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PEP regimine with Sustiva
Aug 8, 2007

Dr. Bob, Thanks for your great column and all that you do. I am on my second day of PEP which started 48 hours after the condom broke while have anal sex (topping) with a guy of unknown status. My regimen consists of 300mg Epivir once daily, 300mg of Retrovir twice daily and 600mg of Sustiva at bedtime. I've read some pretty bad things about Sustiva and am concerned about possible side effects. Could you recommend and alternative drug? If so, would if lessen the effects of the overall PEP if I switched out the Sustiva after a few day?

Response from Dr. Frascino

Hello,

There are a variety of PEP regimens to choose from. However, the choice of a regimen depends on many factors, including drug allergies, number and size of pills, dosing schedules, food requirements, resistance profiles of source patient (if known), etc., etc., etc. That is why I recommend anyone who has had an HIV exposure significant enough to warrant PEP be, if possible, followed by an HIV specialist. The HIV specialist will document actual degree of risk, optimize or change the PEP regimen if needed or desired, evaluate and manage any PEP-related side effects or toxicities and arrange for and interpret post-PEP HIV testing.

We have found this type of service improves PEP compliance and tolerance, avoids unnecessary tests and alleviates many causes of concern and worry for the person taking PEP.

At the Frascino Medical Group, this service has been a great benefit to both community physicians and patients.

Dr. Bob



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