Is Complera better than Atripla? Update

Recently, the FDA announced approval of a new one pill, once-a-day drug regimen for HIV:  Complera.

What’s Complera?  It combines  rilpivirine (Edurant), a new HIV medication from the NNRTI class, and Truvada (tenofovir and emtricitabine), a commonly used combination pill.  It will compete with Atripla, the other one pill once-a-day option (efavirenz and Truvada).

Is Complera better than Atripla?  Complera’s effectiveness is “non-inferior,” meaning “just as good,”  in people with pre-treatment viral loads less than 100,000.

Study participants with higher pretreatment viral loads (>100,000 copies/mL),were more likely to fail on Complera, however.  Doctors call this “virologic failure.”  If Complera fails to control your HIV, and viral resistance develops, it might also eliminate Intelence and Viramune as future drug possibilities.    Doctors call this “cross resistance.”    This is not a good thing.

Remember that viral resistance does not happen all by itself.   The number one reason for a failing HIV drug regimen is missing too many doses.

Complera causes fewer central nervous side effects, such as dizziness and dreams, than Atripla.   If you are experiencing these side effects from Atripla, Complera may be an excellent option for you.

There are some unique features of Complera that make it a bad choice for some.  You must eat when you take it, preferably a high fat meal, to absorb it adequately.   Drinking a can of Ensure was found to be inadequate.

It’s ALSO not absorbed well if you are taking acid lowering medications, such as antacids or Zantac.  Prilosec (omeprazole) or similar acid blockers can NOT be used with it.

In the updated DHHS “Guidelines for the Use of AntiretroviralAgents in HIV-1 Infected Adults and Adolescents,” Complera is an “alternative” treatment for HIV, and Atripla is still “preferred.”

Complera is approved for use for people with HIV who have not been other previous treatements for it.  Studies are underway to see if people on other HIV medications can be safely switched to Complera.   The providers I work with are quite comfortable switching their patients to Complera if they are well controlled on their current regimen.

So what’s the bottom line? 

Complera is a great new choice for HIV, but it will not replace Atripla.   Complera causes less dizziness and dreams than Atipla.  If you have a high viral load, tend to miss doses, eat irregularly, or take acid-lowering stomach medication, Atripla is still a better choice for you.

About William Larson, Pharm.D.

Pharmacist, partnered, living in Minneapolis, the City of Lakes. Interests include fitness, gardening, travel (cruising), yoga, cooking, piano, and social media.

Posted on August 17, 2011, in Treatment and tagged , , , , , , , . Bookmark the permalink. 55 Comments.

  1. Hi William, I just came across your blog while researching medication. Thx for your work! I wonder if you have any info on whether it would be acceptable to switch from Atripla to Complera after 2+ years on Atripla? My doc mentioned switching due to relatively minor, but annoying side affects of Atripla. Mostly anxiety and sleep issues. I started treatment with a VL of 40K and went to undetectable in like 45 days. I also had a TERRIBLE rash! My T-Cells did not rebound and have consistently hovered around 400. I’m 49 and tested POZ in 2008. I am very good about adherence and have only missed one dose in 2 years.

    Any thoughts, info or suggestions are welcomed.

    m

    • HI Michael,
      Thanks for your kind comments. Complera sounds like a great option for you. It’s quite possible that the anxiety and sleep issue would improve if you switched to Complera, and I cannot think of a downside here. Adherence (taking it every day) will still be very important. You also should eat a good meal with it, and you should not be on Prilosec or similar acid blockers. Hope this helps.
      Bill

  2. I tried Atripla and man what a ride. I had violent dreams and fighting in my sleep. I now take Truvida and Raltegravir and to be quite honest, I am tired of taking so many pills. I also take medication for high blood pressure, depression and and acid reflux. I would like to know if Complara would be good for me?

