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Individual med change..."dangerous?"
Mar 29, 2009

I have been on Isentress-2x's aday w/Truvada-1 a day for about 2 yrs now. I recently moved to another state and my "new" Dr. suggested, ("to make remembering my 2nd Isetress dose easier"), to take both doses of Isentress at one time w/ my other a.m. meds. My question is this; -without a genotype to go by and, w/out "all" my records-25yrs worth, is this a wise decision considering of that the "double dosing of Isentress" is in the trial stages? Thanks, Dave HIV/Aids 25+yrs Ft. Lauderdale Fla.

Response from Dr. McGowan

Dear Dave,

Thanks for your question. You have been on successful treatment with your combo for 2 years...have you had difficulty with adherence to the twice daily regimen? If that is what has prompted this switch then it is an issue that must be addressed to maintain your success.

As you mentioned, the use of Isentress once a day is currently under investigation in the QDMRK study. The study will look at treatment naive patients only...that is when this combo is the FIRST EVER treatment used. We have learned that Isentress is less forgiving if someone has previously failed treatment (in the SWITCHMRK study). That is, if there is the potential for some drug resistance (in your case to Truvada) from prior treatment, the Isentress may be less able to keep the virus suppressed, the regimen may be especially vulnerable if the blood level gets low (24 hours after a once daily dose for example). Although this dose may turn out to be fine, we have been surprised in the past and it would be best to wait for the results of the trial. If you need a once-daily treatment there are other alternatives that you may want to explore with your doctor.

Best, Joe



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