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Atripla+Extra dose of Efavirenz 200 mg

Jul 24, 2011

Hi Doc, I live in Australia and been diagnosed with HIV + active TB on January 2011. Now i still on TB medication ( Rifadin + Isoniazid) and for HIV i took Atripla once a day. My VL now 209 and CD4 Count 504. My doctor told me to have extra dose of Efavirenz ( 200mg)on Feb 2011 . He said it needs to boost up my immune system until i stop TB medication later by the end of July 2011. My question is : when i stop TB medication and also extra dose of efavirenz later, and just have Atripla once a day, is there any possibility for drug ( atripla) resistance, because reduce the dose of 200mg efavirenz?


rgds, Ivan

Response from Dr. McGowan

Dear Ivan,

Your doctor is correct in adding the extra 200 mg of efavirenz while you are on TB treatment.

This is because the rifadin (rifampin) will cause a DECREASE in the efavirenz level, which is compenated for by the extra 200 mg capsule.

Once the rifadin is complete then the extra 200 mg can be stopped or else the efavirenz level will be too high in the blood. So there would be no risk of losing control from that, but it could avoid some side effects from over exposure to meds.

Best, Joe

following up : infected couple but too much confusion

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