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Time Zones and Meds
Apr 20, 2005

Great site :)

Quick question: I am currently taking Truvada in the am (usually between 6 -7 am) and Sustiva in the pm (between 8-9). In july, I am planning on going to Europe and will spend almost a month there. Given that they're 8 hours ahead of central daylight time, I was wondering how to best take my meds. Given the half lives of the meds do I just switch, or do I gradually change. If it helps, I have had a great response (undetec., 38%, 800+ t cells) to the meds. Thanks :-)

Response from Dr. Sherer

The simple answer is to do your best to maintain an every 24 hour schedule with both pills according to your body's 24 hour clock, for which time zones are irrelevant. They simply confuse our schedules, and, of course, schedules are critical to steady adherence.

There is only an 8 hour difference. If you gradually adjust 1-2 hours per day, it will take you a week to return to your usual dosage times.

In general, if you are going to err (i.e. an interval greater than, or less than, 24 hours), err on the side of intervals LESS than 24 hours.

Here's how it might work, with a US departure at 6pm, assuming an 8 hour flight:

US Time Europe time day before flight TRV 6am / EFV 8 pm 2pm /4am (next)

day of flight TRV 6am / EFV 8 pm 2pm / 4am (nxt d)

day after flt TRV 1pm / EFV 2am

2nd day after flt TRV 12 noon /EFV 12 MN

3d day after flt TRV 10 am / EFV 10 pm

4th day after flt TRV 8 am / EFV 8 pm

5th day after flt TRV 6am / EFV 8 pm

And, of course, you would need to reverse the process with your return to the US.

As always, I suggest that you talk to your doctor about these concerns.

Backbone of therapy gone now what?
Viread/3TC versus Truvada

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