Dear Dr.

I am going to Mexico for 5 days and wonder if there is any harm in stopping all meds for 5 days.. current CD4 1100 and UD viral load for many years.

Also can you take all 4 Kaletra pills at once or will you get more side effects that way or is it better to split the dosage.

Thanks in advance.

Hello and thanks for posting.

I generally don't recommend treatment interruptions unless there are extenuating circumstances or medication intolerance. Part of the reason for this is risk of rebound virus (and associated symptoms) as well as the possibility of developing drug resistance (though low if all medications are discontinued). Longer term discontinuations of HIV medications were associated with increased risk of complications and all-cause death in the huge SMART clinical trial.

As for dosing, if you're currently taking and tolerating Kaletra dosed twice daily, there's little problem in taking all of the pills once daily. The once-daily dosing isn't recommended for people with significant drug resistance, and is associated (in treatment naive persons) with a somewhat greater risk of GI side effects.

I hope that helps. Buen viaje, BY