atripla, or sustiva + truvada, or sustiva + ftc + viread/tenofovir

[Guest guest]

hi guys,

i have posted several times about this but i thought maybe i should

do so again because the issue keeps coming up: side effects of one

or all of these medications, which are really all the same thing,

just in different combinations.

in this age where taking as few meds as possible is emphasized (over-

emphasized?), we seem to forget that we don't HAVE to take the daily

dose all at once. for many people, taking one pill once a day seems

to be the holy grail of dosing. for me, it is more important that i

have meds that work and at the same time have as few side effects as

possible so that i can have a better quality of life. i don't have

any problem taking pills two or three or four times a day, and would

greatly prefer that to having problematic side effects.

i could not take atripla because the side effects of the sustiva at

full dose were intolerable for me. so instead i take truvada once a

day and then take the sustiva dose over the course of the day in

three separate pills, each equal to one-third of the recommended

daily dosing. this is possible - but getting a doctor to prescribe

it requires that they are able to think outside of the box, and

perhaps requires you're being a strong advocate for this dosing, or

you might not get it. i have been doing this for about six or seven

years and have maintained an undetectable viral load and stable t-

cell count.

personally, i would try to do the same with viread if i were having

slight trouble with my kidneys, as someone recently mentioned. i'm

not sure the every other day dosing suggested by your doctor would be

adequate to avoid the virus's developing resistance, and then you'd

be back where you started in terms of trying to find a combination

that works for you.

i would first try taking the recommended daily dose of viread broken

up over the day, like i'm doing with sustiva, or taking the full dose

one day and maybe half a dose the next day. but either way, i would

break it up over the course of the day. maybe the full dose all at

once is what is taxing your kidneys, and maybe they could handle the

alternative dosing that i'm describing. only one way to find out!

again, you have to have a doctor who is able to think outside the box

and experiment with something new (it sounds like you do, if he is

thinking about having you take the med one day off and one day on).

the docs might tell you that a lower dose pill is not available, and

that is often not correct. these meds are almost all available in

children's doses, and that's where you find them. they are not

manufactured in the lower dose FOR ADULTS, but what's the

difference? it's the same med, only in a lower dose, and there is no

reason that they cannot be prescribed for adults. THE DOCTOR HAS TO

BE ABLE TO THINK OUTSIDE OF THE BOX! (do i sound like a broken

record? lol)

if your combination is working for you, it is best to stay with it as

long as possible or you begin cycling through the available meds and

may end up running through all available options and being left with

none - or none that is acceptable for whatever reasons.

i have never had a problem with adherence. in all of my years of

taking meds, i've probably missed no more than five doses, and those

were in unusual circumstances such as when i had an unexpected change

in plans for the day, etc.

i take pills in public all of the time, often in front of people who

don't know my health status, and it's no big deal. after all,

different people take medications all of the time for various

reasons, so there is no reason to feel self-concious about it. most

people don't give it a second thought when they see you do it (unless

perhaps you " look sick " , and any self-consciousness you have might be

more about that than about taking a medication in front of someone

else anyway).

having said that, i sometimes hide it when i take them, depending on

the situation. even when out in a restaurant with strangers - or on

a first date with someone who doesn't yet know my status - i have

excused myself to go to the bathroom just before or even right after

the food has arrived - which i often do anyway, to pee or wash my

hands, and sometimes both! - popped the pills in my mouth in the

bathroom or on my way back to the table, and taken a drink of water

as soon as i sat down again. it works even if someone has spoken to

you - you just take the drink of water before answering. they don't

know that you just took a pill or two. or i discretely put it/them

in my mouth when the other party has gone to the bathroom, or is

otherwise distracted. it really is a lot easier than you might think.

and i'm not anal about taking the pills at the same time every day

either. it's a myth that that matters so much. as long as you take

them all within a 24 - 30 hour period, you're fine.

but i digress. in short, i encourage you to consider taking more

pills more frequently in order to avoid side effects, instead of

being stuck on the idea that fewer pills less frequently is

necessarily better - especially for your overall quality of life.

that's my two and a half cents. i hope some of my fellow travellers

along this path in life find it helpful ...

regards to all,

don