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Driving myself crazy over Crixivan
Jan 11, 1999

Hi, my name is Jim. First of all I would like to say THANK YOU for the work you do on this site! I truly believe you set a lot of people's minds at ease. I have been taking Crixivan+Combivir for 8 months and this is the first drug regimen I have been on. Before treatment cd4=280/viral load=86,000. Presently cd4=560/viral load=undetectable. Problem: In the morning I am supposed to take meds at 9:30 but I consider my cut off time(the latest I should take dose) to be 10:30--I always give myself an hour leeway. Lately I don't take the morning dose until around 11:00. I am worried that by doing this I will mess up the progress I've made or even worse become resistant. I am really upset about this and would like to know what your opinion is on taking the morning dose like I have been(I've been doing this for about 1 month). Thank You!!

Response from Dr. Currier

Dear Jim-

It sounds like you have been doing a great job with your meds given the results you have seen to date. You are right to be concerned about delaying your doses by over an hour. It may be worthwhile reviewing your daily schedule and medications dosing with your doctor. The goal is to keep the crixivan doses 8 hours apart, so if your first dose is at 11, that means you need to stay up very late to get 3 doses in in one day. I would look atthe reasons you are late and consider whether there is a way to get a dose in earlier in the day. On the other hand if the problem is that you sleep late and stay up until the wee hours ( 3am) then this schedule could work. So the bottom line- you need to try to find a schedule that lets you get 3 doses in 8 hours apart. I wish that we had better data on twice daily dosing, but it does not look like that can be recommended and the studies to look at this in people who got supressed on every 8 hour dosing will not be completed. Hope you can work something out.

-JC



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