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Author Topic: Switching Meds....  (Read 2360 times)

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Offline jimbalaya

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Switching Meds....
« on: October 11, 2012, 09:11:29 PM »
Greetings all,

So I know I've posted about a million times before about the issues I've been having with my combo of Reyataz/Norvir/Truvada.....I know that it is a very minor cosmetic side affect, but after 4 months of being on meds, I am still experiencing jaundice related issues, especially with yellowing eyes, so my doctor told me that when we meet next on October 30th he will switch my meds.  In doing research I see that Complera and Stribild are for treatment naive patients only....any thoughts as far as what might be a good alternative to what I'm taking now?  Could I switch from what I'm taking to Atripla?   The meds are working fine and I'm very close to being UD; I really and truly hate to switch because physically the side effects after the first week were non-existent, but it's adversely affecting me in a mental way; avoiding eye contact, social situations, etc.

I would just like to go into my appointment with some idea of what might be a good alternative; even though I trust my doctor implicitly and will take his advice....I just figure, "the more you know, the more you know".   Thanks all!

Offline Miss Philicia

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Re: Switching Meds....
« Reply #1 on: October 11, 2012, 09:25:19 PM »
If you need to stay on PI-based regimen, I would just switch out the Reyataz for Prezista and keep everything else the same. What was your doctor's reasoning for going with a Reyataz based regimen initially?
"Iíve slept with enough men to know that Iím not gay"

Offline jimbalaya

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Re: Switching Meds....
« Reply #2 on: October 11, 2012, 09:34:45 PM »
Thanks for the advice....I am not 100% sure why he suggested Reyataz....my partner and I were not resistant to anything so we were open to multiple options for first lines of treatment; we avoided Atripla because my hubby is prone to depression, etc.  He just told us that this combo was one of the preferred ways to get the virus under control quickly......and we honestly don't care if we have one pill or 3, or even if it's once or twice a day......those issues didn't bother us, so we went with the R/T/N combo.....he told us on our last visit that I was the second patient in the last ten years that he has worked with  to have such a strong reaction to Reyataz...my bilirubin level is still up near 10 (it should be lower than 2).

Offline Miss Philicia

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Re: Switching Meds....
« Reply #3 on: October 11, 2012, 09:53:30 PM »
fyi: prezista is a morning dose and an evening one, so you also pair it each dose with norvir

You can also look at isentress plus truvada. Norvir isn't used in that combo.

And, of course, you can chose Atripla since you don't have depression issues

Those are the 3 remaining choices in the NIH "preferred" list
"Iíve slept with enough men to know that Iím not gay"

Offline jimbalaya

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Re: Switching Meds....
« Reply #4 on: October 11, 2012, 10:11:50 PM »
Thanks for the info Miss P.....appreciate it!    :)   

Offline ad2san

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Re: Switching Meds....
« Reply #5 on: October 12, 2012, 03:06:32 AM »
I there. Your may discuss with your doc about Viramune XR ... This is what my doc recommended when I had to switch off Reyataz due to Kidneys problems. Once a day too.

Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
Aug 2014 CD4 639 UD 25%
Switched January 2015 to Triumeq
May 2015 CD4 807 UD 31%
Switched Nov 2016 to Genvoya due to gastric problems
November 2016 CD4 847 UD 32%

Offline newt

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Re: Switching Meds....
« Reply #6 on: October 12, 2012, 07:01:58 AM »
fyi: prezista is a morning dose and an evening one, so you also pair it each dose with norvir

For people with no PI resistance the dose for Prezista is 800mg 1 x day plus 100mg Norvir booster. This is 3 tablets.  In my experience Prezista is easier Reyataz, having taken both.

Atripla, yes, an effective option if you want once a day dosing.

Isentress, 2 x day but very effective, and importantly has no interactions with cholesterol.

Don't like Complera personally, as you must have it with a full meal (500 calories) for it to work. While other drugs come with a do/don't eat food recommendation (chiefly to reduce side effects), they still work with no food/a snack, which to my mind is more practical.

Hope this helps

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

Offline Ann

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Re: Switching Meds....
« Reply #7 on: October 12, 2012, 08:32:40 AM »
fyi: prezista is a morning dose and an evening one, so you also pair it each dose with norvir

That's only true for people like your good self who have resistance issues. Many of us (including me) can take it once a day. From the Prezista information page...


Once-Daily Dose: Two 400 mg Prezista tablets plus one 100 mg Norvir tablet once a day for people who have never taken antiretroviral drugs and for treatment experienced individuals who do not carry any Prezista resistance HIV mutations.

Twice-Daily Dose: One 600 mg Prezista tablet plus one 100 mg Norvir tablet twice a day for treatment experienced individuals who carry one or more Prezista resistance HIV mutations.

ah, I see Newt beat me to it, but I've already written it so it stays :)

Jim, I recently started too. I wanted to avoid any combo with Sustiva in it and for quite a while I planned on starting with Reyataz/Norvir/Truvada, but then the more I thought about it, the more I realised that Prezista/Norvir/Truvada was the way to go, mainly because of the possible bilirubin issue. I know quite a few people on the PNT combo who have little, if no side effects and that's what I went with.

I had a bit more diarrhea than normal for me in the first two weeks, but since then it's been plain sailing. The only caveat with Prezista is that you need to take it with a little bit of food, but it's not like with Complera where you need a full meal. A snack will do.

BTW, I considered Isentress for a while too, but when the study came out saying that once a day dosing with it wasn't going to fly, I ruled it out. While I haven't missed any doses, I'm crap at taking meds exactly on time once a day, never mind twice a day so a once a day combo is what I needed. Isentress is less forgiving than a lot of other meds on the issue of timing, so that was an important consideration as well.

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Offline jimbalaya

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Re: Switching Meds....
« Reply #8 on: October 12, 2012, 06:21:56 PM »
Thanks Ann & Newt....I appreciate the advice, especially from people as knowledgable as you two are.  :)  As much as it would be convenient to go with Atripla as it's one pill once a day, I do worry about the sustiva component, and my partner and I are trying to stay on the same meds (it just makes it easier for us).....so I will definitely look at Prezista, and see what the Doc thinks as well or course.   

My eyes are super yellow today for some reason (some days are way worse than others), so I'm counting down the days until October 30th.   :)   


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