Question
Can I switch to take meds in the morning instead of the evening?
18 December 2011. Related: Adherence, All topics.
I have just started treatment this week on a combination of truvada, ritonavir and atazanavir.
I have started taking them in the evening but with my work I now think moving to taking them at breakfast would be easier.
Can I just start doing that or is it more complicated than that now I’ve started?
Answer
Hi
There is a lot of flexibility in timing to find what works best for you.
With the meds in your combination is also easy to switch from evening to morning. Take your last evening dose at the usual time, and then take another dose the next morning at the time you want to take them. You are doing this to make sure you never leave more than 24 hours between doses, when the drug levels could drop too low and risk resistance.
Your drug levels will be slightly higher for the first few hours of dose the next day. This is unlikely to be a risk because there is already a wide range of variability in drug levels achieved by different people.
If you are worried about this, your last evening dose could be taken without the ritonavir, but this might be unecessarily cautious.
The only meds that really need to be taken at night are efavirenz and rilpivirine, or the combined pills that include these meds (Atripla and Complera).
Your HIV pharmacist would also be able to talk to you about this on the phone if you want to check this with the clinic first.
Hi AA, thanks for explaining your situation so carefully.
There is lots of flexibility for dosing so that you can find a schedule that works for you and the way you live.
The time does affect how well the drugs work, so please don’t worry about this.
Recommendations about taking in the morning or evening are really about whther they should be taken before you go to sleep or after you wake up. This is important to know if you have shift work that often means you work at night and sleep in the day.
There are only two main HIV meds that have these recomendations.
One is efavirenz – which used to be included in the first-line combination for naby years. Efavirenz has side effects that affect the mood and energy levels in abpout 50% of people. It is easier if you are sleeping after taking efavirenz, so this is recommeded to take before you sleep.
Dolutegrvir is a more modern drug that is included in the combination TLD which more people use now when they start. One of the side effects of dolutegravir is insomnia approximately 5% of people report insomnia and not sleeping well. So this is why dolitegravir and TLD is recommended after you have slept and when you want to stay awake.
If you are lucky and don’t get these side effects you can pick whatever time is best for your routine.
And people working night shifts need to remember that time is not for morning or night, but for after or before you sleep.
Hi, I usually take my ARV at 9 AM but decided to switch to 9 PM because I work nights and have trouble sleeping during the day. However, the new schedule isn’t working for me as I’m used to the 9 AM timing. Is it okay to switch back to the 9 AM schedule? I understand this timing is crucial. What symptoms should I watch for that might indicate the ARV is less effective due to the change in timing?
Hi Annah, this doesn’t sound like a side effect of HIV meds which most people take without any problems. Please speak to your doctor about these symtoms which may be caused by something else, especially fever.
Hi Annah here, I am taking HIV med but I have this fever which is too much. Is this some kind of side effects for HIV meds. My face, hands and neck became dark after taking HIV meds. I’ve been taking them for 2 months now
Hi Atoyebi, yes you are able to switch the time of your medication again. It is more important that you find a time that suits you and if 10 pm is not working, switching is recommended.
These occasional switches are not a problem and will not risk your treatment failing. To switch you can take your treatment as normal at 10 pm and the following morning take another dose at 5 am. Having 2 doses close together on one occasion is not going to be a problem. From this point you can then continue treatment as normal at 5 am each morning.
Hello, I am undetected vera loads, initially I was taking my drug by 6 am, later I switched to 10 pm, but now i wanted to switch to 5 am and i hope it’ll be okay with me?. This is because of the challenges I faced waking up to unirate has been a big challenge for me. Please your quick response will be appreciated.
Hi Lilian, please speak with your doctor/pharmacist about when you can take your treatment. i-base is an HIV treatment charity and we are not doctors. We do not provide information/advice about other medication/illnesses.
I have been taking Entrip 10mg for about 8 weeks and I usually take them at night.The doctor has chaged me to Dytrex 30mg. I would like to take them in the morning instead of night time. Is it possible
Hi Angel, yes you can switch the time of your treatment. What is the name of the treatment you are taking? Some HIV treatments are recommended to be taken at certain times to avoid side effects.
If you are switching from night to morning, you can take your night dose as normal. It will then be okay to take your next dose in the morning the following day. One occasion with taking your treatment 12 hours apart is not going to be a problem.
You can then continue with your treatment as normal taking it in the morning instead of the evenings.
Hi can i switch to taking pill from night to morning?
And how it works?