Cramps and Joint Pain
Apr 16, 2008
I recently started Atripla (2 1/2mo) . I have been on HIV meds for 10 yrs with little side effects but my ID MD said I might get some benefit from the Atripla. I am undectectable and my CD4 is 610. I have horrible, detailed nightmares and terrific muscle cramps. She thinks these my subside with time..Whats your thoughts. I am not getting a lot of sleep and feel bruised in my legs and upper arms all day. Thank you
Response from Dr. Henry
If the nightmares and cramps started when starting the Atripla then one of the components of Atripla (most likely the efavirenz) is very likely contributing to your symptoms. For most (> 90%) efavirenz related bothersome side effects diminish after the first 4 weeks. After 10 weeks if still persisting then you may be one of the unlikely ones with persistent problems. You could check the efavirenz levels to see if they are running high (in which case a dose reduction might need to be considered with stopping Atripla and dosing the individual components separately). A monitored trial of switching components (such as a boosted PI for the efavirenz) often can pinpoint the problem while resulting in a suitable alternative. KH
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