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Switch to TRUVADA?
Jul 1, 2005

I am on Sustiva, Epivir, & Viread. I have been offered (by a second doctor now) to trade in my Epivir/Viread, and switch to Truvada.

I was informed that the chemicals in Truvada have a longer "half-life" and thus stay in the body longer than E/V. {16 hours versus 10 hours}

My doctor said a head-to-head study has never been done. I'm guessing this has something to do with the politics of multi-million dollar drig dealing. (Comment on this if you care to.)

But isn't it common sense to switch to Truvada as it will be active in my system slightly longer?

Sustiva, apparently is the "workhorse" of the regimen.

Thanks, Kasey in Texas

Response from Dr. Pierone

It is certainly reasonable to switch Viread + Epivir to Truvada (Viread + Emtriva) since Epivir and Emtriva are similar in activity. The driving force for switching in most cases in going from 2 pills per day to one to produce a more convenient regimen. In addition, there may be some cost savings for patients that have a separate co-pay fee for every prescription. It is also true that Emtriva has a longer persistence in blood and in immune cells so if pills are forgotten there would probably be a lower risk of developing drug resistant virus. The potential downside is that a few percent of patients treated with Emtriva have developed hyperpigmented spots on their palms. This side effect occurs more commonly in dark skinned individuals. If these spots do arise, I don't know if they go away when the medication is stopped (having never seen them personally). There is also the expectation that attempts to combine Sustiva and Truvada will be successfully combined into a single "triple" pill by 2006. The added convenience and novelty of a "one pill, once a day" regimen may add some impetus to a switching strategy. Thanks for posting.



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