Question

What should I replace Atripla with?

18 July 2009. Related: All topics, Changing treatment.

Please help.

I have been on Atripla for over 1 year and previously on Sustiva and Truvada. I have come to the end of this regime due to severe bouts of depression. I can no longer sustain this medication, despite that it works very well.

I have healthy CD4 count and undetectable viral load. My specialist has given me brochures to read regarding changing my medicines, however I’m lost. There seems to be such a choice. Can anyone really recommend a good stable replacement for Atripla?

Any help or advice would be much appreciated.

Answer

Answer: Simon Collins

If you are not resistant to any medicine (this should have been checked upon initiation of therapy and most probably your doctor has the results), then the choice is really wide and could be overwhelming.

Generally, you can swap efavirenz (Sustiva) to nevirapine or to a boosted PI like atazanavir, for instance. There is some information on the possible options here.

Finally, although it is a small technical point about use of words, if you are experiencing side effect with any conbinations then it is not ‘working well’.

Any treatment has to be both effective and tolerable. Modifying your treatment to switch from efavirenz to an alternative is easy and I hope works well and imroves your outlook on life.

Also, ask your doctor which switch drugs s/he recommends first and start the discussion based on asking about the advantages and disadvantages of each one.

Good luck with the switch!