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Author Topic: Starting Meds  (Read 4316 times)

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Offline magnoman

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Starting Meds
« on: November 06, 2013, 01:58:41 AM »
So my partner is starting meds this week and annoyingly I am not going to be here.  I am slightly confused as to what his initial meds are going to be, he mentioned some to me, although I hadn't heard of them. There again maybe the Spanish name is different.

He did tell me that he would have to take them twice a day and that it was essential that he took  them at exactly the same time each day, which slightly surprised me as I had understood there to be more flexibility in timings than that. He was also told that he could never drink alcohol whilst on the meds as it would have an impact on his kidneys or liver, which I think he found rather hard to take... not that either of us are heavy drinkers, although he does like to have a few when he goes out.

We are in South America, so I slightly worry that he is being given much older medication and less advanced than in the US or the UK... but I guess I am just worrying needlessly until I actually know what he is being given.

Anyway any advice you think I should give him? He is pretty depressed because here you start meds when your cd4 count is below 250 and he thought that he would have a few years as he was initially diagnosed after ARS last March and his CD4 dropped from 420 or so to 247 between the last two tests... and also here he tells me that it is officially medically called AIDS once you start treatment.....

Although I have told him that the term AIDS isn't really used anymore... but if it was to be AIDS he would have to either have an opportunistic infection or CD4 below 200.

Will report back once I know the exact meds regimen.

Offline magnoman

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Re: Starting Meds
« Reply #1 on: November 06, 2013, 04:24:06 PM »
Ok this is what he told me he was taking... I believe these are all generic names which is why I hadn't heard of them.
2)Lamivudina ...Duovir 1tab /12 h 8am.8pm

Zidoviduna is I believe AZT so it looks as though I was right about them using old medication.  Not totally sure about Lamivudina.

3) Efavirens .... 1tab /24h...8pm

Efavirens is I believe sustiva

I suspect whilst these are definitely better than nothing they aren't the most ideal initial combination. However I am very much aware that a little  knowledge is a dangerous thing.

If anyone can shed more light on this for me I would be grateful.

« Last Edit: November 06, 2013, 04:34:56 PM by magnoman »

Offline Miss Philicia

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Re: Starting Meds
« Reply #2 on: November 06, 2013, 04:44:01 PM »
For the US that is a combination of Combivir (tablet containing the two drugs lamivudine and zidovudine aka epivir and AZT) plus Sustiva (efavirenz).

As far as your other questions, one need not time taking things down to a precise minute of every day, but aiming for the general time makes adherence easier. Similarly with alcohol -- drinking too much means harder work on one's kidney and liver, but it's not going to hurt to go out to dinner and have a glass or two of wine on Saturday.
"I’ve slept with enough men to know that I’m not gay"

Offline magnoman

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Re: Starting Meds
« Reply #3 on: November 06, 2013, 06:25:56 PM »
Thanks.  So combivir and sustiva doesn't sound too bad, although it does look as though meds have advanced a bit since it first came out. 

I appreciate that I probably sound a bit ungrateful that he isn't getting the latest medication especially as I doubt we could afford to pay for any medication and when I first heard of hiv there was no treatment at all.

Still I had got the impression that truvada is currently the best option and I had hoped he would have started with that.

If anyone else out there is taking this or has taken this would love to hear what your additional supplement regime was and whether you have any advice.

 I am going to be in the usa for the next  week and suspect that they're are better supplements available there.

Offline mecch

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Re: Starting Meds
« Reply #4 on: November 06, 2013, 08:35:35 PM »
What do you mean by supplements?  HIV+ people do not necessarily need any special supplements...  Some supplementation is counterproductive if its going to tax the liver or kidneys. Or interact with the HAART. 

The treatment is HAART.  Other than that there are concerns for some people about brittle bones, cholesterol, etc etc.

Ideally the treating doc should be monitoring the HIV+ person to see what if any additional medicine or "supplements" are needed from an established scientific standpoint.

There is nothing "new" about truvada, which yeah, lots of people take because its very effective.  But not new.  I take truvada with one of the newer drugs - Isentress.  Must admit its been great.

Truvada + sustiva = Atripla. Atripla has already been around quite awhile, and the two components in it have been around longer.  :D

Maybe if you are really curious about all the combos available in your country you could search for the information from service organisations, the doctor, or websites in your country.  Its reasonable to be curious and concerned about access to the best meds and I would say it would be helpful if you had full information about what is and isn't available and under what conditions.

Timing is pretty important during the first months of HAART but as Miss P says not down to the precise minute...  When someone is reliably undetectable for awhile, I have heard of doctors being ok, with certain HAART combinations, of pretty damn flexible dosing times. 

