Question
Could I switch to a different NNRTI?
13 October 2008. Related: All topics, Changing treatment.
I started Atripla 3 months ago and I still feel the CNS side effects are negatively affecting my quality of life. I still experience drowsiness, impaired concentration, impaired responses and feel more socially withdrawn. Would it be possible to transfer to a 2nd generation, once a day NNRTI with a better side effect profile? I would rather not opt for twice a day nevirapine.
Answer
Yes, if your quality of life is not good and the side effects do not subside, then it makes sense to consider switching. If you are insistent on a NNRTI, your only option (excluding nevirapine) is etravirine. It, however, is taken twice daily and with food.
In addition, the current approval of etravirine is to be used in the cases of drug resistance. It is probable that your doctor may say ‘no’ to a switch like that as a result of the above mentioned reason.
There is a study going on that looks into switching from efavirenz to etravirine and you may decide to inquire about it in your hospital. It is always easier to get an access via the study, as well as you will receive better monitoring.
There is some detailed information on resistance and etravirine’s susceptibility here.
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