I'm a 61 YO male, diagnode about 2 months ago. My doctor put me on Atripla, which I have just completed the firat 30 days with no side effects that I can tell. I know Atripla is to be taken at bedtime without food, and at least two hours afrer eating. I'm very careful to plan meals so that I have eaten my 7PM just about every evening. I take the pill anywhere between 9 & 10PM with bedtime usually being around 10:15 or so. How critical is this medication as far as maintaining this schedule. Does without food mean no snacks at all with two hours of taking it, a cookie and glass of milk or a piece of fruit between dinner and bedtime? Is there a specific time window that I have to adhere to on a nightly basis. I worry that there will be times when I am with friends or family and because of circumstances beyond my control, I may have to eat late, or may be later than normal taking my med. Just how critical is this stuff? I'm not a heavy eater, don't smoke, don't do recreational drugs, am an extremely light drinker, and I eat reasonably healthy, so except for the HIV, I'm generaly pretty healthy..

The drugs in Atripla have a long half-life (drugs stick around in blood for > 24 hours) so there can be modest variation from day to day as for as timing of dose without much worry. The issue with the recommendation to take on empty stomach comes from concern that food (particularly fatty foods) can increase the level of efavirenz leading to greater risk for side effects (would be just or even more effective). Some patients don't have much in the way of side effects even with higher blood levels of efavirenz so for those patients taking with some food isn't much of a problem. KH