Hi,<\/p>\n
Thanks for your email. I’m sorry to hear about the side effects. This is not unusual with efavirenz and if they have not improved it is very good that you are going to try a different combination.<\/p>\n
Food recommendations are important and rilpivirine does need to be taken with a meal of at least 500 calories. If this doesn’t fit into your lifestyle then talk to your doctor about these options.<\/p>\n
There are several different options for a third drug to be taken with Kivexa (abacavir + 3TC). These may all be possibilities for you, but there may be limitations if you have any underlying health conditions or drug resistance. I have outlined the alternatives below, along with information about dosage and food requirements. If you click on the links you will be able to read more information about each drug.<\/p>\n
Nevirapine probably best matches what you are looking for in terms of food requirements and dosage but you will need to speak to your doctor about whether this is suitable for you.<\/p>\n
The BHIVA guidelines for preferred third drugs are as follows:<\/p>\n
atazanavir\/ritonavir<\/a> (ATV\/r) – this is 2 pills, once daily but\u00a0needs to be taken with food.\u00a0The type of food is not important though, and calorie count is not specified.<\/p>\n darunavir\/ritonavir <\/a>(DRV\/r)\u00a0– again 2 pills, once daily, but with food.\u00a0The type of food is not important though, and calorie count is not specified.<\/p>\n efavirenz <\/a>(EFR)\u00a0– this is the drug you are already on, and mustn;t be taken with a high fat meal.<\/p>\n raltegravir<\/a>\u00a0(RAL) – twice daily, with or without food, but may not be available due to high pricing.<\/p>\n The guidelines also include alternative options that are not so strongly recommended, but which are still useful in many situations:<\/p>\n nevirapine<\/a>\u00a0(NVP) – can be dosed once-daily, after a lead in period of two weeks. With or without food.<\/p>\n lopinavir\/ritonavir <\/a>(LPV\/r) – twice daily, with or without food<\/p>\n fosamprenavir\/ritonavir<\/a> (FPV\/r) –\u00a0twice daily, with or without food<\/p>\n rilpivirine<\/a> (RPV)\u00a0<\/a>– once daily, with a 500 calorie meal.<\/p>\n