Complera and Insomnia

Question

I am taking Complera for a year (no previous treatment) and have had insomnia for most of that time.

I am looking into other causes of the insomnia but in case it is down to the Complera can you suggest an alternative ARV which is a single dose tablet for someone who cannot take Abacavir due to HLA B*5701?

Thank you. From Gentlemen in the UK.

Answer

The rilpivirine in Complera has a lower rate of central nervous system side effects/sleep abnormalities than the efavirenz in Atripla but those adverse symptoms can still occur. Switching to an integrase inhibitor based regimen (such as Genvoya or Stribild or a raltegravir or dolutegravir containing combination) or a boosted protease inhibitor based regimen (such as ritonavir or cobicistat boosed darunavir) likely would have a lower risk for insomnia. Best choice can be individualzed based on your treatment history and clinical situation and may be worth discussing with your HIV provider. KH