By Dr. Theo Hodge, Jr. MD
The pharmaceutical
industry is now presenting a new wonder drug for HIV. It requires
the patient to take only one pill, once a day. However, even with
convenience being a bonus, each of these drugs has its own potential
side effect profile. Let us examine the realities of each pill.
The pharmaceutical industry is now presenting a new wonder drug for HIV. It requires the patient to take only one pill, once a day. The pill consists of three different medications packed into one tablet. The medications are Viread, Emtriva, and Sustiva. Currently the medications exist in separate components. The first two also exist in the form of Truvada (a combination of Viread and Emtriva in the same tablet).
Patient surveys suggest that the fewer pills in a drug regimen, the more likely a patient will take his or her medications as his or her doctor prescribed. Even when taking one pill once a day it is important to remember that medications do not work in combating HIV if the patient does not take the pill every day and on time.
However, even with convenience being a bonus, each of these drugs has its own potential side effect profile. Let us examine the realities of each pill.
Viread and Emtriva belong to a family of HIV medications known as nucleoside reverse transcriptase inhibitors (NRTIs) or “nukes.” On rare occasion, patients taking drugs from this family may develop lactic acidosis (buildup of an acid in the blood) or hepatotoxicity, a serious liver problem.
Symptoms for lactic acidosis include feelings of weakness, unusual muscle pain, trouble breathing, stomach pain or fast/irregular heart beat. Symptoms of severe liver problems include dark cola colored urine, yellow eyes, nausea, loss of appetite, and lightly colored (gray) stools. However, these side effects are exceedingly rare.
The most common side effects of Viread and Emitriva are headache, diarrhea, nausea, rash, vomiting, dizziness, and gas. Typically over time (2-4 weeks), these side effects subside.
Sustiva belongs to the family of HIV medications known as the non-nucleoside reverse transcriptase inhibitors (NNRTIs) or “non-nukes.” Rash is a common side effect that generally resolves itself without a need to stop treatment.
Perhaps the most infamous potential Sustiva side effects include dizziness, trouble sleeping, drowsiness, trouble concentrating, and unusual and vivid dreams. On rare occasions (more likely to occur in patients with a history of mental health issues) some patients have experienced severe depression, strange thoughts, angry behavior or thoughts of suicide. A few have actually committed suicide. The drug is also inappropriate for women considering pregnancy as it may result in birth defects.
Some studies have suggested that Sustiva side effects are more likely to occur in African Americans. One study suggests that African Americans are more likely to be deficient in one of the liver enzymes necessary to metabolize (break down) Sustiva.
It is important to remember that if any component of the new pill no longer has any effect on the virus, then the pill a day therapy is not an option. This is most likely to be true for patients who have been on several different drugs over the years, or who have intermittently taken any one or more of the pill’s components.
Resistance testing (finding out which HIV drug will work) by your physician will assist you in making the appropriate decision. While the one pill a day therapy offers another important option in the treatment of HIV, prevention remains the mainstay in ultimate HIV management. Let us not forget safer sex!
Dr. Theo Hodge, Jr.
650 Pennsylvania Ave, SE
Suite 220
Washington, DC 20003
202-543-2664
After hour emergency:
1- 800-284-9708
Monday, Tuesday, Thursday and Friday 9a to 1p
and 2p to 5p
Wednesday 9a to 1p
At Eastern Market Metro
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