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Third try to find the right combination
Jul 28, 2013

Hello Dr Young. First of all I'd like to thank you for the quality of your work and your availability. There are no such ressources as the body in my country and your ask the experts forum is really quite helpful. Now, I was on Atripla for about 7 weeks and had to stop it (depression, fatigue, insomnnia, lost 15 pounds, etc.). I've been on boosted Reyataz and Truvada since then (about 6 weeks). I've kept the insomnia and tiredness thing and I also have to urinate 3 or 4 times per night (weird side effect I guess) but it was overall better... 5 days ago I began to have jaundice (both eyes and skin) and developped a fever + headaches and sensations of heat/heavy sweating. I phoned my specialist who is considering changing my combination again. Apparently she thinks about Prezista (boosted) and Truvada OR Isentress and Truvada. My questions : - do you think the symptoms I've had for a few days can be related to Reyataz ? - have Isentress or Prezista side effects on insomnia, anxiety, heat intolerance or hyperhydrosis ? - which treatment would you recommend (I'm only resistent to Eviplera/Edurant) ? - and lastly : could my problems be in fact related to Truvada ? I apologize for this very long message and thank you if you take the time to answer it.

Response from Dr. Young

Hello and thanks for posting.

1) The jaundice that you're experiencing is almost for certain a side effect of the Reyataz.

2) Prezista isn't associated with any of these side effects, though insomnia is a rare side effect of Isentress.

3) Either of the regimens you've listed would be very highly recommended regimens. You'd choose between a once-daily, diet requirement (Prezista) and twice-daily (Isentress) regimen- we've had excellent results with both.

4) You're thoughts are comprehensive- if after a third round you're still having some of the effects, you'd have to suspect the other medications in the regimen.

Be well, BY

Stopping medications for a couple of months?
Wait until rash goes away to start treatment?

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