Question
Does Truimeq have fewer side effects that Stribild?
12 May 2016. Related: All topics, Changing treatment, Side effects.
My doctor wants to change my treatment to a once a day regimen to avoid danger of me missing doses; as this happens occasionally with my twice daily regimen.
To give you some background, I was diagnosed in September 2015 and instantly put on Truvada (one daily) and raltegravir (twice daily). I became undetectable and my CD4 returned to normal after about 6 weeks.
I’e just had my first 6 month follow up appointment and everything is still great, my viral load is 27 and all organs functioning normally. But my Dr wants me to change to once a day as the twice daily is sometimes not practical and i accidentally miss doses.
My options are Triumeq or Stribild. I can’t seem to find much information on which one would be better with less side effects.
I should point out that I suffer from anxiety and depression and my current medication exacerbates this slightly. Theres lots of warnings online about Triumeq causing anxiety and depression as one of its main side effect, but my doctor says its the best one with the least side effects?
I basically need advice about side effects of both Triumeq and Stribild and which one would be best. Or whether I should just keep to my current Truvada plus raltegravir regimen?
Answer
Hi
It sounds like your doctor is giving you good information.
Firstly, most people find adherence is easier with once-dailycompared to twice-daily combinations . So it is good that your doctor is suggesting this change.
Secondly, Triumeq probably does have a slightly reduced risk of side effects. This is because Stribild includes a booster drug that in some people causes general side effects like nausea, tiredness and diarhhoea – even though these are usually mild.
Another advantage is that Triumeq can be taken with or without food, but Stribild needs to be taken with food.
Anxiety has been reported with dolutegravir but generally in a very small percentage of people. In this case it would be easy to switch to Stribild as a second option.
The other two drugs in Triumeq – abacavir and lamivudine (3TC) – are similar to the two drugs in Truvada – tenofovir DF and emtricitabine (FTC). Usually it is easy to switch between them but your doctor will use a blood test to check you are not at risk of a reaction to abacavir.
This link on the i-Base website includes summary information on each HIV drug.
https://i-base.info/guides/category/arvs
Each drug page also links to the full prescribing information for each drug on the European Medicines Agency (EMA) website.
Hi – thanks too.
In general, most people have an increase in weight over the first six months after starting HIV treatment.
This is for all drugs and all combinations.
This is more that when not on treatment some of your bodies energy is used by ongoing viral replication.
It is good advice to be more active or to exercise more during the first six months – or to eat a little less – to adjust for this.
For most people, diet and exercise afterwards can bring this dwon again if this is something you are not happy with.
I don’t think there is data to suggest weight gain is linked to dolutegravir as a single drug. That doesn’t mean that in one individual this might be a very rare response – but it is unlikely for most people.
Hi Simon,
Thanks for your insights on Triumeq.
I wanted to ask a further question on the side effects of Triumeq. I have seen one case of a person complaining that Triumeq causes rapid weight gain.
While I have gained a few kilos over the last 6 months on Triumeq,
I think this is more as a result of coming to terms with the diagnosis and general diet, rather than Triumeq.
Certainly, weight gain is NOT a side effect stipulated in the patient information leaflet.
Do you have any opinion on this?
Thanks