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Interrupting Atripla treatment
Apr 16, 2010

I have been on Atripla for 2yrs and currently have an undetectable viral load and cd4 count around 400. My CNS side effects are now 24hrs a day, and have been for about a month. Not sure if the cause is the Atripla I consulted my Dr about stopping treatment for awhile to see if the symptoms (foggy/light headed, sluggish) will go away. He prescribed 2 days worth of Truvada to take once I stop the Atripla since the Sustiva has a longer half life than the other two components of Atripla. Is two days of Truvada long enough? I've been reading online that Sustiva can last a week or two in the system after you stop taking Atripla. Should I go back to my doc and have the prescription changed?

Response from Dr. Henry

There is no well defined duration of therapy for covering the efavirenz "tail" when stopping Atripla (depends on the half life of efavirenz in the blood for a given patient=can vary widely). I have seen 2-10 days used in that setting. An alternative strategy would be to switch off the efavirenz to an alternative depending on treatment/resistance history (such as nevirapine, a boosted PI, or raltegravir). KH

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