Question
If I change the time I take Atripla to fit in with my shift work will it cause resistance?
27 September 2010. Related: Adherence, All topics, Changing treatment, Resistance, Side effects.
I have been taking Atripla over 5 months now. Due to the change in my work schedule I have been taking my medication to suit my work so that I don’t feel tired at work. I have taken my medication daily though does this affect my resistance?
Answer
Thank you for your question.
I am afraid I don’t fully understand what you are asking. Atripla should be taken once a day (daily). Do you mean you have not been taking it daily?
It is important that you take your HIV medications within an hour either side of your designated time. If you are working shifts then Atripla is not always recommended because, as you say, you do not want to be taking it before or during a shift due to the side effects.
If you continually change the time that you take your medication then this could lead to resistance. It could also increase side effects because there will be times when you are taking it less than 24 hours apart and so the levels of drug inside your body will be higher than the recommended dose.
You should talk to your doctor as soon as possible to change your medications so that they fit in better with you life style.
For more information about the importance of adherence please follow this link
I started my night shift two weeks now and I find that atripla does not affect me at all *strange*
HI Nat,
Combining TB and HIV treatment can be difficult because of side effects. It is normal to have a lead-in period where TB treatment is started first. But the World Health Organisation guidelines recommend that when somebody has a CD4 count under 50 they should start ARVs as soon as TB treatment is tolerated (i.e. when side effects become easier to deal with).
The strange dreams you mention and difficulty concentrating are quite common with Atripla. And it’s normal to gain weight when you start ARVs, but it’s important to read through this information on lipodystrophy to make sure this isn’t what you are experiencing.
You shouldn’t divide your tablets without discussing this with your doctor. This would affect the way that the medications were absorbed and could make your treatment less effective. It is important to talk to your doctor about your concerns with working night shifts and see whether you could change the time you take Atripla to fit in with this. Often people working night shifts find that they are not able to take Atripla and need to change to a different treatment because of these concerns. Please see this previous question for more info.
Hi Rebecca, yes my husband is on treatment for his infections but not on ARV’s as yet cuz the doctor says they need to treat the tb infection for at least 6 weeks then they would start the ARV’s by next 2 weeks time. I’ve been taken atripla for more than a year and it works fine but I do have abnormal dreams and I note that I can’t take it on an empty stomach cuz I would hallucinate so I would eat before cuz its not a nice feeling when u do snap out of it it feels like your brain has overworked and u would go insane anytime , I gained a lot of weight on my upper body and I notice I have a slight memory loss but I’m surprise I didn’t lost any of the things I learned in school and I’m still studying and it does not affect my education just some of the experiences I went true but I was wondering if I could divide my tablets in two and drink half first and like after 4 hours drink the other half cuz I would be working night shift from next week so I don’t want the full effects at one time I so forgot to ask my doctor
Hi Nat,
I’m glad to hear how positive you are about your health but I’m sorry to hear how unwell your husband is. Is he being given treatment for these infections and is he receiving ARVs? HIV treatment can still be very effective with CD4 counts this low but it is important that he has access to effective treatment as soon as possible.
I wanna encourage people out there who are hiv positive to think positive about life its not the end of the world one day we are going to find the cure and end all of our misery but whilst waiting for that day to come, eat right, take your meds on time , live life to the fullest with the ones you love and make evry moment count. Having a negative attitude towards this disease is only gonna make things worst and causes the disease to progress faster please just don’t do this to yourself , because I’m goin true an experience with my husband who always have a negative attitude towards this disease and the outcome of it is that his cd4 cells is 23 and he has tb and oral candidiasis and now he’s afraid of what’s gonna happen to him now he’s serious about his health in which I think a miracle needs to be perform on him and I’ve always been thinking positive and my cd4 cells is 993 to this day from 250 the lowest I’ve been and I intend to let it stay high now I’m goin true a phase in my life with my husband I don’t want him to die and leave me alone , just do the right stuff make sure u see your doctor regularly cause we have families and friends who will miss u a lot and we wanna be here with then forever so please THINK POSITIVE.
Hi Nat,
You are right that it is important to take Atripla around the same time every day to keep your viral load controlled. For some people Atripla isn’t the best combination though as it isn’t suitable for people working night shifts due to side effects. In that case it is usually possible to get a different ARV combination which is still taken everyday at the same time but that doesn’t cause the same side effects that can prevent people from being able to work safely.
It is important to make sure that you take your meds everyday but it’s also important that if you have problems with specific ARVs you talk to your doctor so that you can get the best combination for your lifestyle.
From my understanding u should take atripla at a specific time evryday cause if u take it later than your usual time then it would give the virus a chance to multiply or cause damage between that time which in turn would cause ur viral load to go up and u don’t want that so taking your medications at a specific time is very important if u want the best results , you cannot just do what you feel is best for your job life or occassions u need to attend, you need to find ways to cope with evrything around you because if your health is not good then how would u tend to all of these things in life f you are sick.
Hi Carole,
I think the most important thing once your viral load is undetectable is that your treatment fits in with your lifestyle to ensure you have the best quality of life possible. It is better to try to stick to the same time (10:30-11pm if that’s what suits you). As you said, the occasional time if you are home late then you take it a few hours later.
It sounds as if you are getting on well on treatment with a good CD4 count and an undetectable viral load which is fantastic.
Best wishes
Charlotte
Hi Charlotte and Kevin,
My consultant at Mortimer Market also told me I could be relatively relaxed about the time I took my Atrripla pill every day. I should aim to take it when I went to bed every night (for me around 10.30 to 11.00 pm – I work and I’m 63 years old) but that it wouldn’t matter if on the odd occasion this was a couple of hours late, eg if I’d been out and got back late. I’ve followed this advice and generally just taken my pill when I go to bed, at whatever time that is. I hope that this has been OK. I have been on medication for about 18 months now, and my viral load is undetectable, CD4 count 500.
Carole
Hi Charlotte
I read this question and your subsequent answer. You advised that it is important to take your medications “Within an hour either side of your designated time”?. I have had the same conversation with three different HIV consultants who have all advised that although it is always best to try and stick to the designated time as often as possible that on some occassions being four to five hours either side is not a problem. I believe this is determined by how long the patient has been taking HIV medications and also the length of time they have been undetectable. This can of course be different still, dependant upon the HIV medications you take as some are more forgiving than others. I presume you gave this advise based on Atripla itself and the period of time the person asking the question has been taking this medication? Thought I would just point this out to stop all the worriers like me worrying!!! . Thanks Kevin.