If it ain't broke...

Jun 25, 2005

Greetings! I've been on Crixivan (Indinavir) since before it came on the market, plus first AZT and later plus Combivir instead. My CD4s were never less than 385 and they've been over 1200 throughout the decade I've been undetectable. Needless to say, my wonderful doc and I are thrilled. Still, I've been increasingly bothered by the side effects of Crix and fear I'm pre-diabetic, for instance. So the doc's recommending Sustiva (plus Combivir) which is supposed to be less toxic and be easier to take - which sounds good but it's not a step I'd take lightly after such success with Crix. Besides adherence to the drug regimen was never a big problem. So...my question is what are the trade-offs? In short, is there any reason I should _not_ take the plunge and switch? Much appreciate the second opinion!

Response from Dr. Pierone

Hello and thanks for posting. It is great to hear about the great long-term response to Crixivan. The reason to switch a regimen (other than virologic failure) is actual or potential toxicity. It sounds like you are having side effects and so changing Crixivan to Sustiva is a good idea. The potential downside is that you may get side effects from Sustiva that preclude its use. It is common for Sustiva to produce vivid dreams, sleep disturbance, dizziness, and a dopey feeling. These side effects typically recede within the first few weeks after starting. Good luck!