Dec 28, 2006
Dear Doctor Bob,
I have a couple of questions for you.
I am currently taking Sustiva and Combiver as my regiment. But for the past year and a half my Triglycerides and cholesterol have sky rocketed. I have tried several drugs to lower them but no luck and now there going even higher.... I need help & Advice. My Triglycerides are now 1,300 and cholesterol is 345 I am a 41 year old male and I do not want heart problems. So My doctor and I have talked about changing my regiment to Viramune and Epsicom my question is: Stopping the Sustiva and Combiver cold turkey and starting up on the new regiment is that a good thing or bad? I know there in the same class of drugs as my old regiment any advice you may have to help me lower both of these?
Response from Dr. Frascino
With triglycerides topping 1300 and climbing, I would worry more about pancreatitis than heart disease at the moment.
Regarding your regimen change (Sustiva plus Combivir changing to Viramune plus Epzicom), assuming your viral load is well suppressed, you should be able to make the change without difficultly. If your viral load is not completely suppressed, I'd suggest getting a resistance test to help select your next regimen. You may well have many options open to you, including all the protease inhibitors and many nucleoside reverse transcriptase inhibitors (for instance, Viread, which is Truvada plus Emtriva).
My advice regarding your markedly elevated triglycerides and cholesterol would be a consultation with a nutritionist to optimize a low-fat, high-protein diet and to use fish oil in addition to lipid-lowering prescription drugs.
Good luck, Buster!
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