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how to switch from efavirenz to atazanavir

Apr 29, 2012

My name is Anthony and I leave in Mendoza, Argentina. I have been taking Atripla since I was diagnosed in 2009 and despite the great lab results - I am undetectable and my CD4 count is 720, I am considering switching to Reyataz due to serious side effects from the efavirenz -a major depression. I heard that efavirenz remains in our body for several days/weeks after we stop taking it and my question is related to how exactly proceed to switch therapies: Should I stop taking efavirenz and take only Truvada for a few days then start taking it together with atazanavir&ritonavir or should I start with Reyataz&Norvir right together with Truvada the day after i stop taking the efavirenz? Thank you so much for your help. Anthony

Response from Dr. McGowan

Dear Anthony,

Sorry to hear about the depression. Yes, efavirenz (which is part of Atripla) can cause or worsen symptoms of depression.

The best way to switch would be to do it right away. If you took the Atripla last night, just start the Truvada, Norvir and Reyataz today. The efavirenz will wash out of your body over the next few days, but the virus will be blocked by the new meds.

The only time we give a few days of truvada alone after stopping Atripla would be if someone were stopping for a serious side effect (such as a bad rash) and wasn't planning on staying on meds. Since you are changing for long-term management it is best to make the switch straight away and don't give a chance for the virus to break through.

Best, Joe

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