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Adherance
Sep 5, 2002

Hi. Thanks for this forum. It has been an incrediable help to me.

I am on a Sustiva, Epivir, and Viread combination. I take the Viread and Epivir together at dinner and the Sustiva two hours later (food w/Sustiva makes me "buggy"). I keep my adherance within a two hour window. I take my Viread with dinner and with some fat. Is this cool? How much fat does Viread need and what does "same time daily" mean? Is taking my Viread/Epivir between 5:30 and 7:30 okay or should I take it to the minute.

I've read that Viread and Sustiva have a long half life. What does that mean? I assume it means that they remain in your system for days rather than hours. I also read that the virus can develop resistance to Sustiva (and Epivir) very quickly (depending on adherance.) I would have thought a long half-life would cause the opposite.

Since I hope to ride this combo for years to come I really want to understand it and do it right. Thanks. I've read alot but nothing seams to get this specific.

Response from Dr. Little

It sounds like you are doing fabulously well. Adherence to a once daily pill schedule is actually quite a bit easier with regard to the exact time you take your meds each day. While this is not based upon any scientific study, I would guess that if you take your meds at roughly the same time (plus or minus 2 hours) each day, you will do extremely well. The big issue with a once daily regimen, is that any missed dose now represents your entire dosing of drugs for that day - which may have a much greater impact than a single missed dose (out of two doses a day) in a twice a day regimen, which represents only half of the total day's pills missed. With regard to the fat - if you are eating a typical "Western" diet, it is hard for me to fathom that you are not getting enough fat in your diet to promote adequate absorption. You could certainly review this with a nutritionist locally, or on this web site. Keep up the good work.


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