Question
I have just started medication and have a lot of questions…..
14 December 2010. Related: All topics, Changing treatment, Drug interactions, Living with HIV long-term, Newly diagnosed, Recreational drugs, Side effects, Starting treatment, Supplements and herbs, Support.
Dear Team,
I recently found out that I was HIV positive after all my tests. My doctor has put me on Truvada and efavirenz. My CD4 count is 273.
After the first week I got side effects of dizzyness. Now the problem is I don’t get enough sleep after taking my medicine. I have several questions about my medicine:
1. Do I need to change my meal timings?
2. When can I take the pills?
3. Can I go to gym for workout after taking my pills?
4. One guy said those pills I am taking have steroids thats why I don’t get to sleep? Is it true?
5. What are steroids?
6. Can I take protein supplements for my work out?
7. Will I start developing obesity? If so what treatments/diet do you suggest?
8. When can I go for a workout during the day?
9. Being positive makes me more confused about my medications and how manage my life style, what can I do?
10. People/internet all say a healthy lifestyle should make my life easier but what is healthy lifestyle?
11. I am worried about when to take my meals and my tablets and when to sleep, can you help please?
Thank You,
Pozdude
Answer
Dear Pozdude,
Thank you for your questions. I shall try to answer them one at a time using the question numbers you have given as a reference:
1. You do not need to change the time that you have food. However, the efavirenz should not be taken with a high fat meal. Some people find that taking efavirenz on an empty stomach (at least 2 hours after your last meal) reduces side effects such as nausea, vomiting and diarrhoea. If you are experiencing these side effects then you may want to try taking efavirenz just before you go to bed and a few hours after your last meal.
2. It is recommended that efavirenz is taken before you go to bed in the evening. This is to reduce the side effects such as the dizziness and sleep problems you have been experiencing.
3. You can go to the gym when you are on medication but it is not recommended to go striaght after you have taken the pills if you are getting side effects such as dizziness. If the dizziness stops then there should be no problem exercising after taking your medication. It is not safe to be lifting weights or operating machinery whilst you are feeling dizzy. If you take your medication before you go to bed and then wake up, feel ok and want to go to the gym then that is fine. Or if you want to go to the gym in the evening before you take your medication that is also fine providing you feel ok.
4. The HIV medication does not contain steroids. The problems you are having with sleep is a common side effect of the efavirenz. If this does not improve then you should speak to your doctor about changing your medication. For more information about sleep problems and efavirenz please follow this link.
5. Steroids are compounds that your body makes naturally like cholesterols or the sex hormones oestrogen or testosterone. Some people take additional steroids to build up their muscles but there are serious side effects associated with this. Some steroids interact with HIV medication so it is important that if you ever need to take them you check first if it is safe to do so. For an example please follow this link.
6. Some protein supplements are ok. Creatinine isn’t and you should watch out for this. For a similar question please follow this link. (The Atripla mentioned in this question is a tablet which contains both Truvada and efavirenz and so is relevant to you as well).
7. You will not start developing obesity if you continue with a balanced and nutritious diet and with your exercise. However, one of the side effects of some of the older medication is lipodystrophy which is a fat disorder. This can cause fat loss in the arms, legs, face and buttocks and fat gain around the stomach, breasts and shoulders. For more information about lipodystrophy please follow this link. Please also follow these links for more specific information about fat loss and fat accumulation.
8. You can workout anytime you want providing you feel ok and not dizzy. HIV treatments are very individual and you need to find the right treatment for your body but also which fits in with your lifestyle.
9. Starting treatment for HIV is not easy and can be very confusing. Please follow this link the the ‘Introduction to Combination Therapy‘ guide which has in it everything you need to know about starting treatment and what you can do to make it easier. It is written by people who have HIV and have been through the same problems you are currently facing. You may find that it helps you to feel more confident about your treatment and how to manage your lifestyle.
