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Author Topic: Sustiva vs. Viramune? - can be moved to treatment & side effects forum - sorry  (Read 3895 times)

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Offline Dragonette

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My doc (the one who cancelled the appointment) suggests I switch from Sustiva (+ Epivir & Viread) to Viramune.

Since I know that I will have to make the decision there in like 5 minutes I thought I should prepare in advance.

I have neuropathy-like symptoms and I am s*it-scared of lipo. I am 33 y/o with a CD4 of 200 approx, undetectable, % - 0.3
I have a feeling that basically, any drug that I ask for, I will get (their token response is "all drugs have side effects").

What is your recommendation cosidering all the above?
Many thanks.
« Last Edit: April 25, 2007, 01:46:29 PM by Dragonette »
"If you keep one foot in yesterday, and one in tomorrow, you piss all over today". Betty Tacy

Offline Dragonette

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Re: Sustiva vs. Viramune?
« Reply #1 on: April 25, 2007, 08:45:18 AM »
One more addition:

I also want to get pregnant sometime in the the future.
"If you keep one foot in yesterday, and one in tomorrow, you piss all over today". Betty Tacy

Offline lilguru

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Re: Sustiva vs. Viramune?
« Reply #2 on: April 25, 2007, 12:19:29 PM »
Hi, Dragonette,

One of my first drugs was sustiva (2001)  I only took it for a couple of months, I hated it.  I have been taking viramune since.  It was about 1 month after I began taking it (in comibination with combivir) my belly bulged.  I hate that, but my numbers have been steadily improving over the years.  Viramune isn't difficult, not as bad a sustiva was. 

Good luck in your decisions.
September 1987 - HIV+

Offline Dragonette

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Re: Sustiva vs. Viramune?
« Reply #3 on: April 25, 2007, 01:42:22 PM »
Thank you very much for your response.
 I would think it is the combivir who is to blame - i had already switched combivir for viread for this reason (under the pretext of being anemic, which i was, but i was more worried about the lipo).
i am afraid of belly bulging etc but much more of facial fat loss. i am afraid of everything actually. especially after the doc at home told me "it's just a matter of time", and "you will know it when you get it". I know, that must be vain, but I am afraid.

Thanks again
"If you keep one foot in yesterday, and one in tomorrow, you piss all over today". Betty Tacy

Offline frenchpat

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Hi Dragonette,

living in fear is no solution. You wrote elsewhere that you are seeing a therapist, I suggest you talk about this overwhelming fear. I dare say this because I was somewhat in the same boat some time ago.
There are the things you can have influence on, and those you can not. If you are in constant fear of just about everything you will only damage your health faster and further. Try to gain some perspective.

I have lipo and hoped that switching meds would change that. I am not sure it stopped, in fact I think it has not, and now I have the beginning of a hump too... definitely not something I look forward to. So the questions that come back are: Can I do something about this? If so what? If not, how can I change my perspective so I accept myself with this new problem in the future. What can the consequences be if I don't?

I find that laying things on the table help me think straight and veer away from the fear that I, like everyone, feel when something new and nasty springs up. Don't waste too much energy with fear, it will drain you. Better use the energy to find how you can continue living, as happily as possible.

hope this helps,


People have the power - Patti Smith

Offline AustinWesley

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Hey Dragon,

I've not been on here much as of late.

What I know about Viramune/Truvada.  My friend has been on this combo for years.  He has NO side effects and he looks like a Godamn GQ model. 

Lots of folks have the problems w/ Sustiva I'm told.  I'm luckily not one of em.

I have never heard anything about LIPO from my friend or my doc on the Viramune/Truvada combo and certainly my friend does not appear to have issue.  He's been on it I think close to 10 years.

When I was talking with my own doc about which meds the first question I asked was about side effects and  if it would alter my appearence and he said no on this combo also.

I've no idea about the pregnancy issue ..........and THANK GOD  I don't have to worry about that ; )  Something else to ck on though!

Diag. 3/06  Infected aprx. 2 mo. Prior
Date        CD4   %      VL
4/6/06     627    32    36,500     NO MEDS YET!
6/7/06     409    27    36,100
8/23/06   408    25     22,300
1/2/07     354    23     28,700
2/9/07     139    30     23,000  Hep A Vaccine same day???
2/21/07   274    26     18,500 
3/3/07    RX of Truvada/Sustiva Started.
4/5/07    321     27      Undectable 1st mo.  
5/16/07  383     28    Undectable 2nd mo.
8/10/07  422     32   UD <48 on new scale!

Offline Andy Velez

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D, since meds can work differently for women I also recommend you begin a thread with this question in the Women's Forum to see if you get any responses there.

Cover all bases.

Andy Velez

Offline dcfurmuscle

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I take Viramune/Truvada and my sense is, if you are going to be on meds, that this is the best combo out there for low side effects.

I like the fact I can take it once a day.


Offline Dragonette

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Hey guys

Thank you very much for your experiences. I had been away at the conference so couldn't access the forum.  I will keep it in mind that a lot of people recommend Viramune+ Truvada. I am becoming more inclined as I type this. Especially considering the insomnia effects of Sustiva (not walys but sometimes). I had to take a tranquilizer before my talk, and was all fuzzy headed during it (but it went well). I would be grateful for more testimonies, if someone else is reading. Can't get too much feedback on that one.... Thanks again!
"If you keep one foot in yesterday, and one in tomorrow, you piss all over today". Betty Tacy

Offline gerry

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If you are contemplating pregnancy, it is important to switch out of the Sustiva before attempting to get pregnant.  Sustiva is not recommended during the first trimester of pregnancy due to potential teratogenic effects on the fetus (malformations).  Here's a link to an article.

There are no studies available yet that investigates the safety of tenofovir and emtricitabine (components of Truvada) in pregnancy.  Emtricitabine is very similar to epivir and epivir has been used quite extensively in pregnancy, so emtricitabine may be used as an "alternate drug in pregnancy" even with the lack of studies.  However there is no such recommendation at all for tenofovir.  You may want to discuss this with your doctor.  DHHS guidelines Table 29 provides a reference to HIV drugs that can be used in pregnancy:LINK

Regarding the viramune, there is an increased risk of liver toxicity in women who start it and have CD4 counts above 250.  So if your CD4 count is just at 200 and you're undetectable, now would be a good time to contemplate the switch.  Here's a link to the article.  There may also be a higher risk of rash with viramune in women; a 14-day half-dose lead time is usually done to try to lessen the development of a rash: LINK.

Hope that helps.

« Last Edit: April 28, 2007, 09:09:25 AM by gerry »


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