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Missed 2 Doses Of Atripla - REALLY Stressed Out!
Jan 4, 2012

Hi Dr Ben,

Greetings from Australia and compliments of the season to you.

I'm not sure if this is the right forum, but you've kindly answered a question for me in the past, and I hope you can do the same now.

I have been in Atripla for 4 years now, and undetectable every test since starting it. I also have 100% adherence to my meds, having missed 1 dose in that 4 year period.

However, at Christmas time, I went away for a 2 night break and in the excitement of things, forgot to pack my meds. I have NEVER done anything like this before - let's put it down to human nature, and yes, I have learned from the experience.

Because of where I was, there was no access to any Atripla, so consequently I had to miss 2 nights doses.

The last dose I took was on a Friay night at 11.00pm, and the following dose was as soon as I returned home on the following Monday at 8.00am. Therefore that's 57 hours between doses.

I'm really disgusted with myself after 4 years of being pretty-much perfect, and I'm terrified that all the work of the past 4 years will be undone by becoming resistant.

What do you think the chances of that happening are? I know the half-life of Atripla is quite long, but is a 57 hour break cutting it too fine? Madly Googling online has shown me the FOTO study (Five on, Two Off) which gives me hope, but I was wondering your opinion.

My next regular labs is scheduled for two-and-a-half-months time, is it ok to wait until then to see if anything's gone wrong?

Many thanks if you can offer an opinion, and thanks for all the great work you do here. Stressed in Oz!

Response from Dr. Young

Hello Stressed and thanks for posting from Australia.

I wouldn't stress over the two missed doses. If you're viral load was undetectable prior to the misses, there's little risk. As you point out, the FOTO study suggests strongly that the brief interruption is unlikely to cause any problems.

I'd not worry; just get your labs at the routine time.

Be well and Happy New Year. BY



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