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CHANGING DRUMS
Feb 26, 2009

I have been taking sustiva+ Lamividine+ zidovidine for 1 year now and I have not had any problemsgl. I'm planning to conceive soon, and I know Sustiva is not good while pregnant. Which combination is best for me during this time. Please adive me.

Response from Dr. Young

Hello and thanks for your post.

Efavirenz (Sustiva, Stocrin) is usually not recommended during pregnancy, especially during the first trimester- because of risk of certain birth defects.

We'll try to switch female patients planning pregnancy (or during first trimester) from efavirenz to a boosted protease inhibitor- usually lopinavir/ritonavir (Kaletra). AZT+3TC (Combivir) is usually recommended during pregnancy; since you're already taking this, no switch would be needed. Hence, a preferred pregnancy regimen is AZT+3TC + lopinavir/ritonavir. Note that during third trimester, the levels of the protease inhibitor typically drop (as body weight increases), requiring an increase in dose.

I hope this helps.

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