Question
Why does my doctor want to change my meds combination?
22 December 2011. Related: All topics, Changing treatment.
Hello – I am on the following combination: ritonavir, truvada and atazanavir. I have been on this since march (9-months) and it is working really well. I have had no side effects, can tolerate it well and I was undetectable very quickly (still am and my CD4 is climbing gradually).
My doctor, however, suggested that next year she would want to change my combination to Nevirapine. She says it is tolerated just as well but the best bit is that it is only one tablet rather than the three I am now taking. Also it is cheaper.
I want to ask – is there a point in changing therapy if I am tolerating it well and it is working? It is annoying having to take three tablets I agree but I am now (almost) used to it.
Also, is Nevirapine relatively new? I read that the combination I am on is good for women of child bearing age, it is much safer (I am female).
I dont know what to make of this – my main reason for changing would be ease of one tablet but why fix something if it isnt broken?
I am worried that changing therapy might undo all my good work, esp. if the current therapy is working…..plus having to settle into a new regime…and any potential side effects (my first combination was with efavirenz to which I had a horrific allergic reaction…)
Lastly, how likely is a one pill formulation in my current combination? Three tablets is not ideal….
Answer
I think there is possible a typing error in your email. Nevirapine is not a combination tablet. It is a pill on its own and does not contain any other combination of drugs.
The most widely used 3 in 1 combination in the UK is called Atripla, which contains efavirenz, FTC and tenofovir. You said that efavirenz cause bad side effects for you and I’m wondering if you got the drug names mixed up.
Can you please clarify your drugs to us again.
There are lots of reasons to change treatment – usually this is because better drugs are developed. Sometimes cost is also a factor, but this should only be when it is also in your health interests, and certainly not to drugs that would be more difficult.
Changing treatment in itself does not increase your risk of complications. Often changing treatment can improve your quality of life if there are fewer side effects, fewer doses or fewer pills etc.
There is only one other single pill combination. Others are being developed, but I don’t think for the combination you are currently taking.
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