Question
Will my adherence be better if I change medication?
26 October 2011. Related: Adherence, All topics, Changing treatment.
I’ve been on medication for almost 4 years now, and sometimes I do not take it on time or I miss a day or two.
I recently had swollen glands over my ears. I’m currently taking Aspen Lamzid. I want to change to Atripla. I’m waiting for my test result on viral load and CD4.
Do you think I should change my medication? I am very determined and willing to change and adhere to my medication. Do you think this new one is going to change. The last CD4 test was over 600 and VL was undetectable, and that was 3 years ago.
I am also gaining weight, especially my stomach, pls help.
Answer
Thank you for your question.
You have asked a couple of questions and raised a few issues so I will try and respond to them one by one.
You mention that you recently had swollen glands. Swollen glands are usually an indication of a weakened immune system. This could also be as a result of your medication not working properly. However, you indicated that you are taking Aspen Lamzid. This is a combination of two drugs – AZT and 3TC. As guidelines currently do not recommend the use of only two drugs, is there another drug you are taking that you forgot to mention? Do you also know what your viral load is?
You asked whether you could change your medication to Atripla. Switching your medication should be relatively easy. However, here in the UK, guidelines recommend that you need to have an undetectable viral load before you can switch to Atripla. As your viral load test was 3 years ago, it is important that you wait and see what your current test results will be as these will determine whether you can switch.
One of the issues you brought up is that you sometimes have difficulty with taking your medication on time. Taking your medication on time and as prescribed is known as adherence. Adherence includes taking your medication not only at the right time, but also following any diet restrictions. Adherence is the most important thing you have to think about when taking medication or indeed starting a new combination. Taking your medication as prescribed ensures that all the drugs in your combination are at high enough levels to keep HIV under control 24 hours a day. For more information on why adherence is important, please follow this link
You mention too that you are gaining weight around your stomach. Is this the reason why you are not adhering to your medication? If so, have you discussed this, in detail, with your doctor? It is important that your doctor understands how any side effects affect the quality of your life. Once they understand, they can either provide you with support around adherence or switch your medication if that is the best option. Since you are awaiting results for your viral load and CD4 tests, it will be good to discuss this with your doctor when you next go in for your test results. For more information on describing side effects to your doctor, please follow this link
If your viral load is 138,000 while taking Lamzid then you probably have resistance. If so, then Atripla is not a good choice for you now.
Your next combination would need to include a protease inhibitor and you ill need tow other new drugs to use with this.
Adherence will need to become much better, hopefully not missing any doses.
Thank you for your respond. I ‘ve got my result, and my CD4 is 478, and my VL is very high 138thousand. Apparently they re not keen to change me to Altripa, because of my VL, however I don’t understand why cos this is shown that the old medication is not working. Was wondering if you have any opnion of what I should take if they finaly refuse to give me Altripa, bt whiles I’m still awaits their respond, I m taking my medication Aspen Lamzid together with (the one I take at night, orange like) forgot the name! And again to my suprise, I ‘ve manage to adhere into my medication, and follow a good diet, and taking a diet pills duromine, well to my suprise, my swallon gland has dramatically gone down, and I’m feeling much better, so I’m not sure if its because the medication is working again or. But I would real like to switched into a new medication. What is your advice on this, and again I’m taking Vitamin B complex. And about duromine, I take one after a day or two, and I’ve been using them on and off, bt I must say, I don’t have any problem with them (well, I think). So do you think I can do another blood test? Course I must say, I’m feeling much better compare to that 2 weeks or past time where I was on and off in taking my medication. And I use to have a tingle uncomfortable feet, especialy under my feet, and is all gone. Do u think the medication is working, I didn’t have a resistance? Pls help.