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Truvada, Norvir, Prezista - taking late

Feb 5, 2017

Dear Doctor, since 8 months I am on Truvada, Perzista, Norvir. Undetectable. I always took my combo + - 10 mins. Last month I took my pills late twice - 1 hour late, second time 2 hours late.. I heard that Prezista must not be taken late because of developing resistance easily Should I be worried to develop a resistance ? Thank you.

Response from Dr. Young

Hello and thanks for posting.

You have nothing to be worried about.

Yours is a very commonly held misconceptions about modern HIV medications- that they must be taken with stopwatch precision.

In your question is the essential issue- that taking medications 1- or 2 hours after your usual time is "late". It's not late at all. HIV medications today are dosed either once- or twice-daily, not every 24 or 12 hours. That means that as long as you take your meds once a day you'll not non-adherent, nor are you "late". I typically tell my patients that as long as you're within 12 hours of your usual time (for once daily meds: ie., 1/2 of the dosing interval), you're fine. After that, it might be "late", but it's still generally ok.

Remember that if you take your meds 90% of the time, there's no apparent difference in viral suppression rates. That's one missed dose in ten. If you appreciate this observation, you should be able to readily understand why being off by 1 or 2 hours (never mind a few minutes), but otherwise on target, that there won't be a problem.

Last, treatments that use boosted protease inhibitors, like darunavir (Prezista, part of Prezcobix) rarely, if ever, cause drug resistance.

I hope that's helpful, BY



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