Re: Atripla, sleep disturbance, and switching
Nov 19, 2010
Thank you for your answers dated Nov 10. I have been a walking zombie for the last few months because of lack of sleep. It seems like its time for another change of medication. Out of these three combinations what are the pros and cons?
I have slightly elevated liver enzyme and also L33I and L33F mutations. My adherence so far has been 100%. I know the first two are considered first line treatment in the US. Does it mean that they are less toxic and/or have fewer side effects?
Response from Dr. Henry
I would generally recommend option # 2 on a trial basis to see how your brain side effects evolve. That option has highest barrier to resistance and is generally well tolerated. Nevirapine (# 3) would be my 2nd choice but there is a low risk for serious skin problems during first months so careful observation recommended. KH
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