Question
Is ARV drug absorption reduced after colon removal?
13 June 2011. Related: Adherence, All topics, Drug interactions, Opportunistic infections.
I have had my colon removed and passing my movements into a stoma bag until I’m reconnected.
Food passes quickly into the stoma bag and I take Atripla as my ARVs. Since the pill is hard and thick I believe I should cut it in half and take doses 1/2 hour apart. What do you think?
Answer
Hi
This is a good question that would be worth discussion with your doctor.
It will depend on the absorption details for each of the three drugs in Atripla. Many drugs reach their peak levels in blood 1-2 hours after dosing, largely through absorption in the stomach. Unless you are process food much more quickly than this, it shouldn’t be a problem.
Unless your doctor knows of specific research, the easiest way to check this for you is to have a blood level monitoring test (TDM) to measure levels of efavirenz. This are easy to get in the UK, especially when there is a complication relating to drug interactions or absorption.
It would be better to check your current levels of absorption before making any changes to the way you dose your meds. After TDM there are lots of options but this would be more likely to recommended increases the daily dose if this is needed, rather than splitting it which may have no impact.
Please let us know how you get on.
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