Switching PEP Meds Dangerous?
Feb 22, 2012
The following is my timeline on PEP treatment. The original doc put me on efavirenz which is not recommended for PEP anymore, and a cheap generic version of Combivir. I requested a protease inhibitor but she did not give me one. The 2nd doc fixed my Combivir brand and put me on a PI (Kelatra). Even though I nailed my first tablets at only 8 hours post exposure, I was on *no* protease inhibitors until well near 40 hours. Very frustrating. Can you comment on any reduced effectiveness both from taking the wrong thing, and from switching medication brands (while dropping efavirenz) ... all at such an important stage? My exposure was 2 back to back exposures of unprotected insertive vaginal intercourse with an HIV positive female.
3:00pm Sunday Feb 12.
-------- FEB 12
11:00pm (8 hours) took: Efavirenz (600mg) + Zilarvir (150/300)
-------- FEB 13
10:00am (19 hours) took: Efavirenz (600mg) + Zilarvir (150/300)
10:00pm (31 hours) took: Efavirenz (600mg) + Zilarvir (150/300) 11:00pm (32 hours) took: Kaletra (100/400)
-------- FEB 14
11:00am (44 hours) took: Combid + Kaletra 11:00pm (56 hours) took: Combid + Kaletra
Response from Dr. Hightow-Weidman
Hello there- While there isn't a lot of data specifically on efavirenz use as PEP, I'm not aware of any reason why it would not be active especially in the context of a three drug regimen. I think you therefore have been on an active PEP regimen since your exposure and are covered. I would continue for the complete 28 days. Take care,
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