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Sustiva 300mg twice or 600mg once?
Oct 25, 2006

Hi Doctor, For the past 3+ yrs, I've been on: 1)Sustiva 300mg twice daily 2)Abacavir 300mg twice daily 3)3TC 150mg twice daily 4)Kaletra 3 "caps" (fridge) twice daily

and I've been doing very well 24% and undetectable for almost 4 yrs. This morning I was given:

1)Sustiva 300mg twice daily *2)Kivexa once daily *3)Kaletra "tablets" (no fridge) 2 Bid

I was told same meds BUT less pills and here is the real question: since I'm going forward with less pills, should I ask for 600mg Sustiva once daily instead of 300mg twice daily? How likely will taking 600mg once daily turn me into a "psycho"?

Thanks in advance and best regards.

Canadian

Response from Dr. Young

Thanks for your post.

I'm not sure why you're taking your efavirenz (Sustiva, Stocrin) twice daily. The medication is supposed to be taken once-daily (though it's probably not a terrible thing to be taken twice daily).

You could take all of your efavirenz as a 600 mg once-daily dose. Indeed, there is a 600 mg tablet of efavirenz, that could reduce your pill burden further. I wouldn't expect that your side effects should be much different, especially since you tolerate the meds at this point.

The switch from abacavir (Ziagen) + 3TC (Epivir) twice daily to the combination pill abacavir/3TC (Kivexa, Epzicom) makes clear sense and has also reduced your pill count and dosing frequency.

One potential concern is that efavirenz induces the metabolism of lopinavir/ritonavir (Kaletra), some recommend increasing the lopinavir/ritonavir dose (though how to do this with the new tablet formulation is not yet clear).

Best of health, BY



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