HIV Support Group

HIV (also known as human immunodeficiency virus, and formerly known as HTLV-III and lymphadenopathy-associated virus) is a retrovirus that primarily infects vital components of the human immune system which can lead the syndrome known as AIDS. Many of the problems faced by people infected with HIV result from failure of the immune system to protect from opportunistic infections and cancers.

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Taking Atripla in the morning.

I have been taking Atripla for two weeks now and have adjusted to it well, no extreme side affects, no dreams or rash, etc. The only thing I have noticed is that I haven't had a full nights sleep since I started taking it. I always take it right before bed on an empty stomach, yet I wake up around 4 am every night, and usually have to go to the bathroom badly. I can never get back to sleep, I have tried everything. I have tried reading, simply laying back down, taking a xanax, getting up for a *smoke*....nothing helps! I have been reading lately about taking it in the morning instead of at night, there are quite a few people out there who have done the same thing, for the same reason. I have noticed that most of the people who take it during the day have had no real side affects and switching to a day time dose worked great for them. I am just wondering if anyone on this site has any experience with switching from night to day and if the switch was actually beneficial. Any help is appreciated. Thanks.

Replies

DrDuke
DrDuke

There has been a lot of talk here at DS about atripla and vivid dreams and all. I hope some other people reply to this, It really helps for people to share their experiences even if they are average or not remarkable. If only the people with problems write in, we get the impression that everyone has problems.

I see no reason why it would hurt for you to try morning dose instead of evening. If you do, please let us know how that works out for you, whether it is good or bad. Daydreams? I am not sure why an evening dose is recommended if the dreams or other sleep problems are a common side effect.
deleted_user
deleted_user

Atripla for almost 3 yrs now, taking it at night. I have had an anxiety disorder since the '80's, and although I take Xanax ER 3 mg in morning, with up to two 1 mg Xanax for breakthough anxiety, I almost always take one of the 1 mg Xanax at night in order to sleep better since taking Atripla. I'm one of those people that like my father and grandfather before me, only need 4-6 hrs sleep unless my body tells me otherwise. I still have vivid dreams, but being a creative-type, I welcome them. I wanted to reply mainly in case you have any G.I. issues, as I have IBS, and taking Atripla in morning was not advised for that reason and the very fact that if you do take it mornings, you really do not want to eat food for several hours afterwards because due to flood of blood to stomach/G.I. system, you would end up with too much Atripla/levels in your blood, causing more possibility for side effects, especially any heavy carb or fatty foods as even in evening I have tried having some food about an hour after taking Atripla (gives me munchies for some reason), and it always has caused G.I. issues, so limit it to plain high grain toast or applesauce to avoid this. I have a buddy that always worked night shift and before being on disability, he was used to taking Atripla in mornings, when he would normally sleep. He still takes in morning but does have to go back to sleep for a few hours, otherwise he feels rather too medicated to function. Hope this helps from my perspective. In case you read my profile, my peripheral neuropathy started three months before even starting HAART/Atripla, with rather dismal lab #'s in the very beginning, with my I.D. Dr. telling me that hiv is a VERY SMART and adaptive virus, and since I also have degenerative disc disease along with a severe anxiety disorder, hiv simply went to my "Achilles Heal", my CNS, and although I still take Lyrica/Cymbata to help the PN, it still is very prevalent, maybe getting a bit worse, even though I have been undectable for a year and half, with cd4 varying from 1200-1500. I shared this because Atripla is not known to incur neuropathy, however, hiv itself CAN. If you ever feel any tingling, numbness in toes or fingers, talk to your Dr.
Peace!
deleted_user
deleted_user

DrDuke- Thanks for the post and support! And thanks to you too Namnibor!

