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Author Topic: Just started, already missed a dose, timing issues  (Read 2740 times)

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Offline foxes

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  • Posts: 16
Just started, already missed a dose, timing issues
« on: September 21, 2012, 02:07:19 PM »
Ok just started meds... isentress/truvada... really not sure how this is all going to work. My sleep and wake times are wildly inconsistent, they have been all my life, and I doubt that's going to change now.

I took my first dose at 1am on Thurs, second at 1pm on Thurs... I was planning to take the third dose somewhere between 11-12:30 that night, but instead of ended up falling asleep around 9 and waking up at 7am today :-\ Wasn't sure what to do, so I took my third dose and will take the next sometime before my body touches that bed.

Both the doctor and the pharmacist were really vague about dose times and dosage windows. Any insight?

Offline eric48

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Re: Just started, already missed a dose, timing issues
« Reply #1 on: September 21, 2012, 04:54:00 PM »

You have posted a few times, but apparently a bit new to the issues or meds/adherence, etc. Welcome here...

Whatever is being said about how much better people are doing with modern meds and now that the AIDS word has almost disappeared from headline news, what we are dealing with here is a serious business.

The virus is nasty and tricky in many ways.

Once the virus has been 'shut' down, people tend to be a bit more lax about strict timing. Fine with them.

Once you start meds the only thing you should bear in mind is that your VL should reach VL < 50 before more or less month 6

There is nothing more important than that: not even a date, an urgent meeting , some work to finish late at night, whatever.

VL < 50 is you sole and primary target. Once you get there, you can relax a bit.

Starting with any modern combo and proper management gives you an 80% chance to reach that target.
If you don't, well, it is not the end of the world , but it gets more complicated...

20% of people fail on their first line regimen and a lot had to so with adherence/timing especially in the first 6 months.

Isentress (RAL) is once every 12 hours, so it is once every 12 hours SHARP as you get started and later down hte road, you can be somewhat more relaxed about it.

 Isentress is a drug that works markedly fine, actually works better than some scientists/doc where hoping for. mechanisms, pharmacokinetics, long term issues are not yet 100% understood.

It is a great combo that people usually are very happy with.

It is a combo that is (almost) only prescribed as first line in the richest countries.
Even (most) western Europe patients do not have that luxury.

So, fooling around with timing is really taking a chance of wasting a superb opportunity for treatment success and usage of one of the most user friendly combo.

Hope you will be doing fine


« Last Edit: September 21, 2012, 04:58:44 PM by eric48 »
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline Namaste

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Re: Just started, already missed a dose, timing issues
« Reply #2 on: September 21, 2012, 07:29:06 PM »
I started Isentress and Truvada this week, and it's made me pretty drowsy (I've been going to bed at 10:30 instead of 1:00). So maybe factor that into your equation. I chose to go with 10 am and 10 pm.

Offline newt

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  • the one and original newt
Re: Just started, already missed a dose, timing issues
« Reply #3 on: September 22, 2012, 05:45:12 AM »
Perhaps you need to discuss a combo with your doc that is 1 x day and has a forgiving time window. Isentress is not quite 12 hrs sharp, but it's pretty close. This said, one late dose won't matter, but a few missed, especially regularly doing this, will.

- matt
"The object is to be a well patient, not a good patient"

Offline foxes

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Re: Just started, already missed a dose, timing issues
« Reply #4 on: September 27, 2012, 01:34:08 AM »
Well the good news is my dosing has gotten a lot better, feel like I'm getting into the swing of it.

I'm confused though... if Isentress is so sensitive to timing, why were both my doctor and pharmacist so very lax in their instructions? I specifically asked about timing, and the answers given sounded downright sloppy.

Offline foxes

  • Member
  • Posts: 16
Re: Just started, already missed a dose, timing issues
« Reply #5 on: September 27, 2012, 01:41:10 AM »
Did some more googling and found this:


"I would not expect a problem in the majority of patients when doses are taken anywhere from 8-14 hours apart aiming for 12 as ideal."

That's more in line with the answers I got from my medical pros, but more specific and clearly stated. Their vagueness was freaking me out.

Offline PerfectlyHuman

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  • Posts: 23
Re: Just started, already missed a dose, timing issues
« Reply #6 on: September 27, 2012, 09:49:04 PM »
If timing is such a big issue they would have stressed it to u. I'm on Truvada and Isentress. Take em Btwn 7am - 9am and  11pm - 1am. As long u take your meds daily as told I don't see why a few hours late will mess u up.

Offline vaguesbleues

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  • Posts: 96
Re: Just started, already missed a dose, timing issues
« Reply #7 on: October 01, 2012, 08:06:07 PM »
I'd strongly recommend getting a pill-box.  They're fairly cheap, and I believe you can get ones with both AM + PM slots.  This will allow you to easily check to verify whether or not you've taken the meds when you aren't sure if you've missed a dose. 
03/10/2011 - Tested HIV negative
04/26/2011 - Inconclusive WB result
05/19/2011 - Confirmed HIV positive
                     VL < 50, T-Cell 747 (30%)
06/13/2011 - VL 345, T-Cell 841 (30%)
08/23/2011 - VL 50,100, T-Cell 1155 (19%) - CMV
09/18/2011 - Started Atripla
11/07/2011 - VL 489, T-Cell 881 (31%)
02/08/2012 - VL Undetectable!, T-Cell 772 (34%)
08/08/2012 - VL UD, T-Cell 1070 (42%)
11/05/2012 - VL UD, T-Cell 1174 (35%)
03/18/2013 - VL UD, T-Cell 972 (28%)
10/04/2013 - VL UD, T-Cell 1025 (34%)
02/09/2014 - VL UD
07/31/2014 - VL UD
01/29/2015 - VL UD, T-Cell 1027 (32%)
09/15/2015 - VL UD
10/21/2016 - VL UD, T-cell 765 (39%)


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