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Timing
Oct 12, 2004

I am un succesful treatment with Stocrin and Combivir; With the exception of one big blip (VL: 800), I have been undetectable (<20) for almost 4 years now, and the CD4 count has risen from a set point of 130 to 550-600 (and still rising slowly). I usually take the Combivir before going to work at 8:45 AM. I usually take the Stocrin and Combivir just before I go to bad (usually around 10:30 to 11:30 PM), as the Stocrin often causes me depression and tiredness if I take it when I'm awake. Consequently, there can be up to 15 hours between the two doses of Combivir - is that okay?

Response from Dr. Sherer

My answer would be affected by knowing for how long you have been following this schedule. If for a long time, as you imply, it seems that your answer is yes, what you are doing is OK, judging from 4 years of good control of the virus and rising CD4 cells. While combivir is to be taken every 12 hours, the drugs act intracellularly, and minor schedule disruptions are usually not a problem.

On the other hand, if this pattern is more recent, then I would be more cautious. Your options would be to take the second combivir arond 8pm, and still take the stocrin before bed, or start the regimen in the morning later (eg 10-11am). There may be obstacles to either of these alternatives for you that I am unaware of.

I suggest that you talk to your doctor about this question.


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