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Change in Regimen
Nov 27, 2004

I am currently taking Epivir, Zerit, Viread, and Zovirax (for herpes control) as my combination therapy. I have been taking this for several years. It has been suggested by a friend who is also positive that I should switch combinations. He thinks Zerit is outdated and rarely prescribed any longer. Lately I have been experiencing nausea and think it may be due to medications. So what I would like to know is what a good recommended change would be if I choose 2-3 medicines from the NRTI group. I have found that I cannot use Sustiva so NNRTI is not available. And I do not want to take PI because of GI side effects. Thanks for your input.

Response from Dr. Lee

You are not truely on an approved combination therapy. The three antiretrovirals are all from one class. This is usually not recommended. You haven't stated what your t-cells or Viral levels have been running. So, it is not clear if this unusual concept is working. I don't believe there is any reason for you to develop nausea related to the meds after several years on the regimen.

Zerit may have longer-term associated side effects, such as facial wasting, but it is not outdated. It is still used frequently.

It is usually suggested that either a PI (although there are several that do not cause the significant GI effects of others) or an NNRTI (although there are two others in this class that may not produce the side effects you list for Sustiva) is added to 2 NRTI's. You are also saying you don't want any of these options. Do you prefer to allow the virus to do it's own thing? Not sure how I can help. Perhaps you need to talk to a doc for an extended review of your previous therapy, effects and side effects, and options.

Be well.



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