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Changind Meds
Sep 16, 2011

I have been on truvada, lexiva and norvir since 2005. I am undetectable, CD4 on 900, and in good health in general. My Doctor told me I can try to change to Complera. I have my doubts and I would like your opinion about this new Medicine. I am afraid about the resistance it can create, and that is mostly use for peope starting their regime etc.. please help

Response from Dr. McGowan

Thanks for your question. Good docs should always discuss new developments with their patients, it keeps you up to date and your know what your options are. Sometimes "if it ain't broke, don't fix it" is the best approach. Any change has to be considered very carefully.

Since 2 of the 3 medicines in complera are in truvada, the only differnce is the 3rd drug (rilpivirine/Edurant in Complera which is an NNRTI versus Norvir/Lexiva which are Protease Inhibitors).

Some things to consider: Protease Inhibitors which include Norvir are better at suppressing virus if you have a drug resistant strain from past treatment than combinations of truvada + an NNRTI. So if this is your first combination and your virus did not carry drug resistance mutations prior to treatment a switch may be possible.

Some of the things to think about with Complera: Have to take it with a good meal (but not a protein shake- take with something you have to chew).

Avoid antacids (antacids should be administered at least 2 h before or at least 4 h after rilpivirine) and do not use with PPIs (proton pump inhibitors).

Common side effects include: insomnia and headache.

Rilpivirine seems to work best when the viral load was less than 100,000. This may be less of an issue since your virus is already suppressed and the medicine just needs to maintain it. Although there have been no studies on switching people over to Complera from other combiniations.

So there are a few things to think about.

Best, Joe



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