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pill splitting to ease into first regimen?
Aug 28, 2003

Dr. Young:

Following your advice, I am starting tomorrow (Friday 29 August) night on my first HAART regimen, consisting of Combivir + Sustiva. I am, of course, concerned re: the side effects. My doctor suggests taking 1/2 of a Sustiva each of the first three nights (in no way to exceed seven nights) to let it build up in my system a little more slowly, and to take a sleeping pill as well to ward off some of the CNS symptoms.

The sleeping pill is a no-brainer. But what do you think about this "splitting" routine for the first few days? Do you seen any negatives to this approach?

Since I'm starting tomorrow night, any quick reply will be most appreciated.

Thank you.

Response from Dr. Young

I would DEFINITELY not recommend splitting the inital dose of efavirenz (Sustiva) to mitigate the side effects.

The side effects are usually pretty mild and short-lived, in the first place and most importantly, lower doses could very easily place you at greater risk of having the virus acquire drug resistance. Drug resistance could render this potentially very simple drug regimen ineffective within the first weeks of therapy-- an unacceptable risk in an attempt to minimize mild, short term side effects. BY

Is Viral Load a reliable barometer for starting antiretrovirals?
thanks from guy formerly known as confused

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