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Switch from tenofivir due to kidney problems
Aug 24, 2012

I've been on atripla for 3 years & love it, but now have to switch because of kidney issues. I can't take abacavir due to previous allergic reaction.

I'm concerned because atripla is a "preferred" treatment - strong, easy to take, few side effects. What would be some typical combinations for patients with kidney issues?

Thanks for your help.

Response from Dr. McGowan

We sometimes have to use combinations that are not on the "preferred" list, but it does not mean they will not work. They may be better suited for people with specific needs (like kidney issues) or require more pills, etc.

Assuming that there is no drug resistance in your virus, it may be possible to combine drugs from the protease inhibitor class (such as ritonavir + darunavir..which can be once a day, and is a "preferred" drug), with the non-nucleoside class (such as efavirenz, which you are already on), and/or with a CCR5 antagonist (maraviroc, you would need a special "DNA tropism" test since your virus is undetectable to be sure this med wouold work). These classes would be safe in people with kidney funstion problems. May avoid atazanavir (Reyataz) as it can cause kidney stones.

Best, Joe



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