Medications must be taken regularly (at the same time each day and asdirected by your doctor or pharmacist) to ensure there is always a sufficientamount in your blood.

If the concentration is too low, the virus will begin to replicate itself andbecome drug resistant. As a result, the drug will lose its effectiveness onthe virus and your treatment will no longer be effective.

1. Try to integrate taking your medication into your lifestyle, not the other way around.2. Combine the intake of drugs with daily activities: taking your medication after supper, before bedtime or before brushing your teeth, for example, is a systematic way to remember to take it.3. It is usually easier to take medications at home, where you are less likely to forget.4. Changes in routine (trips, weekends, shift changes): before a change occurs, determine which strategies you will use to avoid forgetting your dose of medication.5. Think ahead: always have an extra daily dose on hand. Renew your prescriptions a week early.6. Use tools to adhere to your regimen, such as a pill organizer or a timer or watch with an alarm, or use a journal to keep track of your medications.7. Establish a network (friends / family) that will help you in taking your medicines.

Keep in mind that anyone can have trouble adhering to treatment. Don’thesitate to consult your healthcare team and ask for help.

NRTI COMBINATIONS

KI V E X AAbacavir/Lamivudine

600/300 mg

TR U VA DAEmtricitabine/Tenofovir DF

200/300 mg

DE S C OV YEmtricitabine/Tenofovir AF

200/25 mg

DE S C OV YEmtricitabine/Tenofovir AF

200/10 mg

INSTI

IS E N T R E S SRaltegravir - 400 mg

TI V I CAYDolutegravir - 50 mg

* Dosage 2 times a day is recommended in the presence of a documented or suspected resistance virus to integrase or inthe presence of certain drug interactions.

Combination with INSTI

ST R I B I L D

Elvitegravir/Cobicistat/Emtricitabine/Tenofovir DF150/150/200/300 mg

GE N VOYA

Elvitegravir/Cobicistat/Emtricitabine/Tenofovir AF

150/150/200/10 mg

TR I U M E Q

Abacavir/Lamivudine/Dolutegravir

600/300/50 mg

* Should not be initiated when creatinine clearance is less than 70 ml/min.

** Should not be initiated when creatinine clearance is less than 30 ml/min.

IP

Antiretrovirals frequently prescribed

PR E Z I S TADarunavir - 800 mg

+NO RV I R

Ritonavir - 100 mg

*

*

* *

HIV life-cycle and antiretroviral site of action

MORNING EVENING

WITH WITHOUT

FOOD FOOD

INTI : NUCLEOTIDE OR NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS

INNTI : NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS

IP : PROTEASE INHIBITORS

INSTI : INTEGRASE STRAND TRANSFER INHIBITOR

AT ANY TIME, BUT AT THE SAME TIME EACH DAY

Legende

Different antiretroviral (anti-HIV) drugs act at different stages of HIVreplication.

When taken regularly, according to the instructions, antiretroviral therapylowers the level of virus in the blood (viral load) and improves your immunefunction (CD4+ T lymphocytes).

Our aim is to:

ê lower your viral load to below 20 copies/mLé raise your CD4 count as much as possible

The objective is to maintain your health and reduce the risk of developinginfections which appear when your immune defences are down.

Your viral load is : ________

Your CD4 are : ________

What are the treatment objectives?

Most of the antiretroviral therapies are well tolerated.

However, each individual is different and some people may have sideeffects. You will find here the effects that could be observed with thetherapy that has been prescribed to you.

Before you consider discontinuing your therapy or if you have any sideeffects, talk to your doctor or pharmacist; they can help you with tips tomanage them.

□ Systemic effects: Fatigue, headache, minor aches and pains, musclepain. These effects generally subside after the first weeks of treatment. Theydisappear when your body becomes accustomed to the drugs. Try to startyour therapy when you are well rested. If possible, try to start when youhave few days off. For headache and muscle pain, acetaminophen(Tylenol) may be useful. You should, however, notify your doctor if thesesymptoms are accompanied by fever, a rash, shortness of breath, or if youbecome pale or experience gastrointestinal effects including a loss ofappetite, abdominal pain accompanied by nausea, vomiting or any otherunusual and persistent adverse effects.

□ Gastrointestinal effects: Diarrhea, loss of appetite, nauseasometimes with vomiting. Taking medications with food often helps toreduce digestive effects. First, make sure your medication may be takenwith food. Sometimes changing your schedule can help to better controldigestive effects. Certain people may require medications for the treatmentof nausea, such as dimenhydrinate (Gravol), or diarrhea (Imodium, calciumor other medication). Be sure to notify your doctor if you vomit every day,if you have more than three diarrheal stools a day, if you have a fever, ifthere is blood in your stool and, finally, if the digestive symptoms areaccompanied by intense fatigue or if these symptoms persist and becomeworse. It is essential to avoid dehydration, so you should seek advicewithout delay.

□ Skin reactions: Eruptions (redness) may develop during the first fewweeks of treatment, especially with antiretrovirals in the NNRTI class. Mostof the time, the eruptions are not severe and you will be offered to continueyour medication. At any time, if eruptions occur, it is important to have adoctor assess the severity of your symptoms.

