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Can I Take Raltegravir once a Day ?
Apr 20, 2016

Hello I use Truvada Reyataz Ritonavir and Isentress. I Know raltegravir is twice but I Take it once With the others pills. So my plan is strong simple easy and effective. Me viral load has been undetectable for the last 12 years. Thanks for your opinión.

Response from Dr. Young

Hello and thanks for posting.

You're right that raltegravir (Isentress) is currently approved as a twice-daily medication, as the older QDMRK study showed that when staring treatment, once-daily raltegravir didn't do as well as twice-daily. The difference wasn't huge, but big enough to no pass statistical or FDA muster.

Some doctors (including some highly respected ones in Europe) don't have too much reluctance in using Isentress once-daily (800 mg total), but between being conservative and having too many malpractice lawyers in the US, most American docs have not followed this path.

Part of the reason is two-fold, in my opinion. First, the availability of a once-daily unboosted integrase inhibitor, dolutegravir (Tivicay/part of Triumeq) has rendered the need to do the off-label, unrecommended once-daily dosing of Isentress somewhat moot. Second, a recent study show that a higher 1200 mg dose of Isentress can successfully be dosed once-daily; I'd expect the FDA-approval in the not too distant future, albeit as a two pill once-daily dosing.

So, in the end, I'd consider staying put with your current regimen (and dosing), wait for the once-daily formulation of Isentress; or if you really need to address the issue now, consider replacing Isentress with Tivicay.

I hope that's helpful, BY


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