Question

What is the best time of day to take Atripla?

13 May 2010. Related: Adherence, All topics, Changing treatment, Side effects, Starting treatment.

Hi,

Thanks for your help. I have two questions.
1. What is the best time to take Atripla? When should it be taken after food?

2. My friend has been taking ARV treatment for 2 years. Two years ago his CD4 count was 61. After starting treatment he has had an undetectable viral load continuously. 6 months ago his lab test results showed he had a CD4 count of 241 and an undetectable viral load. However, 3 months ago, his CD4 count went up to 394 and his viral load also rose to 212. Is this result possible? Can both the CD4 and VL rise together? Can it definitely be lab error? What is the tolerable maximum temporary viral load ‘blip’?

Thanks again

Answer

Answer: Charlotte Walker

Thank you for your question.

To answer your first question, most people prefer to take Atripla just before they go to bed to avoid side effects such as feeling tired and dizzy. There is no set time to take Atripla and it depends on your friend’s response to the medication. If he would prefer to take it in the morning and this doesn’t give him any side effects then that is fine.

Recommendations say that Atripla should be taken 2 hours after eating. This is to avoid side effects such as nausea. Taking HIV medication is very individual, some people experience these side effects others don’t. Taking Atripla before the 2 hours is up will not stop the medication from working.

With regards to your friend’s increase in viral load. A viral load blip is where a sudden increase in viral load is seen and then it goes back down again. Unfortunately we do not yet know what causes this but it is quite common. It could be due to a lab error, an underlying infection or something else that we do not yet know about.

A low level blip, which is the most common, can range between 50-200. Some blips can go as high as 2000. For more information please follow this link to a previous question which is similar.

You need to encourage your friend to talk to his doctor and get another test done. It should have been done ideally about 2 weeks after the last test. If the viral load has gone back down again it will mean he has had a viral load blip. If it hasn’t it could indicate that the medication is not working properly.

For further information on viral load blips please follow this link to the section in the i-Base ‘Introduction to Combination Therapy’ guide which deals with this.