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switch from atripla to stribild
Dec 19, 2012

Hi, Ive been positive for 2 years now.... cd4 642, vl undetectable for the last 3 readings (every 3 months) except this last one my vl was 30... my doc said it was a blip... but talked to me about switching from atripla to stribild because I still feel wacky on the atripla.... I definitely still dream heavily and wake up just feeling either amped up or really hungover because I really dont shut off when i sleep... all other of my bloodwork is in normal ranges... my doc said this is the newest one pill regimen, and providing my insurances and adap pay for it... is it worth the switch in your eyes?... what are the pros and cons?... and can i switch back to atripla since its worked the last 2 years if I dont do well on it.... just trying to get second opinions...thank you

Response from Dr. McGowan

Sorry to hear about your ongoing symptoms.

Changing medication because of side effects is a very valid reason. After all, we expect you to be around for a very long time. It is best to have medication that you can live with. As new treatments become available, it is useful to see if they offer any advantages. In clinical studies, the medicines inside Stribild caused much lower rates of the nervous system side effects and sleep problems that you describe getting compared with Atripla. So from that point of view it looks good.

The meds worked equally well in getting the virus under control. It is likely that if Atripla has been working that your virus would not harbor any resistance to Stribild either so that should also be fine.

A couple of things to be aware of: 1) Stribild can cause different interactions with other medications that you may be taking (in addition to your HIV meds) than Atripla does. So your doc needs the full list of everything you are taking to look for interactions. 2) Unlike Atripla, which should be taken on an empty stomach, Stribild should be taken with food. 3) Stribild can effect the way your kidney function is measured on blood tests. This is something your medical provider will have to assess on your blood tests. 4) You should not take antacids within 2-4 hours of taking your Stribild (it can interfere with it's absorption from the stomach).

No, if you switch and don't like the Stribild, you can always go back to the Atripla....just as long as you don't miss any doses during the transitions.

Best, Joe



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