Question

Hello, Dr. Young. I have read you saying that HIV meds don't need to be taken at precisely the same time every day. But I am a little confused about the timing extension. How late can I permit myself to be? How long can a delay be? I'm on TDF+EFV+3TC. And I take them at bed time. Some nights at 1Opm, other nights at 11pm and on weekends at about 5am. Is that ok? Or might resistance occur because of this frequent variation of time? Tks for your always wonderful support.

Answer

Hello and thanks for posting.

You're right- HIV medications do not have to be taken at precisely the same time every day.

Generally, it's better for adherence sake to take them in the same part of the day (e.g., evening or morning). Certainly the difference between 10 and 11 PM is of no consequence. A regularly scheduled 6 hour shift from 1100 to 0500 is larger than most would usually recommend, but not likely to be a problem either. Nonetheless, this situation points out exactly one of the reasons why efavirenz is fading from popularity (and guidelines) in the US and elsewhere- as it's only efavirenz that requires bedtime dosing.

If this is the reason why you're shifting your weekend dosing time, maybe it's time to discuss modern time of day-independent medications with your care provider.

Be well, BY