Q and A

Question

What are the risks missing weekend meds?

Can I safely stop taking my meds over a weekend if I drink and forget to take them?

Answer

Thank you for your question.

The answer depends on the meds you are taking. For most combinations, missing two days meds would increase the risk that you could develop resistance.

If your meds all have long ‘half-lives’ – ie they only leave you body slowly – then you can be more flexible with dosing.

For example, the commonly prescribed 3-in-1 pill called Atripla (efavirenz+tenofovir+FTC) has three long-lasting meds. The FOTO study (Five-On Two-Off) stopped the weekend doses for people already stable on HIV medication.

This study was too small to know the risk of treatment failure or resistance in the long-term. However it was significant that none of the participants had viral load blips or rebounds over a year. The study did not show any benefit with regards to a reduction in side effects of taking the drugs. The main benefit of FOTO would be financial, as it has the potential to reduce drug costs.

These results would not be expected for drugs with shorter half-lives.

Reference: Cohen C et al. The FOTO study: The 48 week extension to assess durability of the strategy of taking efavirenz, tenofovir and emtricitabine Five days On, Two days Off (FOTO) each week in virologically suppressed patients. 5th IAS Conference, 2009. Abstract MOPEB063.
http://library.iasociety.org/AbstractView.aspx?confID=2009&abstractId=3046

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