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kaletra truvuda timing
Dec 19, 2006

Hello,

I recently had to switch my regimen from combivir/sustiva to Kaletra/truvuda. I have been having trouble sticking to a 12-hour interval in taking my daily doses. (I take 3 caps of Kaletra 2 times daily and 1 tab Truvuda once daily).

Part of the reason is because of the refrigeration and food requirements of Kaletra (tablets not yet available in my country).

I usually try to take my AM dose of Kaletra before leaving for work, around 7am. My evening dose is taken usually between 8pm and 10pm, however. (depends on when I arrive home after work). I take Truvada in the evening.

Weekends are also a challenge for me, but that is moreso because of a desire to sleep longer, but I do sometimes attempt to wake up early, eat something small, take my meds, and then sleep again if needed. Typically, I take them between 8 and 9am on the weekends.

What do you advise for taking these meds? Should I take my Truvuda in the morning as it is easier to keep the same schedule? should I make sure to wake up every day even if it is not a working day to take my AM dose?

Also, where I live it is sometimes very hot, so I worry about keeping my Kaletra meds out of the refrigerator for too long...

Will this irregularity in taking my medicine cause resistance? While on my Comb/Stocrin regimen I took the meds at 10am and 10pm, which worked well, but those meds did not have a food requirement.

Thank you very much for your help.

Response from Dr. Daar

Your life will get much easier when the Kaletra tablets become available to you since with these the need to take with food is reduced and there are no temperature issues for storage. In the interim it is important to note that there is considerable flexibility with regards to when Truvada and Kaletra are taken. While ideal for the Truvada to be taken at the same time each day, in all likelihood being off even by several hours would not be a big problem. In addition, it would be fine if you wanted to switch the timing of Truvada from evening to morning. Similarly, Kaletra can be taken every 12 hours, but if you are off even by several hours it probably will not result in emerging drug resistance. I would argue that you should do the best you can with the timing, but the most important thing is that you take the Kaletra twice every day. For this drug a missed dose is probably a bigger problem than whether it is every 12 hours versus 10-14 hours.

Best, Eric


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