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Dec 1, 2006

Ihave been taking Atripla for about 4 months. I have been on HIV meds. since 1990. Because of some poor reports on my kydneys, my Dr. suggested I take Atripla every other day. Is this sound advice, or should I look for another doctor.

Response from Dr. Young

Thanks for your post.

If your having issues related to your kidney function, then the dosing of the medications in Atripla (tenofovir, FTC and efavirenz) may require adjustment. The important thing is that since each medication is variably affected by changes in kidney function, it's not recommended that you simply reduce the dosing frequency of the the combo Atripla, but rather look at the dosing needs of each med separately.

Usually, this means that you'll take tenofovir and FTC less frequently, but since efavirenz isn't metabolized by the kidneys, you'll continue to take this part of Atripla daily. Taking efavirenz less than daily (with normal liver function) means that you're probably getting subtherapeutic levels of this med-- perhaps placing you at risk of drug resistance.

Often, kidney injury is caused by a mixture of factors, not just tenofovir; nevertheless tenofovir-induced kidney injury is usually reversible if managed correctly.

Since you haven't written about the level of your kidney function, I can't help with telling you exactly what dosing frequency is recommended; but feel free to write back with this information.

Best, BY


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