So, I have made the switch to a daytime dose! It is working really great for me. I get up around 6:30-7am and take my Atripla with a bottled water, I am fortuate to not have to be anywhere so I can sit down and let the pill run it's course for about an hour. I do not eat or drink anything else, I usually catch up on my computer work and emails and by the time the hour is up I am feeling normal. The only real side affect is a short period of dizzyness but it is nothing extreme, I can function and do not feel scared, I have still had NO dreams, at all, no daydreams, hallucinations (visual or auditory) and no rash to speak of. I am still having some light stomach issues (bubbling) but if I watch what I eat and don't overstuff myself with junk food, it usually subsides within an hour or two. The diarehha is not getting much better and I have had some slight stomach cramping, ALL is repaired if I take an Immodium along with my morning dose of Atripla. I still feel very much "plugged in" like I have an endless amount of mental energy, I just wish my body felt as if it could keep up. I am beginning to feel the desire to jog or do some light cardio to build my stamina back up, I feel that the past 3 or 4 years my body has been battling HIV so strongly, that I felt mentally and physically drained and stopped pursuing activities that I love. I am now feeling like I can get back out there and do those things, I just have to build myself back up.
For anyone out there just starting Atripla or if you've been on it awhile and you do not like taking it at night, I would suggest talking with your Doctor about switching to a morning dose. It has really given me my precious sleep time back and I feel much better than when I took it at night. Knowing that I am taking it and staying awake scared me at first, you hear and read a lot about this drug and it's side affects. I am fortunate to not have experienced most of them, I hope this doesn't offend those who cannot take it. I simply want to put this out there in case someone who is scared or questioning can see that it isn't as bad as you might think it is, it can be done and you should at least try to see if you can handle it as well as many do. It is very nice to be concerned with only 1 pill a day, and now that I'm sleeping throug the nights, its almost like a vitamin that I take in the morning and it doesn't weigh heavily on my heart as it did before. I am always willing to chat with anyone who might need some advice, answers or just a shoulder to cry on. Many of the guys here have helped me, I hope that this can help someone too.
My love to you all!
deleted_user
deleted_user

Still hanging in there with the Morning Dose! It's working out much better than taking it at night. I feel really great and am sleeping through the night, no serious problems during the day, just a mild case of stomach issues for a few hours after taking it.
deleted_user
deleted_user

glad to read your post i started atripla about a year ago but found that the vivid dreams kept me from getting any sleep.so im glad to hear you had no problems taking it during maybe thats what might work for me! the dizziness and not being able to see at night to drive scared me so now i take truvada and viramune and i find that it works very well .but i do get the tingling in my hands and feet but its only bad at night.
deleted_user
deleted_user

im right there with you guys. im starting atripla tonight and im praying my body reacts to it good. im glad to see u guys posting atripla updates cuz its really been a huge support system to read this and help me get the confidence to try the pill.
deleted_user
deleted_user

when u guys say vivid dreams, and dizzyness. wha do u mean? how r the dreams? r they scary??? do u wake up screaming? and the dizzyness, does it make u nautious, likeif i were to become dizzy, would i feel the need to want to sit down for a while at night?
deleted_user
deleted_user

PerfectDawn, I have not experienced the dreaming side effect, I have normal dreams at night nothing vivid or different about them since I began taking Atripla. I have a dizzy feeling for two hours after taking it, but that wears off, I have gotten use to sort of skipping breakfast because it's best not to eat, I usually take the pill at 7am and by lunch time I feel fine and go about my day. I'll sneak a banana in there around 11am if I get too hungry. I still have my morning coffee, no problems there. I'm just relating to you my experience, yours may be different as you can see, others do not tolerate Atripla as well. I have only been taking it for one month, so I'm no expert, there are others on here who have taken it longer and have more experience. This is just mine, so far.
deleted_user
deleted_user

well thats great to here ur doing ok with the medication so far. i appreciat ereading your posts. i am going to posts how i react to the meds on here as well.
deleted_user
deleted_user

Positivelycharming, thank you for sharing your experience, I am newly diagnosed and start taking Atripla tonight. I feel like Will Smiths character in the horror flick "I am Legend," preparing for my night.
It is June 29, 2011at 9:57pm. I will share my experience and thank you all for taking the time to enlighten those of us who are new on this journey. May we all endure with peace of mind. :)
deleted_user
deleted_user

