Question
Do my medicines still work?
19 May 2009. Related: Adherence, All topics, Resistance.
Is my medication still working if I am taking it between 9am-11am and 9pm-11pm? I am not taking it every day, twice a day at 10 as I should…. is this a problem or does my body know that between these hours the medication will be there?
Answer
Antiretroviral medicines need to be taken every day, if possible always at the same time (but a max of 1-2 difference from the usual dose time may be OK) and following all dietary requirement (some pills need to be taken with food, others on an empty stomach, some foods need to be avoided, etc).
This is important, because the virus needs to be always under pressure by the pills, so that it does not have the chance to replicate and thus to weaken your immune system.
In addition, when the HIV replicates, it makes small changes on its surface that are called mutations. Those mutations may be such that the virus becomes resistant to some, many or sometimes whole classes of ARVs. This may limit substantially the treatment options of somebody in the long run, as we have only a limited number of ARVs and classes.
In order to avoid that you ineed to be adherent to the therapy, thus constantly having enough medicine in your body to stop the virus from replicating.
If you have missed doses for quite a while, it makes sense to discuss this with your doctor and try to find out together what are the reasons and find an easier combination or solve the problem that may cause this. This is particularly important if your viral load is detectable.
There is more information on adherence here, and on resistance here.
Comment