    • Complera might be a great choice for you, unless your virus previously developed a lot of resistance when you took Atripla. In that case, Complera might not work for you. Viral resistance often happens when you miss frequent doses of an HIV medication. I suggest you discuss this with your provider and ask him/her if Complera would work for you. Thanks for writing.
      Bill

  3. I was on truvada & lexiva & norvir & isentress. my 1st dr. was going by my 140,000+ load & count of 38. even then only o.i. was thrush & erosive esophigitis. if i knew woulda never started with all those. i found a doc w/out an ego that is fine w/ me knowing more about pharmacology Than her. stuck @ c. 200cd4 ct. & slowly lapsing into poor compiance we r trying complera. only thing bothers me is that i read rilpy only takes one mutation to Cause resistance. hard to beleive so what r the facts here. Also 1st pill hits hard as I didn’t eat before, so eating is a solid prereq. but one pill a day after 5-7 a day for 5 years is definitely worth a try.

    • Yes, taking it daily is a key to success (and avoiding viral resistance). Try to build a routine that assures that you take it every day, and have some back-ups in place in case you forget, such as a reminder alarm on your cell phone. It requires food for adequate absorption, so glad you’re eating before taking it.

  4. Dr., i have been HIV positive since the late 80’s. Never needed the HIV medication. The T-cell level has lays been above 500>, viro load usually around 10,000. I turned 60 last Nov. In the last 4 years had two pnuemonias. The last one in Jan. of this year was hospitalized for 6 days. Now my doctor put me on Atripla. I have taking it for two weeks now. Side effects like nightmares at night. During the day with dizziness, fatiquness, body aches, muscle twitching, and irregular heart beat off and on. Will all these side effects go away?
    Is it true once you start the Atripla you can’t stop taking it? What should I do? I am not used to all these side effects. I used to be very energetic before taking the drug. Bone and muscle pains make me feel like an 80 yr old man. I hope it will all subside. I don’t feel normal any more!
    Harry

    • Hi Harry,
      Thanks for your message. You can stop Atripla, but I’d like you to talk to your doctor before doing this. Your doctor will likely switch you to a different regimen if you cannot tolerate Atripla.

      You can reduce the nightmares by always taking Atripla on an empty stomach, at least two hours after eating. Most of the side effects you describe improve or go away within the first month after starting Atripla, but sometimes they do not go away for some people.

      I’d let your provider know you are having difficulties, and let them help you.
      Yours,
      Bill

  5. Hi, Dr.

    I am concerned and learned about complera when my anxiety attacks, and anxiety in general, became quite unbearable and “in the way” of my “regular life” from how I was prior taking atripla. Sure, I have felt anxiety before due to life happening, but not to the extent like I do weekly now. I feel like a recent trip to Australia had sparked my anxieties and now they haven’t gone away. They have lowered substantially since the trip, but I still don’t feel right like when I was when I first started atripla, prior to that trip. I have been on atripla for less than a yr (about 8 months). I am 32. Tested positive about 1.5 yrs ago. I experienced the dizzy spells, vivid dreams and got the rash within the first month. I am now undetectable and my t cells are 860.

    Anyway, I guess what I am asking is what are the most profound side effects of complera? I realize everyone is different… Also, what is the main system “attacked” between the two medication? E.g. Atripla concentrates on the central nervous system – can you elaborate on atriplas “attack” on the central nervous system and what complera “attacks?”

    Thanks so much for this blog. Answering a ton of questions, which I have come up with since my visit to my provider who, I will ask more questions on my next visit in a week or so…

    -A

    • Yes, it definitely is. When I was taking Atripla, I had nightmares, was fighting in my sleeep. My husband said I was always talking crazy and I was tired all the time. Now that I am taking Complera, I have not had any side affects at all. I have more energy and I feel good. I would recommend it, especially if you have been taking meds for a while and want to go from multiples to once a day. I love it.

      • Hi Dee,
        Thanks for your comment. I’m glad the medication change is working out well for you. One of my frequent messages to folks with HIV is that if you don’t like your HIV medication, discuss with your provider, and ask for a medication change if possible.
        Yours,
        Bill

      • Thank you for your response. If I must say so myself. Having open communication with your Doctor is the best. We talk about anything and everything that has to do with my body.
        Once again, thank you for you for your response.

