|Delayed dosage and Missing one dose of Combivir
Jul 28, 2007
I have started nPEP for 3 days so far, from Tuesday 17th. Last night (Thursday 19th) when I took Sustiva at a regular scheduled time (9.00PM), I fell sleep and missed my Combivir at 11.00PM, so I took it at 3.00AM. Question 1: Would that be OK if I took the pill 4 hours later than my schedule for Combivir?
Having taken the dose 4 hours later than schedule also made me worried and wondered, so I went and checked the numbers of Combivir and counted them and it turned out that the number of the pills was odd. That made me wondering and suspecting whether I had missed the morning dose at 11:00AM. [This could be a miscount on a pharmacist's part.] Now my other question is (2) if I did miss that morning dose (which I doubt) and took the next one 4 hours later, would that cause a problem with my regimen?
I am going to take the next pill at my regular schedule and adjust my schedule so that I take the evening one together with sustiva to minimize this chance in future.
Could you please let me know ASAP?
Response from Dr. Frascino
This is another example of why I suggest that folks who have had a significant enough HIV exposure to warrant a course of PEP be followed by an HIV specialist if possible. The HIV specialist could accurately document HIV risk, optimize the PEP regimen, handle any dosing inquiries, manage any PEP-related toxicities or side effects and arrange for and interpret post-PEP testing.
Your four hour delay in taking Combivir is not a problem. Similarly if you missed a single dose, you should just continue on with your 28-day regimen as prescribed. Certainly we strive for 100% adherence to the dosing regimen, but begin human mistakes sometimes happen ("manure occurreth"). I do not believe you significantly harmed your chances of PEP being effective.
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