|Switching from Atripla
Feb 19, 2012
Atripla is quite expensive in my country while all other meds are free. I also get drowsy from atripla, not sure what combination is causing that.Can I safely switch from atripla to another combination ?. My CD4 is 560 Viral Load Undetectable. I asked one Doctor about this and he told me I would have to take about six different tablets if I switched. I'm suspicious because he is selling me the Atripla. If I can safely switch whic is the best combination ?. Regards
| Response from Dr. Young
Hello and thanks for posting.
Among the medications in Atripla, the efavirenz part is most likely to cause sleep and/or mood problems. If your symptoms off drowsiness are not attributed to any other causes (such as depression, sleep apnea) and if affecting your quality of life, a switch from efavirenz to another medication might be worth considering.
Depending on where you live, the available options might vary. It would be most reasonable to continue the other 2 medications in Atripla (tenofovir and FTC) if there's no evidence of toxicity (mostly limited to kidney and bone issues).
Efavirenz could safely be replaced with a variety of medications; the NNRTI nevirapine could be an option available to you (so long as you don't have active liver disease); other considerations would be a protease inhibitor or the integrase ihhibitor, raltegravir (though this is generally not available for first-line use in many countries).
Most of these switches should be safe, especially since your viral load is undetectable- this suggests that you don't have any significant issues with drug resistance. No matter what, monitoring your symptoms and labs after a switch is always a good idea, just to make sure that the expected actually happens.
I hope this brief discussion is helpful, BY
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