MEDICATION TIMING - HOW MUCH PRECISION NEEDED? ( ATRIPLA AND FOOD, 2011) (EFAVIRENZ AND FOOD,2011)
Aug 31, 2011
Dear Dr. Frascino, I am under treatment for six months (tenofovir+lamivudina+efavirenz) with excellent results. No side effects at all and undetectable VL with increasing CD4. However, you might help me with some doubts which cause me a lot of stress: 1) I usually take Tenofovir+Lamivudina in the morning and my doctor says it must be on full stomach. I do my best but my job hardly allows me to have breakfast (or any meal) everyday at the same time. I do a lot of travelling. How serious is it to take those two meds on an empty stomach like twice a week? I guess timing is more important than the full stomach so I try to be precise on the timing even if I have to take them on emtpy stomach. My doctor insists on both and this is causing me a lot of stress. 2) Regarding timing, would you consider a window of plus/minus 30 minutes OK for all these 3 medications? A few days ago I found myself almost having a car accident by speeding because I had left meds at home and I am wondering whether this is really necessary. Many thanks in advance for your advice.
Response from Dr. Frascino
Are you working with an HIV specialist physician? I ask, because the advice you are getting is not accurate.
2. These antiretrovirals (like most others) have a reasonably long half-life. (Efavirenz has a very long half-life.) Exact timing for dosing is not critical. You can certainly be several hours early or late without compromising the efficacy of your regimen.
You might want to consider hooking up with a more knowledgeable HIV specialist physician.
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