Rilpivirine (Complera, Odefsey, Edurant) and Pantoprazole: possible?

[tallguy82]

Hello everydoby! I switched from Atripla to Odefsey 20 days ago. I suffer from GERD and little gastitis and use to take pantoprazole 20mg in the mornig while on Atripla and always stayed undetectable. Now that I stay on Odefsey, I am reading everywhere that rilpivirine cannot be taken with any PPIs (because I guess it needs stomach's acidity to be absorbed). The doctor read that I was on pantoprazole on my  medical records but didn't say anything. As I started Odefsey I quit pantoprazole beacuse I was afraid it couldn't work but I need it because I feel stomach ache and a lump in the throat. So, is anybody of you taking any PPIs with rilpivirine (Complera, Odefsey, Edurant) and is still undetectable? Do your doctors say it is possible? Maybe I could take it many hours before Odefsey, even though PPIs work for 24 hours...let me know, thanks!

[Ptrk3]

My advice to you would be to discuss the matter specifically with your doctor (sometimes even healthcare providers are not up to speed on all medication contraindications) and your pharmacist.

It's fine to query forum members, too, for any anecdotal information, but do keep the professionals in mind as you seek an answer to your question.

[tallguy82]

Yes I know what you mean but sometimes it is difficult to reach the doctors on the phone because if they are visiting somebody the cannot answer...the appointments, thanks to the progress with the disease, are every 4/5 months!

[daveR]

For situations like this I use a drug interaction checker. Drugs.com is a fairly good one, has a website and a downloadable app for your phone. It does not replace the advice of a medical professional as Ptrk3 has pointed out, it is best to consult one.

It did however say the interaction between Rilpivirine and Pantoprazole was a major one. Based on that I would not combine them until I had consulted a specialist.

Dave

[tallguy82]

Yes I checked it out and it gives a beautiful red alert!!!

[BKKKevin]

I am not a doctor but it would seem that you could split up the times you take the meds - The pantoprazole in the morning and the HIV meds in the evening with your diner and they would not conflict

[Expat1]

You cannot take PPI meds with Edurant!

If someone tells you otherwise.  Run.

PPIs stop your stomach from making acid.  Edurant needs an acid environment to dissolve and be absorbed.

You can take H2 inhibitors
(nizatidine (Axid)
famotidine (Pepcid, Pepcid AC)
cimetidine (Tagamet, Tagamet HB)
ranitidine (Zantac)

Why because they inhibit H2 they dont stop your stomach from making Proton Pumps.

They must be used   opposite the Edurant.  Example if you take Edurant with breakfast, the H2 inhibitor is take 12 hours later (12 hours before next breakfast).  Still this is not ideal if you have other options.  Like Atripla.

You can also take tums or rolaids as long as it is more than 4 hours from the time  you take Edurant.

On a side note, I formerly was on PPIs for GERD and now take nothing. The GERD cleared up after a few months. 

I also live in the tropics and the doctors here don't like people to be on PPIs anyway because, stomach acid is one of the body's first line of defenses against infections.

Often times I have found my doctors lacking in specific knowledge regarding drug interactions.

Advice if you must take a PPI, dont use Edurant.  (or the combo pills it is in)

The problem is that if you become resistant to The Combo Travada/Edurant you may have eliminated 2 whole classes of HIV drugs forever.

And somewhere else I read that the best hope for PLWH is that the first combo will be the one most likely to bring it under control.

[wardp]

I was on it 11 days with PPI, I changed meds and changed doctor, it is a major no no, you must have better options?

[tallguy82]

Tomorrow I will go to the hospital and ask to change again my regimen after only one month. I didn't imagine all these problems, it is my fault too because I forgot to ask the doctor the compatibility of the two therapies. I am even surprised that they made such limitations with rilpivirine, since PPIs and antacids are the most sold meds in the world and GERD is one of the most popular desease. The fact that you can take antacids after 4 hours that you take rilpivirine has no sense because they both must be taken after a meal!

[Jim Allen]

I am even surprised that they made such limitations with rilpivirine, since PPIs and antacids are the most sold meds in the world and GERD is one of the most popular desease.

GERD is popular ... damn, see I knew I made the wrong choice I went with AIDS  Cursed not to be popular.

Joking aside, sorry to hear though you are having problems and also about the GERD,and as for the HIV meds I don't think they designed them with this limitation on purpose it is however very important to tell your doctor prescribing your HIV medication regarding any other therapies you are on including anything over the counter. This way they can advise you on alternatives to the therapy you are on be it the HIV meds or the other treatments.

Hope all goes well when you see them and switch and you get yourself back on track soon.

Jim   

[tallguy82]

Hi guys! The doctor left me on Odefsey and told me to take one Ranidil 150 mg (ranitidine) in the morning since I take Odefsey in the evening! Thank you all for your support!

[Expat1]

Glad you got it sorted.  Cheers.