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nasty dreams from Sustiva

Aug 3, 2006

My partner changed his meds from Combivir and Viramune to Stockrin and Epivir and tenofovir. Okee. He had no side effect what so ever for 5 months. Only now, since 4 weeks he has really bad dreams, very bad dreams every night. Should he hang on a bit longer to see if it will go away or can he change back to Viramune with tenofovir and epivir? Is that a combination that is okee? He wants to keep his regimen for once a day (also he had started some lipo atrophy from combivir and doesn't want this anymore).

Response from Dr. Pierone

Bad dreams from Sustiva can sometimes interfere with sleep quality to the extent that it simply needs to be changed. Changing to Viramune is reasonable and the combination of Viramune, Epivir, and Viread is fine. Although Viramune is not approved for once daily use, the pharmacokinetics support dosing it once a day. More than 90 percent of our patients on Viramune take it (2 pills) once daily. If he does make this switch he would need to have his liver function tests monitored for signs of liver toxicity. If his CD4 count is greater than 450 this would also increase the risk of liver side effects from Viramune. Thanks for posting and let us know how things turn out for your partner.


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