Getting used to HAART can shock some peoples systems.  So moderation for alcohol for the moment is wise enough.  But again this is individual - how one person is dealing with the mix of a particular HAART combo and alcohol.

An order to stop drinking completely doesn't seem to be medically justified in many cases.  But we don't know the particulars of your friend.

You are really on the ball. Yep, its only an AIDS diagnosis if there are opportunistic illnesses + certain CD4 level.  Yep, the AIDS diagnosis means something different these days.  Your friend will in all likelihood repair his immune system and reach the new normal of living well enough with a chronic "condition". 
« Last Edit: November 06, 2013, 08:43:24 PM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline buginme2

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Re: Starting Meds
« Reply #5 on: November 06, 2013, 08:56:37 PM »
The medications he is on are older.

The NRTI combo of Zidovudine and Lamivudine is an older combo. It is routinely prescribed in limited resource countries and it is not prescribed very much anymore in resource rich countries which usually prescribe Truvada.  The Zidovudine (AZT) does have a higher chance of causing side effects and lipodystrophy than the medications in Truvada.

Efavirenz (Sustiva) is a very effective medication.  It is VERY strong and powerful.  It can cause some side effects, especially the first few weeks you take it but they do settle down after a few weeks.   It is still prescribed somewhat in the US but the past few years they have started to prescribe it less as newer medications with less side effects have come out.

Don't be fancy, just get dancey

Offline magnoman

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Re: Starting Meds
« Reply #6 on: November 07, 2013, 01:19:03 PM »
Thanks all.  From what I can gather there are only two treatment options provided here.  The one they are starting my partner on and one other that they put you on if this treatment doesn't work or if you become resistant to it.

He had a lecture yesterday about nutrition and hygiene. Rather depressingly long list of donts!  And apparently our cat has to go so If anyone is in South America and wants a beautiful and well trained cat let me know!

Offline mecch

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Re: Starting Meds
« Reply #7 on: November 07, 2013, 01:39:32 PM »
Frankly it sounds like a bunch of old hat ideas.
I really doubt your cat has to go.
We could be curious to see the list of don'ts if you care to post it.
Are you willing to say what country this is?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Dan0

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Re: Starting Meds
« Reply #8 on: November 07, 2013, 02:26:49 PM »
I think that I would get rid of the doctor and look for a new one before the cat went.  >:(
"Honey, you should never ask advice from a drunk drag queen who has a show to do." - JG

06/2002 DX
10/2006 Atripla UD
10/2013 Stribild Still UD
04/2016 Genvoya UD

Offline intaglio

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Re: Starting Meds
« Reply #9 on: November 07, 2013, 06:09:52 PM »
I would look long and hard at the reasoning behind getting rid of the cats, too.

We have two and none of my doctors ever mentioned pets in their do's and don't's lists concerning HIV.

I'd also question the dietary restrictions. Unless the meds the doc has prescribed are widely known to have food interactions, I'd have to wonder, like others, if your doc is using very outdated methodology.

It's good to ask questions. In fact, get used to it and question anything that sounds odd in any way. A good doc can point you toward the research or bolster their opinion with the data -and its relevancy to their diagnosis. A less-than-stellar doc will usually inhibit your attempts to better understand. If your doc can't handle scrutiny, it's a good sign you need to be talking to a different doc.
Reality is frequently inaccurate.

Offline phildinftlaudy

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Re: Starting Meds
« Reply #10 on: November 07, 2013, 06:31:08 PM »
I wouldn't think the cat would have to go - however, if CD4 counts are low (under 200), it is advisable to use gloves when changing the litter box and a mask so as to not inhale any particles while changing it... He will also want to wash hands frequently when handling the cat. Cats carry a parasite - toxoplasmosis - which people with very compromised immune systems can contract. This was one of the conditions that my brother had - he had a cat and didn't follow the above protocols when handling the cat and changing litter.

Other than the above, should be no reason to get rid of the cat...
September 13, 2008 - diagnosed +
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline zettainaoru

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Re: Starting Meds
« Reply #11 on: November 11, 2013, 09:52:46 PM »
I also have AZT/3TC but with NVP instead of Efavirens. My CD4 was 200 when i start. It has been 3 months now. Although i dont feel any side effect my blood test said that i got anemia, so probably gonna drop the AZT to tenofovir.

My advice is to keep your partner white and red blood check regularly, especially in the first months. Since AZT can cause anemia. Hit badly in some people.

And i think that vitamin C and vitamin E would be nice to lessen the side-effect of AZT. (Link below)

I dont know how much is effective. Too much of Vitamin C and E is not good either.
Probably 400-800 ie of Vit E and 1000 mg of Vit C daily is enough to lower the side effect of 600 mg AZT/day.

« Last Edit: November 11, 2013, 09:55:49 PM by zettainaoru »


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