Hi, first of all thanks for the time and support you guys give to us. It is invaluable.

I have a couple of questions about taking Atripla and would like to know if I am doing anything wrong.

1. I usually take my medication between 1-2am and am usually very good with this. Is this a tight enough window?

2. As directed on the instruction sheet I don't eat 2hrs prior to taking but sometimes I might eat maybe 45mins after. Is this OK? How important is the food guidance?

3. I have been reading the site tonight and for the 1st time ever I got so enthralled with the reading I missed my normal time by 1hr45mins. Is this something to worry about?

4. I sometimes find myself (maybe 2 times per week) taking my medication after a night out drinking or even while drinking alcohol (mostly beer). Does this reduce the effect of the drugs in Atripla or does it not matter?

Thanks in advance and sorry if these have been answered before but I have been reading "The Body" now for some 4 hrs and don't have the concentration to continue to find the specific answers.

First, I urge you talk to your doctor about these questions, as physicians can differ in their interpretation of the same data.

The requirement for food with efavirenz is due to HIGHER, not lower, plasma levels of EFV in the presence of food. My answer to this question depends on whether you have had any significant side effects with EFV. If not, then I would not be too concerned with this recommendation. However, if you do take your EFV with food in future, and you notice a greater degree of side effects such as dizziness or insomnia, then I would return to using it with an empty stomach.

In general, I advise patients to stay within 2 hours of dosing every 24 hours, so you are staying within that window. One of the advantages of the three drug combination in Atripla is that each drug has a prolonged half life in the plasma, well in excess of 24 hours, so minor variations in dose timing are unlikely to impact the level of drug in the serum.

There is no interaction with alcohol; the problem with alcohol is that it causes dis-inhibition, and often makes discplined people do undisciplined things. If you are only having 1-2 beers and otherwise staying smart about taking your medications on time, you should be OK. Just remember that smart people do stupid things on drugs or alcohol.

As above, talk to your doctor about your concerns and these observations.