Q and A

Question

I missed four doses of atripla. will this cause me health problems?

I last took my Atripla 4 days ago due to circumstances beyond my control.

Should I expect the worst with my health.

I am so confused right now.

Answer

Can I ask what happened this time and whether this is likely to happen again?

This is because, the chance of developing resistance becomes a concern if you miss Atripla doses regularly.

The three drugs in Atripla (efavirenz, FTC and tenofovir) all have good concentrations at the end of each 24-hour dose to cover you for a few hours either way.

This was shown in a study called FOTO which followed people taking Atripla on weekdays and missing the two days at the weekend. After one year everyone still had a viral load that was undetectable (less than 50 copies/mL).

Please follow this link for more information on the FOTO study.

No treatment guidelines recommend following the FOTO strategy, but it is a good example of how an occasional missed dose of Atripla is unlikely to do any harm.

Having said that though,  adhering to your medication is extremely important. Please follow this link for more information on the importance of adherence.

As you missed 4 doses of your medication, it is recommended that you discuss this further with your doctor. This is important especially if you feel that you may be likely to miss as many doses again in the future.

Please also follow this link where a similar question has been answered in more detail.

FOTO STUDY: 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. IAS 2009, Cape Town. Abstract MOPEB063.
http://library.iasociety.org/AbstractView.aspx?confID=2009&abstractId=3046

36 comments

  1. Roy Trevelion

    Hi Annom,

    I’m sorry to hear this. But can you get support from your clinic or doctor? Or there might be a way for you to access your ARVs closer to where you go to school.

    Please let us know what country you live in. There could be organisations that can offer advice and local support.

    You can also ask your clinic if they have support workers who can help you keep your treatment confidential.

    Please let us know more about your situation.

  2. Annom

    Hi I’m a student and haven’t told my parents yet about my status I’ll be going back to school after a week and my ARVs are finished I’ll be skipping a week without drinking them I was asking what will happen

  3. Roy Trevelion

    Hi Edwin,

    Most people will miss a dose at some point, but so long as this is not every week, this is okay. Please see this Q&A for more info.

    What was the reason you missed a dose? Please see this guide to adherence.

  4. Edwin

    What will happen if I missed to take ARVs for one day

  5. Roy Trevelion

    Hi Phumi,

    Taking a double dose by mistake is not great. That’s because you could get more side effects, but it is likely to be okay.

    Here are some tips on taking your pills on time in the right way. Using a weekly pill box helps us to remember to take Atripla once a day.

  6. Phumi

    I took ,2 atripla tge same night in error, will thete be a problem

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