Time may be a human invention, but it can be a very important one when it comes to taking medications. However, should we let the stress of trying to take a medication at the same time every day get in the way of our overall health? Are there any straightforward answers when it comes to time-keeping and medication adherence? On his personal Tumblr ("Ask Dr. Joel"), Joel Gallant, M.D., M.P.H., an HIV doctor at Southwest CARE Center in Santa Fe, New Mexico, answers questions, often in a dry, sarcastic manner, about a host of issues related to HIV treatment and prevention. He recently fielded two questions about taking HIV medications at certain times of the day.
One anonymous user asked:
Dear Dr. Joel, I have been HIV+ for 10 years, and on Atripla for 5 years. I never missed a dose, but in few occasions, as I take it late at night, I delayed it by 3 or 4 hours for falling asleep. Will this affect my results? As well, I know it's better to take Atripla on an empty stomach, but if you do take it after eating, does this reduce the effectiveness of Atripla, or does it just increase the side effects?
Did someone tell you to take Atripla at the same time each day? It's not necessary. The drugs contained in Atripla hang around in your blood for days to weeks, so it makes absolutely no difference when you take it. You could take it at noon one day and at midnight the next. It's generally taken in the evening to allow you to sleep through most of the side effects, but not everyone finds this necessary.
As for food, we only tell people to take Atripla on an empty stomach to reduce side effects, since fat increases the absorption of the efavirenz (Sustiva) component. If it doesn't bother you to take it with food, you can.
One anonymous user asked:
My viral load has been undetectable for a long time now, ever since Sustiva came onto the market. A long time, right? I take my medicine at 7 am. I'm off work for a few days and today I missed the dose. IT's midnight and I just took it, 17 hours late. Is this it? I'm not yet dead, I'm sure of that, but is my regimen doomed? I'm on Prezista / Intelence / Norvir now.
You'll be fine. With the regimens we use today, timing is not important. You can take your meds whenever you want, as long as you take them every day. And in the case of your particular combination, taking it with food is far more important than taking it on time.
Joel Gallant, M.D., M.P.H., is the associate medical director of specialty services at Southwest CARE Center in New Mexico. You can ask him a question directly on his Tumblr page, Ask Dr. Joel.
Mathew Rodriguez is the community editor for TheBody.com and TheBodyPRO.com. You can follow him on Twitter at @mathewrodriguez, like his Facebook page or visit him on his personal website.