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Atripla once a day vs. Truvada in am and sustiva in pm
Jul 18, 2006

I am currently taking Truvada and Sustiva. I take the Truvada in the a.m. and Sustiva in the p.m. with good results (undetectable and stable CD4. I know this is a once a day combo, but I was previously on Videx, Epivir and Sustiva (taking the Videx/epivir in the am- food restriction) I switched to Truvada (still with Sustiva) a year ago and just kept the same dosing schedule. I have thought about taking everything at night, but my logical side says that I have better drug coverage with twice a day dosing. Am I just being overly cautious since this is really meant to be a once daily combo? I may consider switching to Atripla when it is available. I know a once a day regimen would be more unforgiving of missed doses (I have very good adherence). Do you think taking Truvada and Sustiva as a twice daily regimin has any advantage? Thank You.

Response from Dr. Wohl

I commend your committment to being adherent and your dedication to your health!

The long 'lives' of these drugs in your system means that there is sufficient levels of the medication in your blood for 24 hours or more. So, taking the meds all at once should not provide any less of a benefit.

Whether missing once a day is "more unforgiving" than a twice a regimen is not clear to me. The greatest risk of resistance is when moderate levels of drug are present - especially moderate levels of a single agent in the absence of its partner drugs. With the long lives of all the agents in Atripla, I am less worried about this happening.

DW



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