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Author Topic: New Poz - Atripla Question - Fatigue/Eyes  (Read 3763 times)

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Offline SteveS

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New Poz - Atripla Question - Fatigue/Eyes
« on: June 08, 2013, 01:21:28 PM »
Hey - thanks for feedback and support. This is all new and hard.

I am brand new Poz, on Atripla for three weeks. Very low viral load (less than 400) very high Cd4 (around 1000).

I have not had any real side effects - the first two weeks actually were fine. But this third week, I am very, very tired. I wake up tired after 8 hours of sleep. I would say that I have about 50% of my normal energy. And, my eyes in particular feel somewhat fuzzy - kind of like your eyes feel the first 10 minutes you wake in the morning? But I feel that all day.

Is this normal? Is it normal for there to be no real side effects the first few weeks and then for some to kick in? I have read that I need to give meds at least a full 6-8 weeks to see how the body adjusts?

Any input in really, really appreciated.

Offline buginme2

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #1 on: June 08, 2013, 07:44:39 PM »
Being newly diagnosed with a low viral load is there a reason they started you on Atripla?  Complera would have been a better option.

Yes it's normal to have side effects when you start treatment.  They should dissipate as time moves forward.  If they don't, switch to something else.
Don't be fancy, just get dancey

Offline SteveS

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #2 on: June 09, 2013, 01:33:18 AM »
I really appreciate you taking the time to reply. I don't know why the doc chose Atripla. Can I ask why you think Complera would have been better? I was - obviously - kind of in shock and totally new to this and went with the recommendation. The thing that I am finding odd is that I really did not feel any side effects the first two weeks, but this week I am - mainly the fatigue. A noticeable fatigue. But are you saying that that is somewhat "normal"? I guess I would have thought I would have felt any side effects immediately. I really appreciate you responding and any input you have is appreciated.

Offline Ann

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #3 on: June 09, 2013, 06:51:52 AM »
Steve, I have a suspicion that when Bugs said he would have thought your doctor would have started you on Complera rather than Atripla is because Complera has a better side-effect profile than Atripla. I honestly don't know why doctors are still prescribing that med because...

One of the drugs in Atripla is Sustiva, and Sustiva is notorious for nervous system and psych side-effects. One of the things Sustiva can do is mess up your sleep and lots of people have the fatigue side-effect because they're not getting quality sleep, even when they're getting quantity sleep.

And yes, it can take a couple weeks before side-effects become apparent. They may completely dissipate in time, they may get slightly better, and they may even get worse. With Sustiva, some people can go for years before they start noticing mood-swings, and/or anxiety and/or depression that can be associated with Sustiva.

For some people, Sustiva just doesn't bother them at all.

Regardless of whether a person gets Sustiva side-effects or has an easy ride with it, it is very effective against hiv. I guess that's probably why doctors do still use it, but if I were in charge of the world a doctor, I'd be prescribing other, equally effective meds rather than risk my patient turning out to be someone who has a hard time with Sustiva side-effects. There are too many other effective meds today that don't have the potential to make a person bonkers or turn them into a quality-sleep-deprived zombie.

You may want to read through another thread here - The Sustiva/Atripla Thread. I've just stickied that thread at the top of the Treatment forum because it's an important thread and it was starting to slip down the page.

Have you found the Treatments and Lessons sections of this website yet? There's links to all sorts of goodies in the light grey/dark grey bars at the top of every forum page. Hover your cursor over them and drop-down list appear.

Oh, and I moved your thread into the Questions About Treatments and Side-Effects forum as you're asking about treatments and side-effects. It's a better fit.

Hang in there - it's a steep learning-curve for sure but you'll get there in the end and you're going to be ok.
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Offline buginme2

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #4 on: June 09, 2013, 12:02:44 PM »
Can I ask why you think Complera would have been better? . But are you saying that that is somewhat "normal"?

1.  Better isn't really the right word.  Atripla is very strong against HIV and has been the standard that other drugs have been compared against for years.  For almost a decade no other drug combination has shown to be better at beating down the virus than Atripla.  With that said, you started with such a low viral load.  Since your doctor went for a NNRTI/NRTI combo Complera would have been a much more tolerable option.  It's the same drug class as Atripla its just newer with less side effects (however, it shouldn't  be used in people starting with a very high viral load which you don't fall into).

That said, there could be reasons your doctor chose Atripla over one of the newer combos.  One is not better than another. 

2.   I'm not saying its normal but I'm not saying its not normal.  That sounds like a cop out but it's hard for someone to say what your experiencing is drug related, HIV related, or something else related.  Your fatigue may be Atripla related but it may not. 

Fatigue is one of the most common complaints for HIV positive people, even those with undetectable viral loads on medication.  Sometimes it's the drugs, sometimes it's not.  If it continues tell your doctor so they can try and locate the problem. 

Don't be fancy, just get dancey

Offline SteveS

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #5 on: June 09, 2013, 07:24:27 PM »
I really have to again say thank you. I am not able to disclose to anyone so this is my only place to talk to anyone about this nightmare.

