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Adherence Issues
Mar 15, 2004

I started taking meds 110 days ago. I am on viramune, viread, epivir twice a day. I have missed 4 evening doses and 2 morning doses in the past 100 days. Sometimes I take my morning dose a few hours late but never outside of the 3 hour window i've been told about. If I really clamp down now should I be OK or should I throw in the towell and switch to a once a day treatment. I would like to try to find some new ways to remind myself to take my meds before I change. On the other hand I'm wondering if its worth the risk. How long does it take to build resistance? At what point, if I still haven't manage to achieve the 95 mark, should I ask to be changed to a once a day which I assume would be a change from viramune to Sustiva. I wanted to avoid Sustiva because of the cns side effects but I take my chances with nightmares if it means not building resistance.

Response from Dr. Lee

No medicines can work for you if you don't take them. It is possible that you would do even worse with a once a day regimen, because if you miss them for a day there may be a greater likelihood of viral rebound before the next dose. I suggest you figure why you have missed so many doses. There is probably a pattern that you can identify and then work to change your behavior. Is it simply forgetfulness or some other problems? Try a beeper, a phone call from a friend or a service, a timer, watch or alarm clock. Until you find out what the issues are, don't just switch medicines. You'll be likely to have the same problem.

Be well.



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