Dear Dr. Sherer, I just started taking Atripla medication a week ago. Even though I am clear that it should be taken at the same time every day, is there an acceptable window (2-3 hours) that one could take the medicine without risking anything? Some (non HIV) medicine indicate that taking the prescribed medication within a 3 hour period is acceptable. Is this the case with Atripla? Many thanks for answering this.....
I discourage my patients from any extended duration between doses that is outside the prescribed interval, i.e. 24 hours with Atripla.
In my opinion, a single episode that extends an extra 1-2 hours would be unlikely to lead to resistance, but this cannot be said with certainty for all patients. There is a fair amount of variablity between patients in the drug levels that are achieved. Two hours may be of little consequence to one patient who has higher drug levels, but actually the same delay might lead to su-optimal drug levels in another patient who achieves lower average levels.
A larger concern is that if a patient is led to understand that such an interval is 'no problem', then this understanding may lead is patient to consecutive misses of that duration for several days in a row, which might lead to further reductions in drug levels and a greater risk of resistance.
So I return to my original statement: It is wisest to take the drugs as prescribed, at the prescribed intervals, to give yourself the best possible chance of preventing resistance.
I urge you to talk to your doctor about this question, and to show him or her this response.