  6. This sounds great- from 3/19 I went ahead and changed to complera. And felt great the first 4 days. I did have an anxiety attack at work last week on the 5th day of Taking complera. I did go to my dr and told her about It and she feels that some of the atripla may still be in my body “phasing out” which could be why I may still be having small bouts (episode) of anxiety, nervousness, etc. would you all think that is true? Like atripla takes a few weeks to totally phase out?
    Thanks
    -A

    • Hi Alex,
      It takes about ten days for efavirenz to be eliminated from your body. Efavirenz is the component in Atripla which is NOT in Complera, and it is the medication which is more associated with dreams, anxiety, and dizziness. I suggest you continue to be in close contact with your doctor if you have more panic attacks. Hope it goes well.
      Yours,
      Bill

  7. Hi Bill-

    Complera seems to be going great! However, I was wondering if I can have a glass of wine or a beer with dinner while taking complera during that time. Or should I avoid alcohol all together? It’s a bit difficult, cause I would like to have a wine with freinds and all… Especially at dinner parties. Thoughts on complera and having alcohol (max two glasses of wine)?

    A little bit about how I drink- I drink mostly wine and sometimes beer. Since taking complera I have been reluctant to drink any alcohol. Although better for my health overall, I still want that glass every now and then to relax and enjoy the wine with my food.

    Thanks
    Alex

    • Hi Alex,
      Alcohol does not prevent Complera from working. The biggest concern I have about alcohol is that drinking may cause you to miss doses of your HIV medication. A glass of wine should not be a problem.
      Yours,
      Bill

  8. hi what happens when you don eat a meal with it i have been constipated and stomach pains i eat a meal but some times forget to take the pill and take it later thinking the food is still in my stomach so do these pills cause bowel problems ,,, thanks tim

    • Hi Tim,
      I would not expect Complera to cause constipation. Try not to miss the Complera, take with a small meal for absorption. If you need to vary it a few hours, that should be okay as long as you don’t forget to take it every day. Look for other reasons for constipation: diet, other medications, not enough exercise or water. If it persists, talk to your provider.
      Yours,
      Bill

  9. Bill – thanks for the reassurance on the glass of wine. The gift in disguise is that since I was unsure, I avoided alcohol completely and now don’t want to drink as much as I used to. Although when with freinds it’s nice to have some. At any rate, def going good with the complera now.

    Tim – I did take the complera once about 3 hours after dinner, too and I did have the headaches and tummy aches but not the constipation – in fact, was quite the opposite lol. But yes, drink plenty of water and exercise!

    – Alex xx

  10. So true, just the idea of taking meds is stressful. Just like my freind said “hidden in our biggest trauma is our greatest gift” xoxo Alex

  11. Hi I am taking truvada, prevista, insentra , norvir. My viral load is 0 and t cells around 1100.
    I am simply wanting to take less pills would complera work for me. Atripla did not.

    • HI Josh. I’m glad you are doing so well. I can understand why you would want to simplify yours medcations. Complera might work for you, but it depends on if you developed resistance while taking Atripla. In order to determine this, your provider would look at your genotype while you were on Atripla. There are other one pill options coming out soon which might also be good for you.
      Bill

  12. I just recently changed meds from truvera and isentress to tripla..It ran havoc with my anxiety meds and methadone what now?

  13. I am getting ready to start complera and am nervouse about a few things:

    1. the side affects- what should I expect? Dizziness, lucid dreams, man boobs? All kinda scary!

    2. If not taken with a meal will it be like missing a dose all together? And also should I take it just after my meal or can I take it within the hour?

    Thanks!

