May 11, 2002
Dear Doctor 41 years old, HCV+ HIV+(naive), Cd4 240, VL 190000. No opportunistic infections present. First therapy since 10/04/2002 with Zerit 40mg daily(40mg x 2),VidexEC 400mg(x1)daily, Sustiva 600mg at bedtime, Xanax 0,25mg daily. Side effects of new therapy: vivid beautilful dreams and nightmares, little dizziness early morning, sensation of out it (like psychedelic down drugs)for 1-2 hours, anxiety,stomach discomfort/burning/bloated after Videx. No problem, i known that are side effects of initial teraphy(I hope), but anxiety is very unbearable.
Now, have some questions: 1) Xanax(alprazolam) increase or decrease Sustiva blood concentration? 2) What are the bensodiazepines suggestion (short or long activity?) to lock anxiety from Sustiva side effects? 3) Ginseng have interaction with Sustiva? 4) Stomach Antacids (e.g Omeprazole,Ranitidine) are suggestion with Zerit,VidexEc,Sustiva meds?
sorry for my bad English. Marcello
| Response from Dr. Henry
I often recommend trazadone (25-50 mg) at night for the Sustiva side effects. Lorazepam 1-2 mg also can be helpful in the first 1-2 months. Xanax can work also. I don't recommend antacid use with the medications. Gingseng can worsen agitation or trouble sleeping (especially when used with caffeine) so I would be cautious using it with Sustiva as long as you are having Sustiva side effects. KH
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