|Kaletra or Sustiva
Jun 25, 2006
Thank you again Dr Young. I will meet with the hospital pharmacist to ask more questions on the side effect of Sustiva before I make my decision to change from Kaletra. I was told there there is a lot of patient having cholesterol problems with Kaletra. Is it the same with Sustiva? Which one is more toxic? Right now I take Kaletra and combivir twice a day. 6 Kaletra and 2 combivir each day. With Sustiva I would take only once a day, does this make it less toxic?
You answer is helping me understand that I should ask more questions before making the switch. I need to be sure myself, it is my body after all. All I want is continue feeling good, continue to work. I'm expecting a promotion soon, I wouldn't want Sustiva affecting my concentration in the work I do. Those are all questions that I have and need to be certain before making such an important decision.
Thank you, and this should be my last question.
| Response from Dr. Young
Thanks for your post.
In general, more patients have significant increases with lopinavir/ritonavir (Kaletra) than efavirenz (Sustiva, Stocrin). It's important to know that with any medication, a small fraction of patients develop side effects or toxicity that require treatment modification.
As to your question about once- or twice-daily medications, both lopinavir/ritonavir and efavirenz can be taken once daily. The dosing frequency of the medication has little to do overall to do with side effect profiles-- that is to say not all once-daily drugs are necessarily better tolerated than twice-daily. Indeed, when taken once-daily, lopinavir/ritonavir has more issues with side effects (mostly gastrointestinal) than when taken twice daily.
You should also be aware that in the US, lopinavir/ritonavir has been reformulated into a tablet that is taken 2 tablets twice daily or 4 tablets once-daily. This new pill tends to be better tolerated than the previous capsule formulation.
I hope this helps, BY
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