Re: Tenofovir, Leading HIV Medication, Linked with Risk of Kidney Di

[Guest guest]

I don't believe there are any studies that indicate that taking meds on

alternate schedules discussed on this list is effective or save in the general

population.

Let me make myself clear: I am not questioning the success of the individuals

who've shared.

Yes, some drugs have longer half-lives than others (meaning they tend to stay at

significant levels in the blood stream for a longer time after you take them.)

But just because one of these alternate scheduling strategies works for some

individuals doesn't mean it will work for you. Moreover, the process of finding

out by definition involves risk.

To understand this, one has to understand the bigger picture. We all know that

how a particular drug works in an individual varies, affected by many factors.

Those factors can include things like age, weight, sex, diet, and most

definitely genetics. When a drug is tested for approval, the goal is to find a

dose that is highly effective in most people under real world conditions.

Sometimes the desire to use a higher dose to create a higher margin of error is

challenged by a need to minimize side effects. A happy medium must be found,

but fortunately this has been less problematic with newer anti-virals.

In other words, although it's know that blood levels will vary widely from

individual to individual, the goal is to have a dose that is effective even in

folks whose individual situation yields a lower blood level. The situation

includes the factors I listed plus the day to day variations in those factors,

including adherence.

So, if you try this experiment (I sure wouldn't ever without doing so in

collaboration with my provider,) there will be some risk (I don't think anyone

can say how much) that you will be a person who ends up with lower drug levels;

if those levels are sub-optimal you could develop resistance to that drug or

class of drugs.

One of the advanatages of having drugs with long half-lives is that they are

adherence forgiving. In other words, they decrease the likelihood of failure

(resistance) with occasional irregular dosing. So, if your adherence is not

perfect, you could end up with suboptimal dosing at times which entails the same

risk.

I congratulate the folks who have been able to make this work. My adherence is

quite good, but not perfect, so this wouldn't be an avenue I personally would

pursue unless side effects became extreme or I was forced by some system failure

to temporarily adopt it while waiting for access to meds.

mark

Mark Hubbard

Nashville TN

>

> This is very interesting; something that I'd very much like to do myself. I

> will ask my own physician about it but, in the meantime, does anyone know if

> this 5-day regimen is effective for those taking Truvada? And, to the

> original poster, are you aware of any reputable sources/studies to back this

> up?

>