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Dosing of Truvada and Isentress for Travelling Banker
Dec 6, 2009

Dear Dr. Young. Hello from Hong Kong!

Thank you for the wonderfull work you and your colleagues do in this forum. I am a banker and travel to the US frequently and also accross Asia regularly, thus encountering many different time zones in which I would work for periods ranging from just a few days at a time upto several weeks at a time away from Hong Kong. My twice daily dosing of Isentress and Truvada becomes rather difficult to folllow to the exact hour when traversing these time zones which can vary anywhere from 3hrs to 6 hrs to 12hrs from my normal Hong Kong time zone. The 12 hr change with the US is easier since I simply swop my morning and evening doses. However, having to wake in the very early hours of the morning when travelling west for shorter distances, make maintining the 12hr dosing schedule very difficult / invonvenient. My current regimen is "perfect" otherwise and I have absolutely no side effects.

Could you please advise me on how strictly i need to adhere to the 12 hr interval between dosages of Isentress and Truvada? So, for example would changing the schedule by upto 6 hrs be OK or am I risking potential resistance issues? If 6 hrs are too long, what amount of leeway do you think I could safely apply in my frequent travels. Needless to say, I will always take the 2 doses per day (every day) - I guess I just want to be ble to stick as closely to my 7AM - 7PM Hong Kong schedule irrespective of where in the world I find myself. Waking up at 3 in the morning in one city to take my pills because it would be the equivalent of 7AM in Hong Kong makes effectively operating in my stressful job during the day a major challenge....

Thank you for your kind advice - Sressed Banker in Hong Kong

P.S. The CNS side effects of Atripla makes this once daily dosing option unsuitable for me.

Response from Dr. Young

Hello and thank you for your post from Hong Kong.

I think that you have the right idea- as a frequent international traveler, I can sympathize with your situation. So long as you're not changing locations every other day, you can simply set your clock to your destination and take your twice daily regimen on the local clock.

Hopefully we'll begin to see data on once-daily dosing for Isentress-- this could make your dosing easier in the future.

Be well, travel safe.

BY



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