10. A healthy lifestyle is very straightforward, eat a healthy balanced diet (for more information about what this involves follow this link), take regular exercise, look after yourself, if you smoke you should think about cutting down or stopping, if you drink or take drugs try to do so in moderation, try to get enough sleep and to avoid stress wherever possible. Here is a similar question which you might find useful.
11. You should try wherever possible to continue your life as normal, just as you had done before you started medication. Your treatment should fit around you not the other way round. It sounds as if you are experiencing some side effects from the efavirenz that is affecting you negatively. You should try to speak to your HIV doctor about this soon and ask them to change the efavirenz to something that does not give you these side effects. For more information about side effects associated with efavirenz please follow this link.
Your health, both mental and physical is what is most important. If you are finding your medication is effecting you in a bad way then you should try to change it and find the right combination for you and your liefstyle. This will ensure you get the best quality of life possible.
Please let us know how you get on.
Best wishes
Charlie
Hi Kedibone,
The issues that you’re having could be due to a number of reasons. If you’ve been on medication since February it’s unlikely that it will be related to your medication. If the clinic where you go the staff aren’t helpful, you may need to see someone else. You should have had a CD4 count test done, have they said why this hasn’t been done?
Hi I found out about my status February an started my treatment March I didn’t have any side effects up until now my tummy it’s feeling bad cramps an I don’t go to toilet normally anymore an the boring part it’s the clinic that I go to will never ask or help but just give me pills I don’t know nothing about cd4 I’m puzzled
Hi Kwazi,
What does the doctor say about your tummy acting up? The active meds in different brands are usually exactly the same. So you can ask if you are very sensitive to other non active ingredients that go in the pills. What HIV meds (ARVs) are you taking?
However, it’s a good idea to talk to the doctor to make sure you get the brand that works best for you. You can ask the doctor about the taste buds problem too.
Do you have access to your CD4 count and viral load? Please let us know.
Hi Doc I hv been taking the meds for some years now…my problem is that everytime I go fetch my meds it’s always a different brand name and I’ve noticed that my tummy acts up each time… another thing is how can regain my taste buds after each dose cos everytime I swallow I always take a sweet or eat something cos my mouth becomes tasteless
Hi Lihle,
Tribuss is a generic version of Atripla. The side effects that are commonly associated to tribuss are discussed here: http://i-base.info/guides/1561 Aching feet could be due to something else, this will need to be discussed with your doctor.
I have just started taking medication it’s been 3 weeks, I am taking tribuss . what I want to know is if it’s normal to feel heat in the stomach and also my feet painful
Hi Blessing,
Sorry to hear about your recent diagnosis. But it’s good that you’ve already started taking HIV meds. What is the name of the drug? A 3 in 1 drug that is taken before bedtime is Atripla. Other names for this can be Odimune or Tribuss, please see here for a list of other names.
We are not doctors at i-Base so it’s a good idea to see the doctor about your symptoms. They can check whether they are side effects or symptoms of another infection.
Yes you can eat a something light or some fruit after your medication.
please Doc.I just got tested nd was placed on the 3in 1 drugs to bi taken @ night some hours after meal..ave been taking it for close to a month now consistently . 4 days ago I observed am having some side effect..like fever and serious night sweat.of which have been given drugs to take care of it..2 days after..I discovered sore throat which am still battling now.
pls I want to kW are they normal side effect of the drugs which will clear with time or early symptom of the virus.?..
2 .Can I eat something lite or eat fruit after my night medication?
Hi Angela,
It’s great you’ve started HIV meds and your CD4 count is fine. But what is your viral load. Your meds should reduce your viral load quickly and help get it to undetectable.
Unfortunately at the moment there’s not a cure for HIV. So we have to take the meds all the time.
Here’s a link to ART in Pictures that shows you what happens to your CD4 count and viral load when your start ART.
Angela: I just started my med 2weeks ago and my cd4 fine can I stop and start after 2years or 3?