Question
Pain and drug switching
10 September 2007. Related: All topics, Changing treatment, Opportunistic infections, Side effects.
My partner is on Sustiva (efavirenz) and Truvada (tenofovir/FTC) once daily taken before bedtime ideally, but my partner takes them early before he goes night duty.
My problem is that my partner suffers excrutiating abdominal pains and sometimes nightmares. l have advised him to go back to his consultant and have the medication reviewed, or possible change his combi. His cd count is above 400 and vl is undectable.
Please could you give me more advise on how to help him, cause l feel he has no quality of life as he is always complaining of pain, nightmares and so forth.
Give us other combi that have less side effects that he can choose from.
Answer
Hi
Your post raises two things that may be very different and unrelated.
On the question of ‘excruciating pain’ – this is something your partner needs to see the doctor about.
Any level of pain, and especially when this is significant, could be caused by many different things. The doctor needs to take a full examination and history and look into whatever could be causing this. This is unlikely to be a drug side effect. Don’t let this go on for any longer without doing something.
Nightmares are a well reported side effect of efavirenz, which can also cause mood changes and disturbed sleep, and not sleeping properly itself then contributes to energy and mood levels.
Most people take efavirenz before going to sleep, so your partner is unusual in taking evafirenz at nights if he then goes straight to work because of working shifts. For some people this can interfer with their ability to work, and if his shifts switch between days and nights, this may be another reason to choose a different drug.
Switching is very easy though, but will depend on your partners treatment history, and this will have to be done in consultation with his doctor.
Choices could include switching efavirenz to:
- once-daily atazanavir/ritonavir, or
- twice-daily, and possibly, once-daily nevirapine, or
- twice-daily Kaletra
For a brief overview of each of these drugs, try aidsmeds.com
Two earlier questions asked about switching from efavirenz and these may also be useful to read:
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