    • Hi Jaime,
      No need to be nervous. Complera is very well tolerated by most people. I do not expect you’ll feel much different at all, although any time you start new medication there can be a period of adjustment. I usually suggest that my patients start a new medication on their day off when they can be close to home.
      You might have some nausea, but it should not be severe. You should eat a meal of at least 400 calores, such as 2 slices of whole-wheat toast with peanut butter, fresh fruit, and 1 cup of apple juice. If you take it within an hour of eating, that should be fine. Taking it with food should reduce nausea, and it assures that it is well absorbed into you system.
      Try to not miss taking it. If you miss a dose of Complera within 12 hours of the time you usually take it, take your dose of Complera with a meal as soon as possible. Then, take your next dose of Complera at the regularly scheduled time
      If you miss a dose of Complera by more than 12 hours of the time you usually take it, wait and then take the next dose of Complera at the regularly scheduled time.
      Do not take more than your prescribed dose to make up for a missed dose. Don’t double your dose to “catch up.”
      Try to take it at about the same time everyday with a medium or large meal. This might take some planning if you are away from home at medication time. You could pack some nuts and granola bars in your bag for emergency snacks.
      If you get a rash, be sure to let your doctor know right away. Some rashes can be severe, and you so I always recommend calling right away if you get a rash.
      Let me know how it goes!
      Bill

    • Jaime-
      I had the same concerns and although we r different ppl and we can have different reactions i wouldnt worry. Just make sure i eat, serioulsly. I eat my dinner and immediately i take it. Even when im out with friends amd having wine or whatsver ill stop and drink a whole glass of water and im good. No one has to know i just say im taking a multi-vitamin…I have had NO side effects at all. Only one time when i took it 2 hours after eating…. I didnt sleep well. And had a headache and tummy ache. Also, I had missed a dose and took it the next day and no drama all good.
      Other than not knowing the long term effects i am loving complera.
      Keep us posted.
      Alex
      Xoxo

  14. Hi Bill, I been taking complera for 3 weeks already. Since last week I been feeling Heartburns,stomach bloated,difficulty breathing and I have trouble swollowing. I have to burp for about 3 hours so that it can go away. It all start about same time I take it and gets worse for about 5 hours later.

    • Hi Juan,
      That sounds very uncomfortable. I suggest you go back to your doctor soon (even today), especially if you are having difficulty breathing or swallowing. This is not a typical response to Complera. How much are you eating when you take it? Do not be tempted to take Prilosec, or similar acid blocking stomach medications, because it will interfere with the absorption of the Complera. Let me know what happens, okay?
      Bill

  15. First of all, thank you for all the information you have shared thus far!! It has been very helpful!! My question is….What type of “fatty food” or drink can be taken with Complera?

    • Hi CeeJay,

      Thanks for your question about food to eat with Complera. You should take Complera with a meal of 400 calories or more. You can accomplish this in a number of ways. A protein drink does not replace a meal because they tend to be much lower in calories, so read the label.

      Here are some suggestions from the Complera website for a breakfast meal:

      2 slices of whole-wheat toast with peanut butter, fresh fruit, and 1 cup of apple juice

      Plain bagel with 2 tbsp cream cheese, yogurt, and a banana

      2 Pop-Tarts®, yogurt, and 1 cup of apple juice
      Dunkin’ Donuts® blueberry muffin and a small coffee with cream

      Starbucks® strawberry and blueberry yogurt parfait and a tall latte

      2 eggs, 2 strips of bacon, and 2 slices of wheat toast with butter

      Let me know how it goes. Does anyone else have any suggestions?

      • Hi!
        I have been on Complera since feb and the meals have been super easy! I do a protien and complex carb everytime and veggies. I like to take it for dinner as that tends to by biggest meal. I mainly do a grilled chicken breast, quinoa with spinach and sprinkle low fat mozz strings on the quinoa. And a gooood cup of mixed veggies. And a small dessert. And right after that i take the complera. I do look at the nutrition facts to see the calories per serving on any new dishes i come up with.

        Best and love
        Alex

  16. My stomach hurt burn is bad since the switch from Atrila to completra. plus my stomach has been gas up ive been on completra from 2 weeks.Atripla had been very fatique what should I do

    • I’m sorry to hear the switch has not gone well. I suggest you call your provider or go back for a follow-up appointment. He can evaluate you and help you decide what to do next. Sometimes it requires a medication change, sometimes it requires treating you for something else. Don’t give up!

