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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.

Exposure:

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

etc....

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,

LHW



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