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Improving mobility by increasing daily dose of DMP 266 (Sustiva)
Sep 22, 2000

My current drug regime consists of AZT, DDI, and DMP266.

When I first started with DMP266, I took the recommended 3 tablets (600mg)daily. I have severe walking difficulties caused by HIV related brain disease 4 years ago (before I started any therapy), and the introduction of DMP266 improved my mobility significantly.

Gradually the effect lessened. I increased the daily dose to 800mg, and the same thing occurred - initial improvement, then a return to how it was before.

I have now asked my doctor, and the pharmacist, if I can increase the dose to 1000mg per day to see if this will maintain my mobility. They have no idea, and do not know even if taking this much of the drug will be harmful.

Can anyone help at all?

Response from Dr. Stryker

You are already on a high dose of DMP-266 (now known as efavirenz, or Sustiva), and I think it would be unwise to continue pushing the dose. Probably no extra benefit, and certainly the possibility for additional side effects and drug-drug interactions. You don't say what kind of brain disease you have, but if it is HIV-related (not an opportunistic infection) than you are probably getting enough coverage from efavirenz already. Discuss other possibilities with your neurologist. Best, RAS

Rick Stryker, M.D., M.P.H.

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