  17. ive been taking complera for 10 days now, my doctor switched me from kaletra due to high cholesterol , i have been getting heart burn after 4 hours of taking the pill with a meal .
    it comes and goes .. is this going to go away? my doctor also gave me zantac 150 mg before i started complera and said to take one if i get heart burn … the complera site says its not the best thing to do …

    • Hopefully the heart burn will go away soon. In the mean time, you should get relief from antacids or H2 blockers, such as Zantac. Here are some tips to take them safely with Complera:

      H2 blockers (Zantac (ranitidine), Tagamet (cimetidine), and Pepcid (famotidine) must be separated from the Complera. You can take Zantac and other H2 blockers at least 12 hours before or at least 4 hours after taking Complera. So let’s say you take Complera with breakfast each day at 7 AM. You could take the Zantac between 11 AM and 7 PM.

      Antacids are another option. These are medications like Tums, Maalox, or Rolaids. These should also be separated from Complera. Take an antacid either 2 hours before or 4 hours after you take Complera.

      Proton pump inhibitors, such as Prilosec (omeprazole) or Nexium (esomeprazole) should never be used while taking Complera.

      The reason for these rules is that Complera needs acid in your stomach for adequate absorption, and H2 blockers, H2 blockers, and proton pump inhibitors all block acid in your stomach to varying degrees.

      You might talk to your doctor about additional things you can do to avoid heartburn, such as avoiding large meals or certain foods which might trigger it and not laying down too soon after eating.

      I would give it at least a month to see if it goes away, but if your heart burn lasts longer than that, I suggest you see your doctor and ask about another medication option.

      Thanks for writing.
      Bill

  18. my question is ive been on atrippla for 5 years and i went for my check up my viral load was undetectable les then 50 my tcells were 890 ..now i go back and my virol load went to up to 500 .my tcell 860 ..thye doctor wants to change me becouse i guess i got immune to the atrippla my question is ..will complera work for me ..thanks steve

    • Hi Steve,
      I don’t have enough information to answer your question, unfortunately. It is possible that your virus might also be resistant to Complera, but without a genotype, we cannot know for sure. Typically you cannot get a genotype until your viral load is at least 1000 copies or more. Complera and Atripla are closely related, so I would not recommend switching to Complera unless you have a genotype that says it is okay.

      You could stay on Atripla and monitor your viral load more closely or switch to new classes of medications that you have not previously received. We would prefer to have more information from a genotype before making such a switch, however.

      I need to ask about your adherence. If you have been missing doses, this could explain your viral load increase. It’s possible that getting back to perfect adherence will bring your viral load back down unless your virus has developed resistance. The most likely reason for viral resistance is missing doses.
      Good luck!
      Bill

  19. Hi. Stumbled upon this blog in doing research about one pill regimens. Newly diagnosed here about 6 months ago. At last blood test a week ago, CD4 count was 1200 and Viral load was 50K. Doc wants to start getting the VL down to undetectable even though my CD4 counts are really good. So.. I’m debating between Atripla and Complera. Which to take? I like the idea of a pill at bedtime which seems so easy.. compared to having to eat a meal with a pill, but I dont like the idea of the psychological effects of Atripla. Are the crazy dreams and dizziness guaranteed? What about other toxicity like liver etc. What would you recommend?

    • Hi Adam,
      You ask a question that many of my patients and their doctors face: Which one pill regimen would be best for them? It’s really something we have to consider on a case by case basis.

      Either medication will work great for you as long as you take it daily. if you are likely to miss doses, you will be setting yourself up for problems with these medications, and a one pill regimen may not be for you.

      Atripla often causes some sleep disturbance and vivid dreams. These may go away with time, or they may continue. Taking Atripla on an empty stomach will help reduce the liklihood of the dreams.

