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Why would my doctor prescribe Isentress once a day?
Jan 30, 2010

I'm treatment naive, no drug resistance. My doctor and I agreed I should initiate treatment, and we talked about Atripla versus a combination of Isentress/Truvada. We decided to try the latter, and he told me to take both Isentress pills at the same time. He also said these drugs will be available as a one-pill combination in late 2010. (I have found no information online supporting this claim.) I did my research, and the official dosing recommendation for Isentress is 2x daily. Why would my doctor say it was ok to take both pills 1x daily? Should I follow his advice? What am I missing here?

Response from Dr. McGowan

Your doctor is eluding to some data on how the drug works. For many meds the blood level at the lowest point during the day (usually just before the next dose) is the most vulnerable time. This is called the "trough" level. Keeping that level high 24/7 keeps the drugs active. With these kinds of drugs taking them more than once during the day would be important depending on how fast the liver and/or kidneys can clean them out. Some reports suggest that Isentress may work differently. It's potency may be more related to the total amount of drug taken during the day rather than how often it is taken. That is called the total exposure one has to drug. If true than it wouldn't matter if you took the pills together or separately as long as you took the full dose every day. The study to confirm this has not been completed, so it is not the "official" dosing recommendation.

Hope this helps, Joe



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