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Question

How often can I miss a dose?

Hi, I have been on Sustiva/Truvada for 7 months and only missed 1 dose.
In your opinion how often could you safeley miss a dose? Not intending to purposely miss doses just a question really. Thanks!

Answer

I have a very traditional opinion and will have to say that you cannot miss doses safely.

The thing is that HIV does not mutate selectively, it does it randomly. Hense missing a dose is like a Russian roulette. During the period when the virus can replicate (as there is not enough medication to supress it in your body), it can mutate in such a way, that it becomes resistant to the medication, but it also can mutate in a way that it does not become resistant.

Hence every missed dose is a potential resistance provoker and it is more true with the non-nucleoside reverse transcriptase inhibitors (Sustiva and Viramune) than with the protease inhibitors.

At the same time, as I mentioned before, not every missed dose will by default lead to resistance, but, again, less is better.

84 comments

  1. Roy Trevelion •

    Hi Sadiq,
    That’s right, if you can’t take it at the regular time, take it as soon as you remember. Almost everyone will be late or miss a dose occasionally. It only becomes a problem if it happens regularly.

  2. Sadiq •

    Hi I’m HIV positive which is on medication, I missed my normal timing of taking the tablet. I took it 3 hrs later. Can that be a problem for me?

  3. Lisa Thorley •

    Hi Pink,

    Your body will have absorbed the meds by then. Have you thought about taking them at another time of day?

  4. Pink •

    Am pregnant and my viral load is undetectable but lately when I take my meds I vomit after 20-30mins, does it mean the medicine won’t work?

  5. Roy Trevelion •

    Hi AR,
    What ARVs are you taking? And did you miss 2 days in a row? Please see this similar Q&A for Atripla.

  6. AR •

    Hi,

    Im a HIV positive and taking Arv med for almost 3 months i missed to take my med twice within a week im worried that i’ve become resistant already . Please advice. thanks

  7. Lisa Thorley •

    Hi Vox,

    As long as your viral load is undetectable there isn’t any risk. Your viral load won’t have rebounded just because you missed one dose of meds.

  8. Vox •

    Hi, am positive and 3 months back, my viral load was zero so I missed drug (that is 3 months after the viral load test) on one night then the following night I took the drug and in the morning I had unprotected sex with my partner after she insisted. So my question is, have I infected her with the virus?

  9. Simon Collins •

    Hi Precious, your friend will be okay. She has done amazingly well to be so good with meds for so long. Nearly everyone misses a dose occasionally. The meds are good enough to cover odd missed doses. So long as this is not regular, she will be fine.

  10. Precious •

    My friend is HIV+ and Arvs medication for more than 10 years. She missed 2 days will that be of danger? She so scared

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