taking atripla in the morning

Question

Is there a real big medical problem in taking Atripla in the morning?

Answer

The main concern with AM dosing relates to the timing of central nervous side effects (often less if sleeping during the peak time) that occurs in the first hours (when levels of the drugs are the highest in the blood). For some patients that is not much of an issue so they can take Atripla OK in the morning (large meals with fat in them tend to increase the levels of efavirenz with higher rate of brain side effects related to those levels). I would guess that perhaps 10% of patients I have in Atripla take the doses in the morning and do OK with that. KH