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the quad vs complera

Oct 10, 2012

I have decided that it is time to drop atripla and move on to either complera or the quad. I hear that complera isnt as strong as the quad and i also hear that the quad isnt really a quad bec it uses 3 active ingredients and 1 booster. And needing a full meal with complera will be a hassle as after 10 yrs of taking meds at bedtime, I prefer to keep this routine. My ID doc likes the quad bec of the hassle of full meal with complera. I do what I think is best based on the experts like you.. which one would you choose considering vl never was high and has been < 48 since first med during the viracept days. ?

Response from Dr. Young

Hi and thanks for posting.

Both Stribild ("quad") and Complera are listed as Alternative Regimens in the current US DHHS Treatment Guidelines. Complera is less potent when used to initiate treatment in people with high viral loads and should be used with caution in this circumstance. One study presented last year showed that it is generally safe to switch from Atripla to Complera- such switch data haven't yet been presented on Atripla to Stribild.

The meal requirement for Complera can be problematic, but be mindful that Stribild should be taken with food, just not the full meal.

If you're currently intolerant of the efavirenz part of Atripla (not a rare occurance), either switch is acceptable, but the other factors, such as side effects or dosing restrictions will (as you point out) affect the final decision. This is also a very good time to make sure that the tenofovir part of Atripla is also right for you-- do you have any evidence of kidney or bone problems? If so, it's worth considering whether a bigger switch of medicines in indicated.

Overall, I'd think that in your situation, a monitored switch to Stribild would seem to be a very reasonable thing.

Be well, BY

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