OK - Doc did not say why she chose Atripla. She mentioned Stribild, but that it was relatively new and so that Atripla was more "proven" in terms of long term side effects, etc., and she just felt most comfortable with it. She did not mention Complera.

Can I ask - if I switch from Atripla now to Complera - does that mean that I will not be able to have Atripla as future option should I need it? If you change off of a med, is it "off the list" for your future?

It is very strange - today I SHOULD be tired because I had a lot of activity today -but I feel fine. But I am telling you the last 5 days it was as if I had a serious hangover ALL DAY LONG.

My next appointment is Friday. I will talk through all of this with her.


Offline buginme2

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #6 on: June 09, 2013, 08:01:03 PM »
If you change off of a med, is it "off the list" for your future?

No, you can change meds, change again, change back to something you had prior.  What matters is if your virus mutates and you develop resistance.  Resistance can occur if you are not adherent to your meds.  If you miss doses, or if you are on a combination that requires you to take your meds as separate pills and you only take two when you should be taking three.  Or if you take a week off and then start again or decide you don't want to take it on the weekends, etc.  Sometimes shit happens out of the blue but its very rare. 

Adherence to your meds is probably the most important aspect of having HIV.  Therefore, in my opinion it's crucial to be on a medication that you tolerate well that's easy for you to take every day.  Every day<<

Atripla is more proven than the other single tablet options (Complera and Stribild).  So in that aspect your doctor is correct.  My advice, give it time.  Sometimes it takes a few months to work out the kinks of a new medication.  If the side effects become bothersome to the point where it starts to affect your adherence, that is a red flag that should be discussed. 

Don't be fancy, just get dancey

Offline SteveS

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #7 on: June 09, 2013, 08:27:35 PM »
BIM2 -

I really, really thank you for all this. It is so helpful!

The good thing is I am slightly obsessive. I will never, never forget a dose. So adherence will not be a problem. So - this is good. I am going to "tough it out" for a few months on the Atripla and see what happens. Again - the only thing so far is the fatigue - and was only for about 5 of the 20 days I have been on it. Knowing I can go "back to it" if I need to is also good...but for now I will probably stay with it.

I have heard it is OK to do your daily dose an hour earlier or an hour later - is that true? Must be, right? With my work, it is occasionally hard to hit the dosage exactly "on the dot", but it will always be within 60 minutes or so....That will be ok?

I have always been a big vitamin / supplement user so again, in that way - adherence should not be an issue....

Thanks again....

Offline buginme2

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #8 on: June 09, 2013, 11:10:03 PM »
It doesn't matter what time you take it an you can be an hour, two, three, five, ten whatever hours different each day.  As long as you take it.

However, one thing to mention.  Atripla should be taken on an empty stomach at least two hours after you last meal preferably before you go to bed.  Taking it with food doesn't make it work less, it actually makes it work more.  This is when you can experience some pretty significant side effects. 

An experiment may be to increase the time from your last meal to when your taking you pill to see if it reduces the fatigue. 

Once you get used to the medicine after a few months you can start eating closer to when you take the pill.  After a year or so it won't be an issue and you will prob be able to eat at the same time as you take your medicine.  But in the beginning, until you get used to it.  Empty stomach.
Don't be fancy, just get dancey

Offline SteveS

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #9 on: June 10, 2013, 02:13:17 AM »
Well - that explains a LOT. I wish they would explain this all more! Thanks SO MUCH!

Offline Stlguy1976

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Re: New Poz - Atripla Question - Fatigue/Eyes
« Reply #10 on: June 14, 2013, 01:49:46 PM »
I have been on Atripla since diagnosis (almost two years now) and it has done great for me with few side effects.  At the time my viral load was 1 million + so it was a great option for me and brought my VL to UD within 6 weeks.  Now almost two years in I am seriously considering a switch myself.  I have experienced fatigue as well as aniexity/ediginess and it has seemed to have gotten progressively worse for me.  At my last appointment I discussed with my doctor about possibly switching meds and he thought Complera would be a great option.  As he mentioned at the time of my diagnosis it was not due to my high VL.  As others mentioned there are quite a few different treatments available now so if something is not working for you do not be afraid to bring it up.  I feel like I stuck with it long enough and gave it a chance and I think it is time to move on. 

Anyway that has been my experience and where I think I am headed.  Looking forward to my next appointment to get my doctors input. 
Diagnosed: October 4, 2011
11/2/11 - CD4 21 2% VL 1,200,000 (started Atripla)
12/16/2011 - CD4 207 13% VL???
03/14/2012- CD4 148 11% VL UD
06/13/2012 - CD4 230 12% VL UD
09/27/2012 - CD4 220 13% VL
1/2/2013 - CD4 237 12% VL UD
4/27/2013 - CD4 251 12% VL 290
6/26/2013 - CD4 256 15% VL UD
6/26/2013 switched to Complera
10/16/2013 - CD4 278 15% VL UD?
1/18/2014 - CD4 308 VL UD
1/21/2015 - CD4 392 16% VL UD
10/23/2015 - CD4 192 18% VL ?


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