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Timing of meds: every day exactly the same?

Apr 13, 2006

I am taking 3TC, Sustiva and Viread. Have been on meds since May 2005, and the effect was almost immediate: viral load undectectable, CD4 went from less than 200 to over 400 almost immediately. Since then, CD4's are inching up, and were just over 450 at last count (November), and viral load has stayed undetectable.

My question relates to the timing of medication at night: I tend to take it before bedtime, but my bedtime changes, anywhere between 10pm to 3 or 4 am depending on the night, although most nights its around the same time. If I am up later but take my meds earlier to stick with a 24h cycle, it ruins the rest of my evening as the Sustive kicks in and makes me feel dizzy and drowsy.

Am I running a long-term risk by not sticking to a precise 24 schedule? Or is it ok for me to occasionally take meds within two or three hours of my usual time. I have never missed a dose.

Thanks very much for your advice.

Response from Dr. Pierone

You are not in jeopardy by taking your medications at different times in order to accommodate your schedule and avoid Sustiva-related side effects. The actual intracellular persistence of Viread and Epivir is prolonged for several days and Sustiva has effective levels for most people at least a week after the last dose. I am glad that you are doing so well and wish you the best.

T-cells down but viral load unchanged
starting meds

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