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Timing of Sustiva
Jun 21, 1999

I know that we are supposed to take our meds as prescribed and that it is important to take them on time, but for those meds (like Sustiva) where it is to be taken at bedtime - does that still mean the same time every night? How big a difference does it make if you are late in taking your meds by say an hour or two?

Thanks so much

Response from Dr. Cohen

Well.... it turns out that the answer to this can depend on several factors, especially which med we are talking about. But one of the benefits of Sustiva is that it has a long time in the body before it is metabolized and eliminated - so that an hour or two flexibility should not threaten its success. For other meds - those with much shorter times in the body - we do fear that the schedule can matter more. But one of the benefits of a combination of meds is that while one of them has a lower blood level, the others are hopefully still doing the job and keeping HIV under control.

And your viral load may also have an impact on this issue -- since with a higher viral load there is more opportunity for even a briefly low blood level to "invite" HIV to mutate, whereas if your viral load is already below 50 copies - then there is much less chance that anything would happen in that hour or two...

Hope that helps. CC



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