Question
I missed four doses of atripla. will this cause me health problems?
21 December 2011. Related: Adherence, All topics.
I last took my Atripla 4 days ago due to circumstances beyond my control.
Should I expect the worst with my health.
I am so confused right now.
Answer
Can I ask what happened this time and whether this is likely to happen again?
This is because, the chance of developing resistance becomes a concern if you miss Atripla doses regularly.
The three drugs in Atripla (efavirenz, FTC and tenofovir) all have good concentrations at the end of each 24-hour dose to cover you for a few hours either way.
This was shown in a study called FOTO which followed people taking Atripla on weekdays and missing the two days at the weekend. After one year everyone still had a viral load that was undetectable (less than 50 copies/mL).
Please follow this link for more information on the FOTO study.
No treatment guidelines recommend following the FOTO strategy, but it is a good example of how an occasional missed dose of Atripla is unlikely to do any harm.
Having said that though, adhering to your medication is extremely important. Please follow this link for more information on the importance of adherence.
As you missed 4 doses of your medication, it is recommended that you discuss this further with your doctor. This is important especially if you feel that you may be likely to miss as many doses again in the future.
Please also follow this link where a similar question has been answered in more detail.
FOTO STUDY: Cohen C et al. The FOTO study: The 48 week extension to assess durability of the strategy of taking efavirenz, tenofovir and emtricitabine Five days On, Two days Off (FOTO) each week in virologically suppressed patients. IAS 2009, Cape Town. Abstract MOPEB063.
http://library.iasociety.org/AbstractView.aspx?confID=2009&abstractId=3046
Hi Roslyn,
Yes you should continue with your daily dose as normal. Though you were 5 days without medication your viral load should still be OK.
I missed atripla four days now started taking it April 20 now clinic was out of stock received them today day5 should I contue with my daily dose
Hi Shalex,
If you’re missing meds and on a regular basis this will affect how they work. Can you try and take them when you go to the bathroom? Is there any chance you can get some privacy?
Hi I have been on Atripla for 8 months now. Am in college and I find it very difficult to take my meds because am scared my roommates will see me taking.. Hence, I miss a lot.. What do I do?
Hi Ronnie,
Though not ideal, you should be OK. What’s important is that you try not to miss them again.
Hello. I have been on trivent for a year and viral load is indictable .due to circumstances beyond my control I skipped 3 days of meds. Is that a train smash?
Hi Alex – if your viral load is undetectable, then you have been lucky so far and take take to health workers at your clinic about some of the things you are worrying about. If your viral load is still detectable, then by talking to your doctor there may an alternative treatment that may be less likely to develop resistance. Without details about your individual CD4, viral load and treatment it is difficult to comment any further.
Lots of people who are still coming to terms with HIV find it difficult to believe how effective treatment can be. This is likely to get better and easier with time – it does for most people – until you realise you have gone a day or a few days without thinking about HIV. Soon, apart from when you take your meds, you will find it becomes a much less important aspect of life. It does get easier.
If your tiredness is because your are not sleeping well because of efavirenz, there are alternative meds that would be easier to use.
I swear, because of my busy work life, on top of my personal life which I keep busy, I am always so tired, and that sometimes causes me to knock out cold before taking my medications. I have missed so many doses since I started treatment, I am actually scared for my health… (partly because I still have not 100% accepted my situation, sometimes even doubt the diagnosis… sometimes I wish I did not even have to worry about the meds, and im afraid that something horrible health wise that will lead me to the hospital needs to happen for me to realize the seriousness of it all…)
This is something to talk to your doctor about. If you still have meds, then you can take them again now.
If you don’t have meds for another reason is this something your clinic knows about?
If you are having difficulty with adherence, your clinic cannot help unless you talk to them about it.
I missed so many doses of Atripla i am scared