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 Nathan,
You’re going to be OK. Viral loads don’t rebound that quick. Please see Q4 here: http://i-base.info/qa/what-are-the-most-asked-questions
Hi,
I’m stressing so bad… I missed a dose for like 28 hours 4 weeks ago and I also missed another dose for like 9 hours few weeks before that. Not because I chose to do it, it just slipped my mind.
I haven’t had blood test for a while so don’t know if my viral load is still undetectable. I’m very concern because of the above… Does this means I’m not undetectable anymore and is easily transmit because I missed a dose here and there? The drugs were Truvada and Isentress/Raltegravir.
Hi Thandiwe,
I’m sorry to hear this. It’s important that you talk to your doctor when you get the new supply. You can ask for a test to make sure there is no drug resistance and that Acriptega will continue working well.
If you live in South Africa you can contact the Treatment Action Campaign for local support and to help with access to treatment.
My local clinic has been closed and I have run out of meds. I take Acriptega. I can only have acsses after three days. Should o be worried?
Hi Thomas,
Though not ideal, you’ll be OK. However, it’s really important that you try and remember to take your meds daily.
I miss 2 days in 1 week atripla what can go wrong. ….because of my work load at work it slip my mind
Hi Zee,
Yes you can miss your 7am dose and take it at 7pm. Then just carry on at 7pm every day.
Many people take Atripla at bedtime to help reduce side effects.
Hello,i usually take my STR of atripla around 7am,can i change to 7pm?thank you
Hi Tolu,
Missing doses very occasionally can be fine. But it’s not ideal if it happens a lot.
What other HIV meds are you taking. And do you have access to your CD4 count and viral load results? Please let us know, and tell us what meds you were taking first-line.
I.am about to missed 2days of my drug using at night lamivudine. Hope dis won’t affect my health . I m on second line .