Hi, I live in Thailand and am travelling to The US in ten days time (Florida). I take Truvada and Sustiva every night (Thai time) at 9 pm before going to bed. There is an 11 hour time difference. My doctore here suggested that i adjust my dose by an hour a day so that when I arrive in The States I'll be taking my medicine at 9 pm Local. Would you think this is reasonable or should I just continue to take my meds at 9 pm Thai time (10 am Florida time). I plan to be in Florida for 5 weeks. Your opinion would be greatly appreciated.

Frank

Dear Frank,

You certainly can make the gradual adjustment, but if your viral load has been suppressed and you will be here for an extended period of time, I would just make the switch on the day your arrive...keep taking it at 9PM (US time). On the day you arrive you will be a few hours behind, and when you return you will be several hours early, but that will not cause any significant toxicity or risk for your meds. The meds are not cleared that quickly so there is some "forgiveness" in the dose timing. Also having 2 doses closer together will not be toxic, the levels will balance out again quickly.

Best, Joe