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Is there any advantage from switching from Atripla to QUAD?
May 21, 2012

I just heard the FDA may approve the QUAD pill. Since this is a newer pill, it may be better than Atripla? Should I switch?

Response from Mr. Vergel

QUAD is a one pill taken once a day containing an integrase inhibitor (elvitegravir), a booster (cobicistat), and two nucleoside analogs (tenofovir- Viread and emtricitabine- Emtriva). It has been reviewed positively by a FDA panel for a potential approval in the near future. It will be the third one pill, once a day regimen in the market after Atripla and Endurant.

Many questions remain about QUAD. Studies have shown decreases in creatinine clearance (kidney function). It has not been studied in many people with CD4 cells under 200 cells/ml and women. We do not know all its interactions with other drugs used in HIV.

If you are doing well on Atripla without fatigue, anxiety, sleep problems, depression, I would not switch. If you are having side effects, talk to your doctor about the other two DHHS guidelines recommended "first line" regimens: Isentress plus Truvada and Boosted Reyataz or Prezista plus Truvada.

I should remind people that just because a drug is newer, it does not necessarily mean it is better.

Nelson Vergel



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