Good morning, I survived the night, it was very interesting. Atripla definitely affected my central nervous system, coupled with vivid dreams, I felt as though I had swallowed a nano bot, and became a transformer. My limbs seem to work consistently through the night in conjunction with my dreams, heavy breathing and my heart seem to bounce out of control working in harmony with my dreams and the bots (lol). My roommate is in the medical field, he checked my heart rate in the night and it was normal, so the medicine defies normality. I'm glad to be awake, and if this continues I will switch to day time. I feel normal this morning, I'm experiencing a light itch that is not allocated to one area, seems to be my left hand one second and my foot another, then my shoulder. Otherwise, no other symptoms. Other than feeling like I have been infiltrated by robots I am ok. We will survive :)
deleted_user
deleted_user

Well I'm on week 3, had ALL the side effects. I had decided to try it in the morning as it would suit my life style. It was absolutely impossible. It was like a chemical kosh for 5 hours, couldn't concentrate on anything, felt on the verge of panic and horribly disturbing thoughts. The dreams were the least of my problems but 8 hours of computer games and sex while asleep was exhausting. I was on the verge of giving up. I decided to switch the evening which took a few days to adjust the time, and the side effects persisted as strong as ever. Then someone here suggested taking 500mg of magnesium with the Attripla. It changed everything the effects were reduced considerably so much so I am able to write this email having taken the pill 1 hour and 45 mins ago. Unheard of before the magnesium. I can't tell you the relief I'm feeling. I am now considering moving to a morning dose again. The dreams are not so intense although I do want to pee in the early hours.

I am now just left with a raised rash on my chest which looks horrid but I am prepared to wait this one out. Before the magnesium tip I felt I been to hell and back, a localised rash is a walk in the park in comparison and the thought I can return to a morning dose pure joy !
deleted_user
deleted_user

I took Efavirenz-Lamivudine-Tenofovir (the components of Atripla) for 2 months, at bedtime, on an empty stomach, by the book. The first 2 weeks were tough, dizzy after 2 hours, almost no sleep, then once barely asleep really awful dreams, liver pain, diarrheia, terrible digestions... After 2 weeks it started to get better, but still very difficult to sleep, mayber 2-3 hours tops a night. So, on the advice of my doctor, I started to take it right after breakfast, and now I am sleeping again much better, and basically I still only had the digestive problems, so overall the switch was positive. My CD4 was above 500 and 30 %, so as I was concerned with possible lipodystrophy associated with Efavirenz, I switched to Atazanavir+Ritonavir, still after breakfast, and the stomach problems are gone, so I would say I am pretty much set. Read a lot, and ask many questions, there are all kinds of treatment options available out there, and among them, there is the one best suited for you. As it is a lifelong medication, there is no reason why you should stick to a regimen that makes you sick or uncomfortable. Cheers
art1st
art1st

Hi,

I've been on Atripla for 3.5 years now and did about two of them on an early morning dose. I've since switched back to a bedtime dose and feel much better for it. The main reason for switching back was that sometimes I was too spaced out and found it hard to concentrate or function circa 3-4 hours in from taking the pill. The reason I originally switched to a morning dose was to try and live as normal a life as possible without the possible contraindications associated with taking the meds with food. However, having moved back to the bedtime routine I don't worry at all about meals, fatty foods or alcohol and have to say I now have some of the best sleep I've ever had.

Atripla and HIV meds seem to affect people in very different and sometimes extreme ways and I believe the advice to take at night time is there solely that you sleep through some of the possible side effects. So I say try and adapt to whatever suits you and your lifestyle the best. For what it's worth and having tried both options I would say the morning dose would probably suit someone who works late or afternoon shifts. FYI the half-life of Atripla is circa 36 hours so there is no need to take your meds at exactly the same time each day. My specialist reckons that if it's within an hour or two each day and as long as you even it out every few days then that is fine as you keep constant levels of the drugs in your blood stream.

Take care!
deleted_user
deleted_user

Still taking the magnesium, the side effects have all but gone, the rash is almost gone. Now I am considering a return to a morning dose. Magnesium has been a real life saver for me.

Seriously if you are having side effects try the magnesium supplement it is bloody amazing !!!!!!!