change of medication
Aug 17, 2007
Hi, I am worried with my doctor's decision to change my nevirapine over with effavirenz. I had been taking azt and ddi for 2,5 years, when nevirapine was added. Total time of treatment is 10,5 yrs as of today, of which 8 yrs with nevirapiine. No serious side effects, undetedtable v. load for 8,5 yrs. What could the rationale be to change nevirapine with effavirenz? I also take lipitor 20mg for hereditary hyperlipidemia; my age is 38, male. Is the change of any worth? Thank you for your attention!
Response from Dr. Young
Thanks for your post.
If you've read my other posts, you'll know that I'm a very conservative treater when it comes to switching from long-term successful treatments.
In your case, 8.5 years of success is very difficult to argue with- especially if you're not having any issues with side effects or adherence. In-class (in this case NNRTI-NNRTI) switches can be done with relative safety, since the medications work by similar mechanisms and have similar (though not identical resistance profiles).
I'd ask your doctor as to why he or she is suggesting the change. If anything the lipid profile of nevirapine is slightly more favorable than that of efavirenz, so that shouldn't be the basis of the switch.
Hope this helps, BY
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