Switching to one tablet regieme

Question

Morning, Following a diagnosis for Cancer (Lunphoma B-cell), I was diagnosed HIV+. I started Truvada & Isentress immediately which works well for me. Following a recent holiday, I was wondering if it would be easier to take one table a day rather than three. (I worried about taking / or forgetting to taking the night ISENTRESS tablet, as I was out of my normal environment, also I a different time zone) I have no side effects from my medication and I breezed through the chemo for the cancer. In general I seem to tolerate medications well. Would you recommend I switch just for the convenience of one tablet a day rather than three? Is it as easy as stop taking one regime and start another? Would you recommend a particular triplet based on my current regiment. Thanks for your assistance. Dave

Answer

Hello Dave and thanks for posting.

Your question is really two- is it better to take medications once (vs twice daily), and/or is it better to take one (vs more than one) pill.

Your current regimen comprises three pills over two doses, but it's important to be mindful that the regimen is among the 5 recommended by the April 2015 US treatment guidelines- it was actually shown to be superior in a large study to potent once-daily regimens (including one of the other recommended regimens). If you're doing well, tolerating the meds and don't have problems with the twice-daily or more than one pill per day dosing aspects, then there's no imperative to switch.

That said, if you think that a one pill, once-daily regimen offers you significant possible benefits, then there are two integrase inhibitor-based combo pills (Stribild and Triumeq) on the guidelines that are recommended, and a third (Complera) that has been well studied for switching stable patients. Among the integrase regimens, Stribild (like your current medications, uses tenofovir and FTC (Truvada), it also has increased possible drug-drug interactions and a food requirement. Triumeq requires genetic testing, as it contains different NRTI medications (abacavir and 3TC), but has fewer drug interactions and no diet restriction. If you have kidney or bone problems, the later offers a tenofovir-free option that has been avoids medication-related risks. Complera uses a different class of medication (NNRTI, non-nuke) and also has a diet restriction (should be taken with a meal), but is very well tolerated.

I'd suggest speaking to your care provider about the pros and cons of maintaining or switching your regimen, and about which regimens offers the best risk and benefits for you.

Be well, BY