      Complera is a great alternative. You should take it with a meal. If you do not eat regular meals, this may not be a good choice. You also should not take proton pump inhibitors, like Prilosec, with Complera.

      Liver toxicity is not likely. Your doctor will monitor your kidney function.

      If it were me, I would opt for the Complera to reduce the likelihood of central nervous effects. I also eat regular meals, so fitting it into my schedule is easy.

      Thanks for reading my blog. You have inspired me to write more regularly for it. Let our readers know what you decide to do, if you will, and tell us how it goes for you.

      Yours,
      Bill

      • so are you suggesting that perhaps I look at multipill options? I had presumed that one a day pills were the best options out there but it sounds like there are others. I dont know that I will have issues with compliance, but one never knows. I dont like the necessity of the food component with Complera but also dont like the neurotoxicity potential of the Atripla. Proton pump inhibitors are not an issue (I had to google that to find out what they are).. and other than the hiv infection, I’m completely healthy with no drug dependencies or anything of that nature. i’m stumped really on what to do.

      • Hi Adam,
        Multipill options are still a great option for treatment of HIV. Prezista, a protease inhibitor, is highly effective and it has a higher barrier to resistance thatn Complera and Atripla. Prezista is much harder to screw up if you miss a dose here and there. It would require that you also Norvir separately along with a backbone nucleoside combination, usually Truvada. You could take all three pills once a day, but it should be with food.

        Since we are on the topic of multitablet regiments, another great regimen is Isentress, tablet twice a day, plus Truvada, one tablet once a day. Isentress must be taken twice a day, however.

        Tivicay or dolutegravir was just approved by the FDA this month. It is a new integrase inhibitor that can be taken once a day without the need for “boosting.” It is extremely potent. I’ll be blogging about it in the weeks to come. It does not yet come in a one pill formulation, but that may happen next year sometime. If your doctor prescribed Tivicay at this time, you would likely combine it with Truvada or Epzicom. This then would be just two pills once a day.

        A disadvantage of multitablet regimens is the possibility that you will leave one or more tablets out of the regimen by mistake, greately reducing its effectiveness and increasing the chances of viral resistance.

        Stribild is another great one pill option. I don’t believe we’ve discussed that one yet. It should be taken with food.

        If you want to delve into this further, a great resource is the DHHS HIV Guidelines: http://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/11/what-to-start

        It is is possible to switch regimens if you start one and do no like it for some reasons. We have many patients who try two or three regimens or more before they find one they like. It is important to stay in close communication with your provider, especially when starting or changing HIV therapy.

        Best,
        Bill

  20. Hi Adam, I started this thread a couple of years ago and William has kept it going, answering all the posts. Thanks William! As to the drugs, I’m still on Atripla. Since Complera was fairly new at the time, I decided not to change. Atripla and I continue to have a love-hate relationship. Some mornings I get up and my first thought of the day is, “I’m changing meds!” And then the fog lifts and I move on. Other days, I feel fine, or so it seems.

    Yes, one pill at bedtime sounds like a minimally invasive course, but trust me, that pill opens a can of worms! LOL. For me, still after 4.5 years, I often feel I live two lives. The “movie” in my sleep and then the “real” life when I get up. At times it’s exhausting. Sometimes, it’s highly entertaining. But sadly, I don’t remember what it feels like to feel normal. I also take a low dose Valium, to help with agitation and anxiety, which adds its own element to the “fog”. Eventually, I had to start on Lipitor to get my cholesterol in check. So, turns out it’s not “one pill” for me.

    If you eat light and early meals for dinner, it definitely helps. But I love to cook and have friends over, and if I eat late without enough time to digest the food, those nights are tough.

    My viral load has remained undetectable. My T cells only recently started to go up. So there are benefits. The drug works. And it’s my understanding – and William can comment on this – Atripla works on the blood/brain barrier issues. I still think about changing. When my former MD returns from his 3 year sabbatical, and I may go back to him for counsel.

    You have many options. More than were available when I originally reached out to William, so get as much info as you can. If I had to do it over today, I would opt for something other than Atripla.

