|Emtriva+Sustiva+Viread... Food or no food?
Aug 5, 2004
Now, at the last minute, just as I was getting my first Rx for this combination, my doctor changed his recommendation to Emtriva+Sustiva+Viread. He said I could take all 3 pills before going to bed (11:30pm) so that the effects of the Sustiva are minimized. He also said that 2 of these pills will soon be comined into one making it a 2-pill regimen.
When I shared this with the treatment advocate, he was puzzled that my doc didn't recommend taking the Viread at mealtime as recommended.
Would it be acceptable to take all 3 pills at bedtime? Is this a combo you would endorse? My latest #'s on May '04 were 166/11%/55K, a gradual decline over the last year (July '03: 323/18%/93K).
P/S... This website and your personal attention to your "online patients" is an awesome resource which has provided me with lots of information and assurances! Thanks!
| Response from Dr. Conway
Thanks for your kind comments about the site.
Food alters the drug levels of Viread in a complex way. If a high fat meal is consumed, then the overall drug exposure is increased by up to 40%, with a delay in the time to achieving a peak level and a much slower clearance of the drug. Interestingly, the peak drug concetration is only increased by 14% or less. If a smaller meal is taken, then there is little or no effect on drug levels.
So, in practice, given that:
-food does not alter peak and trough drug concentrations that much -the effect is only seen with a heavy, high fat meal -we have such a good therapeutic margin with the Viread to start with
...we do not worry so much about giving Viread with food, at least in our centre.
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