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Adherence issues
Apr 11, 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. Young

Thanks for your question.

Seems to me that you're doing a very acceptable (if not excellent) job at adherence. A total of 6 missed doses in 100 days (220 doses) is a ~97% adherence rate. This would be fine with me, if you were my patient.

Your introspection is noteworthy and may be the kind of analysis that may allow you to have even better adherence in the future. Understanding the particulars about each missed dose may help troubleshoot things in the future-- would a pill box or other reminder help? Alternatively, would having a spare dose of medications on hand (away from your medicine cabinet) help?

As for resistance, so long as your viral load remains suppressed, I'd have no reason to think that your having any issues with drug resistance.

Hope this helps, BY



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