Currently, antiretroviral drugs for HIV treatment have been developed from the prior formulations that were used 10-20 years ago. In Thailand, there are several new formulations of antiretroviral drugs that have been proven to effectively control the HIV virus with minimal side effects on the body.
Consultation and treatment for HIV
Frequently used HIV medications
The commonly used HIV medications at present include both combined and separate tablets, such as:
- Biktarvy: One pill per day. This is the original medication from Gilead, a leading producer of antiretroviral drugs. It has minimal side effects and is taken only once a day, without causing headaches or long-term side effects on the kidneys and bones.
- Kocitaf: One pill per day, similar to Biktarvy. It is a medication from Mylan, a pharmaceutical company based in India. It has similar components to Biktarvy and minimal side effects. However, it is more affordable due to not being the original medication.
- Acriptega: One pill per day. This medication is used in Thailand as a replacement for Teevir (the original medication being Atripla). It is also manufactured by Mylan. The advantage of Acriptega over Teevir is the absence of headaches and dizziness. However, it still contains TDF, a medication that may cause issues with the kidneys or bones in the long term. The first two medications mentioned (Biktarvy and Kocitaf) have already been modified from TDF to TAF, to resolve this issue.
- Dolutegravir: This is a single drug , and it is not suitable for individuals who prefer not to take more than one pill per day. Dolutegravir needs to be taken in combination with at least one more antiretroviral drug. The most common combinations are with lamivudine (Lamivir) or rilpivirine (Edurant). People who believe that fewer medications result in fewer long-term side effects may be interested in this regimen, as it only requires two medications (a two-drug regimen) to effectively control the virus.
For consultation on HIV medication, you can seek additional information from experts at the Glove Clinic. You can make an appointment through their inbox, Line Official @gloveclinic (with an ad preceding it), or call 092-4149254 during business hours (10:00 AM – 7:00 PM, every day).
Consultation and treatment for HIV.
Review of HIV Antiviral Drugs (Old Formulas)
In the previous article, we reviewed HIV antiviral drugs in the current era. This time, we will review some of the HIV antiviral drugs that have been commonly used in the past 10-20 years. We will categorize the antiviral drugs into three main groups for easier understanding.
- Single Tablet Regimen (Teevir, Trustiva)
Undoubtedly, the ultimate hero of antiviral drugs from before 2010 to 2020 is Teevir, or what many people call the “magic pill.” This generic drug of Atripla was the first to combine three different types of antiviral drugs into one pill that can be taken once a day. This was a revolutionary approach to HIV treatment, as patients used to take multiple pills daily. Teevir has shown relatively good efficacy compared to other antiviral drugs, with fewer side effects, particularly lipodystrophy. However, it should be noted that Teevir or Atripla may cause sleep disturbances, nightmares, and mood swings due to its component called efavirenz, affecting about 10-15% of patients. In such cases, some patients may need to switch to other drug regimens. - Two Tablets Regimen (Ricovir-EM or Teno-EM with Edurant)
To address the side effects of efavirenz, such as dizziness and nightmares, a new formulation was developed. The main drug replacing efavirenz in this regimen is rilpivirine, also known as Edurant. It is combined with the backbone of Teevir, which is tenofovir and emtricitabine. This combination is available as Complera in other countries, but not in Thailand. Therefore, Thai patients need to take Edurant with Ricovir-EM or Teno-EM (the original drug is Truvada), which combines tenofovir and emtricitabine. Many people who take PrEP may be familiar with these tablets. The limitation of this regimen is that it needs to be taken with food or immediately after a meal since rilpivirine or Edurant requires stomach acidity for proper absorption. - Ancient HIV Drugs That May Be Forgotten (Neravir)
We mention this drug because there are still patients who take nevirapine or Neravir, which belongs to the same group as efavirenz and rilpivirine (NNRTI). Although nevirapine was developed before efavirenz, it was not as popular due to the risk of severe hypersensitivity reactions in patients with CD4 counts above 300-400. However, this reaction usually occurs within the first few months of taking the drug. Therefore, if nevirapine is well-tolerated, patients can continue taking it. The advantage of nevirapine is that it has minimal side effects on the brain and mental health compared to efavirenz. Additionally, it is relatively affordable. The downside is that it needs to be taken twice a day with a backbone drug, making it a three-tablet daily regimen.
Using old formulas does not necessarily mean the drugs are not good. We need to consider the appropriate drug regimen for each patient based on factors such as comorbidities, pill burden, lifestyle, and economic status. Patients who have no side effects from old drug regimens do not always need to upgrade to newer ones. It is advisable to consult with specialists or treating physicians to gain a better understanding of antiviral drugs.
For consultation on HIV medication, you can seek additional information from experts at the Glove Clinic. You can make an appointment through their inbox, Line Official @gloveclinic (with an ad preceding it), or call 092-4149254 during business hours (10:00 AM – 7:00 PM, every day).
