way.
Also here in Canada it's pretty much standard practise to take Viramune once a day in its current form. So again... once a day pills... just like Atripla. Only difference instead of one Pill... I take 3.

Also I want to make it clear that I did Very well on Atripla... and would still go back to it if for what ever reason Viramune didn't agree with me. I was actually quite hesitant to take my doctor's recommendation to switch... since the side effect were so minimal. I say that because I think Atripla (read Sustiva) has such a bad rap... reason we see so many people in almost a panic the first few days they take the drug... more so then any other combos.

Now that I'm on Viramune I do see some minor improvements in mood and sleep that I wasn't even aware that had changed (your milage may vary).

I do miss the nice coating Atripla has... although they are good sized pills, they did go down easier than the smaller 3 pill combo I'm on now

[StacheBC]

So you are not a true pill buddy of mine, but close enough, and I wish you well

Eric

side note: I am now able to take it in the morning (at the beginning, I really had to take my combo in the evenings... but no more, and I find the morning more convenient, but, that, of course is a personal choice)

Pill Buddies we are 

Glad you're able to "take it" in the morning 
I myself like to Give AND Take in the morning, afternoon and night.