Question
Is it ok if I take my meds 15 or 30 mins late?
10 October 2016. Related: Adherence, All topics.
Do you have to take your arvs at exactly the same time each day? Will for example 30 mins (or even an hour) each way have any impact whatsoever on the suppression of the virus or cause resistance? I am worried as even though I take them every day some days it is 15 or 30 mins later or earlier than the previous day.
Answer
Thank you for your question.
It is sometimes difficult to take your meds at the exact same time everyday.
Even when starting, there is a window of about an hour either side of your target time when it is still fine to take them.
For example, if you want to take your meds every night at 10 pm, then any time between 9pm and 11pm will be fine.
Everyone has a few times when we forget our meds though.
The less this happens the better. But if it does happen once in a while then there is nothing to worry about. If you forget in the future, take them as soon as you remember. However, if this is already close to the next dose DO NOT take a double dose.
Once you get an undetectable viral load, especially if it has been undetectable for several years, you have more flexibility. This partly depends on which drugs you are using.
Some once daily drugs (including tenofovir DF, emtricitabine and efavirinz) have long half-lives. This means drug levels stay in your body for long enough to cover being several hours late or even missing a dose completely.
Several studies are looking at whether reduced dosing might be safe – for example by only taking ART for four days a week. We need bigger studies before we know if this is safe though.
Note: this question was updated in October 2016 from and original answer in April 2011.
Hi Jamal, you’re treatment is still working and HIV is being suppressed. There are other factors that can make viral load appear higher on tests than it acutally is. Recent infections/vaccines or ‘blips’ can cause a temporary increase in viral load. As your viral load has been relatively stable with little fluctuation between results, it shows that HIV is being constantly suppressed. How often do you have your viral load tested and do you know your CD4 count?
Hey,I’ve been taking TLD for three years now…and my viral load has not been fully suppressed,I started with 470 copies,200 copies,84 copies and now I’m at 240 copies,what should I do?
Hi Nauseated, I am sorry to hear you are struggling with side effects. How long have you been feeling like this? has it been since starting your treatment or longer?
Unfortunately it is not recommended to take them together. Rifampacin used in Tb treatment reduces how much efavirenz is absorbed by the body. As you take Trivenz in the evening, nausea is most likely caused by Rifafour. Have you mentioned this to your doctor? and how long will you be on Rifafour treatment for?
I started on Trivenz on the 3rd Nov and they later found TB so i had to take TB meds together with ART from the 18th. I’m taking the Trivenz at night and the Rifafour TB meds during the day. This is keeping me nauseous the whole day ,makes it impossibletobe functional at work. Is it possible to just take everything during the night?
Hi Natashq, while on PEP you are protected from further HIV exposures. PEP will also act as PrEP for the duration of the course of treatment. You can finish your course of PEP when originally planned.
Am worried I had sex with apostive person while on pep what can I do?
Hi Peter, do you know if your partner was on treatment? and if they were do you know if they were undetectable? Being undetectable means there is no risk, and even if not treatment will significantly reduce the risk of transmission.
Starting PEP as early as you did is excellent. This will ensure that it can be as effective as PEP is. Unfortunately you are unable to test now. You will need to test 6 weeks post PEP. PEP can interfere with HIV testing and not give accurate results.
Please follow this link for more information about testing and transmission: https://i-base.info/qa/factsheets/hiv-transmission-and-testing
Hello, I had unprotected sex with a positive partner. However I started pep 8hours lator after I tested negative. I’m I still safe.
Hi Lesetja, missing one dose of medication is not going to risk your viral load going up. The risk of viral load going back up becomes more probable after missing ART for 3/4 days. This can be even longer if you are already undetectable.
HY HOW MANY DAYS DOES IT NORMALLY TAKE FOR A VIRAL LOAD TO GO UP IF MISS DOSES…….SOMETIMES WHEN I MISS DOSE FOR A DAY OR TWO I TAKE 2 TABLETS AT THE SAME TIME FOR THE PREVIOUS ONES I MISSED , DOES THAT HAVE AN EFFECT