May 6, 2004
A friend had to stop efavirenz due to persistant side effects. He switched to nevirapine but had to stop that due to rash (it was not SJS). He can't recall if he did the 2-week ramp-up (since he doesn't recall it, I would guess he didn't).
Is there any use in rechallenging with nevirapine? Studies I've read say no, but I thought perhaps if he tried it again with the ramp-up, it might work. He'd rather not do a PI, but that seems his only option if the NNRTIs are out.
Response from Dr. Henry
If the nevirapine reaction has mild without any liver reaction I have occasinally re-challenged the patient (though I usually don't stop nevirapine for mild rash in the first place but follow carefully). Many docs would go to a PI and then once suppressed maybe try something like Trizivir + Viread if that suits the situation and there was interest in not being on a PI for the long term. KH
What exactly are the symptoms of high insulin, insulin resistance and very high normal glucose levels?
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