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Switching meds
Nov 27, 2005

Hello,

I am currently on Sustiva and Combivir. I would like to get pregnant within the next six months. Should I switch off of this combination (even though it has been effective) and, if so, when would be a good time to do so?

Thank you,

Annie

Response from Dr. Young

Thanks for your post.

It's great to hear that you're well-- well enough to consider planning a family.

The only issue with your current regimen is the use of efavirenz (Sustiva, Stocrin) during pregnancy. The problem is that efavirenz is not recommended during pregnancy because of risk of fetal injury. For this reason, if your seriously interested in becoming pregnant, I'd recommend switching to a different "third" drug.

Many maternal-fetal HIV experts recommend the use of a protease inhibitor during pregnancy- recommendations vary, but some use nelfinavir (Viracept), while others will use a boosted PI, such as Kaletra. All would probably recommend that you continue on your Combivir (AZT+3TC), since AZT has been strongly associated with protection against mother-to-child transmission of HIV.

When to switch is not really critical, other than to do so several weeks before becoming pregnant, to allow the efavirenz to be completely out of your system.

Good luck, let us know how things turn out for you. BY



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