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Severe allergic to Sustiva - whatabout others in the same class?
May 4, 2011

Hi Dr. Henry,

I began ART with Isentress and Truvada about 2 months ago and was doing well. VL was fully suppressed from 20k copies within 3 weeks. But I switched to try Atripla because of the ease of taking one pill. Now I developed severe rash allergic on Day 8 (no CNS side effect though). I kept taking it for the next two nights but in the end I had to be taken off the med. MY doctor thinks I am allergic to the Sustiva component in Atripla. I am going to go back to Truvada and Isentress for now.

Long story short I have to relocate to outside the US soon and drug availability and affordability is limited. My question is that if I am allergic to Sustiva, will I likely be allergic to other drugs that belong to the same class? I hate to be using the older-generation meds because of the other side effect.

Can you recommend a combination of Truvada plus something else that should work to keep my virus suppressed. The Isentress, for instance, is too expensive for me to afford the medication. Thanks a lot.

Response from Dr. Henry

Many patient who were intolerant to efavirenz can take nevirapine which is in same class and often available outside the US at a reduced cost (sometims generic). You may want to discuss with your HIV doctor to see if a trial switch to nevirapine with observation may be worth considering. Rilprivine (another drug is same NNRTI class as efavirenz) combined with Truvada is under study as a one pill a day drug but likely would be more expensive than the nevirapine option. KH

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