When needed, taking an antihistamine may help reduce the itchiness. In rare cases, the reaction may be severe and treatment may have to bediscontinued.

If you have a fever and feel your condition deteriorates (severe tiredness,gastrointestinal effects, ulcers in the mouth, difficulty breathing, etc.),promptly notify the doctor or go to the hospital.

□ Increase of the bilirubine: atazanavir (Reyataz) can cause ajaundice, which is a yellow coloring of your skin and the white of youreyes. This effect, if it shows itself, tends to decrease over time.

Jaundice is not dangerous and does not require to stop the therapy.However, if the jaundice bothers you, discuss it with your healthcareprofessional.

□ Central nervous system: Abnormal dreams, drowsiness orinsomnia, dizziness, changes in mood, etc. These effects can appear invarious degrees with certain antiretrovirals, but especially with efavirenz(Sustiva, Atripla). These effects disappear after two weeks in most people.Talk to your doctor if they persist beyond 4 weeks.

What unwanted effects may I expect?

Most HIV drugs can interact with other drugs. It is important to let yourpharmacist or doctor know about all other prescription drugs, over-the-counter medications, natural products and recreational drugs you areusing.

Mixing medication !

ANTIRETROVIRALS

Why do i need to take the drug regularly?

INTI

3T CLamivudine - 300 mg

3T CLamivudine - 150 mg

RE T R OV I RZidovudine - 100 mg

VI D E X ECDidanosine

400 mg > 60 kg

VI R E A DTenofovir DF - 300 mg

ZE R I TStavudine - 40 mg

> 60 kg

ZI AG E NAbacavir - 300 mg

Combination with INNTI

AT R I P L AEfavirenz/Emtricitabine/

Tenofovir DF600/200/300 mg

CO M P L E R ARilpivirine/Emtricitabine/

Tenofovir DF25/200/300 mg

* Avoid taking with high-fat meals.** Meal with approximately 390 calories. Taking this medication

with a nutritional drink (Boost, Ensure, etc.) is not sufficient to absorb rilpivirine adequately.

INNTI

IN T E L E N C EEtravirine - 200 mg

ED U R A N TRilpivirine - 25 mg

SU S T I VAEfavirenz - 600 mg

VI R A M U N ENevirapine - 200 mg

VI R A M U N E X RNevirapine - 400 mg

* Meal with approximately 533 calories. Taking this medication with a nutritional drink (Boost, Ensure, etc.) is not sufficient to absorb rilpivirine adequately.

** Avoid taking with high-fat meals. *** First 14 days of treatment: the posology is 1 tablet of

200 mg per day.**** Following the first 14 days of treatment: the posology is

200 mg twice a day or 400 mg once a day.

Combination with INTI

CO M B I V I RLamivudine/Zidovudine

150/300 mg

TR I Z I V I RLamivudine/

Zidovudine/Abacavir150/300/300 mg

Other antiretrovirals

*

* *

* *

* * *

* * * *

* * * *

*

Other antiretrovirals

KA L E T R ALopinavir/Ritonavir

200/50 mg

PR E Z C O B I XDarunavir/Cobicistat

800/150 mg

EVO TA ZAtazanavir/Cobicistat

300/150 mg

RE YATA ZAtazanavir - 200 mg

VI R AC E P TNelfinavir - 625 mg

* The twice a day schedule is recommended for pregnant women, for those who take medicine which can decrease the efficacy of Kaletra (inducers of the CYP 3A4) and in presenceof a virus with 3 mutations or more on the protease gene.

** In the presence of a virus with at least 1 mutation or more specific to darunavir.

*** In the presence of a virus with at least 1 mutation on the protease gene.

CCR5 Inhibitor

CE L S E N T R IMaraviroc - 150 mg

CE L S E N T R IMaraviroc - 300 mg

Fusion Inhibitor

FU Z E O N

Enfuvirtide - 90 mg

PR E Z I S TADarunavir - 600 mg

+NO RV I R

Ritonavir - 100 mg

RE YATA ZAtazanavir - 300 mg

+NO RV I R

Ritonavir - 100 mg

AP T I V U STipranavir - 250 mg

+NO RV I R

Ritonavir - 100 mg

IN V I R A S ESaquinavir - 500 mg

+NO RV I R

Ritonavir - 100 mg

TE L Z I RFosamprenavir

700 mg+

NO RV I RRitonavir - 100 mg

*

* *

* * *

* * *

Boosted PIs

Persons to contact

Notes

Schedule of your medication

NameWith foodyes / no

Hour

With blood tests to be performed on a regular basis, your doctor will be ableto see the effectiveness of the drugs and also to prevent adverse effects that cansometimes occur in some individuals.

This is why it is important to regularly do your blood tests and attend yourmedical appointments.

w w w . h i v m e d i c a t i o n g u i d e . c o m

M a y 2 0 17 © R a c h e l T h e r r i e n