    • Hi Michael,
      Thanks for your persective. I think you summarized some of the challenges of Atripla very well. Efavirenz, in Atripla, is responsible for the CNS adverse effects. Other HIV medications penetrate the blood brain barrier a little more, and some penetrate it less.

      Michael, I would encourage you to have that conversation with your doctor about switching medications. There are some great alternatives now. If you switch to Complera, for example, your sleep will likely be affected less, and your lipids should improve.

      Some people don’t mind Atripla, and therefore I’m not suggesting that everyone needs to change.

      Thanks for your contribution!

      Bill

  21. I think there is too much adoration of Rilpivirine on this site (the key component NNRTI of Complera). The fact is that Rilpivirine is the same family as efeverenze. I tried a switch from boosted Duranavir (only becuase of the need to have steroid treatment). My doc prescribed Rilpivirine ) That was the nastiest experience of my life. Total dizziness 24/7 anxiety paranoia, fog and fatigue all day and night, unable to work or drive r even walk. I told my doc i didnt want a NNRTI. They are all the same. They have vile side effects that dont go away and a -0.00000% resistance threshold.

    I WOULD ADVISE ANYONE TO STAY CLEAR OF THESE MEDS IF YOU VALUE QUALITY OF LIFE AND SANITY.

    • Hi Mary. Sorry to hear you had a bad experience on Complera. I think your comment illustrates that everyone is different when it comes to HIV treatment. A medication that doesn’t work for you or one with too many side effects might be a great choice for someone else. NNRTIs are not all the same. They are a great option for many people living with HIV. We all have the choice of which medicines we will take.

      • Hello again. Thought id provide an update. Decided to commence treatment with Atripla..and aside from about a week of heart palpitations at night (which i attributed more to my own anxiety than anything else) and some pretty crazy lucid dreams at night (exacerbated by latenight eating…especially fatty foods) things are great. My viral load dropped from 50k to undetectable in about 4 weeks. My cd4 count was always higher than most and has remained stable over 1100 for about a year now. Ive been on Atripla since Sept’13. I will be switching over to a new one pill regimen once approved in Canada but otherwise ive had zero qualms about my decision to take Atripla. The food requirement of Complera was what convinced me to go the Atripla route, and much prefer to sleep off any side effects that may result. I havent had any dizziness with Aptripla post the first week. The dreams..while sleep depriving at times…are book worthy. Film worthy even. I just wish i would have written them down from the beginning. Ha.

  22. Thanks for your update, Adam. The dreams from Atripla can be amazing. I once dreamt that I was at a party at Martha Stewart’s home. It was very exciting!

  23. I just have a really huge concern. I have been taking complera and have only been on this regimen. I had lapses of time in which I didn’t take the meds and would be fine usually a two week span. I then started to take it faithfully. I recently was undetectable in July we are in September now I have a 6,000 copies. I stopped taking the meds mid July because I thought I was pregnant and I am I am now 10 weeks. Will this cause complications for me in the future? Up to this point complera is a great medication, my ID told me if I were to get pregnant he would have to change my meds. Please advise I am so distraught and upset I don’t know what to do with myself 😞

    • Hi, thanks for your question. First, I want to ask you to take a deep breath and relax, because you will be okay! It’s not surprising that you have a viral load of 6000 if you stopped the Complera in mid-July.

      You will need to resume HIV medication while you are pregnant, and after, too. You doctor will likely do a genotype to determine the best combination for you. This will determine if the virus in your body has developed any mutations. In addition, there are certain combinations that we have more experience using during pregnancy.

      Once you get started on medications again, it will be important to take them daily without any stops. If you are able to do this, you and your baby should be okay.

      Thanks for writing

      • Thank you so much. He advised I start the complera again and will check the viral load in 4 weeks. In 5 weeks I have an appointment with him. I just want to thank you for replying and making me feel better. All the nurses were ecstatic about the baby and said I am in great hands. I will continue to keep you posted. Thanks again :) :) your a god send

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