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missed dose two days in a row
Oct 4, 2010


i was diagnosed just over a year ago and was quickly put on epzicom, prezista, and norvir. my vl has been either undetectable or <90 since January 2010.

I have been 100% adherent, but realized this morning I had missed the last two days in a row. (I recently changed jobs so my routine changed slightly. I packed my pillboxes for work, but forgot to actually take them).

I called my dr. this morning and his nurse said to just start taking them normally today and make sure not to miss anymore.

would a two day lapse like I just had nomally cause long term harm?

thanks so much for your input.

Response from Dr. McGowan

Thanks for your question. Many people have a similar experience.

The good news is that since your viral load has been fully suppressed for so long missing a couple of doses should not make much difference as long as you start right back. It may take the virus a few days to "wake up" after the meds get out of your bloodstream. So restarting right away will prevent that.

It is a different situiation if the missed doses happen early on before the virus is undectable or if you regularly miss doses- that is much more risky for letting drug resistance develop because the virus is growing when the level of meds in the blood is too low.

Best, Joe

How to manage patients who defualt from INH prophylaxis

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