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One Week into PEP + running low on meds, what should I do?
I began Post Exposure Profylaxis therapy six days ago approximately seven hours after a possible exposure. I recieved a prescription for one weeks worth of combivir from the emergency room doctor with instructions to follow up with my regular physician. That prescription has almost been used up. I have four pills left but am yet to take my second dose for today. I wont be able to see a doctor until after the weekend (today is friday) which means if i take my second dose today then I will not be able to take both doses on sunday and will be left with no pills on monday. So my question is, would it be best to continue taking two pills a day until they run out and risk having a day or two without meds in the time between when I run out and get another prescription, or should I start breaking them in half and take 1/2 pill twice a day until I can get a refill in order to maintain a continuous level (albeit lower than that prescribed) of ARV in my blood? I guess an essentially equivalent question would be: When taking PEP, is it worse to miss a few doses during the course of treatment or to take a lower dose for some portion of the treatment?
thank you for the comments so far, but my original question still hasnt really been addressed. Would it be best to try to streatch out these remaining four pills as long as possible by breaking them in half or should i continue with two a day and risk missing a day or two?
do you happen know to what degree pep efficacy is reduced by shortening the duration of treatment?
Also, while your exposure was high risk, it is somewhat questionable whether it qualifies for PEP since you don't know whether your partner was infected. However, I can understand why you would question your partner's negative status given his behavior.
well the other issue is that even if i were to get another script i couldn't fill it until sometime next week because I have no money.
I would think that the hospital that prescribed you PEP would be willing to prescribe you enough combivir to tide you over until your doctor's appointment. Why don't you call them and tell them your situation?
I should also note that I am worried about possibly not being able to afford the rest of my pep regiment. What can be done when someone cannot afford the cost of ARV medications?
Exposure details:
I am a 21 year old gay male and at the time of exposure my status was negative. My partner was a 45 year old gay male whose status I can not be sure of although he insisted he was negative. I was in the receptive role and insisted on using a condom. I could tell from his behavior that he was unaccustomed to using condoms although he did not complain verbally. He put the condom on with his penis in position underneath me where I couldnt see. I became worried because it didn't feel like there was a condom on and after about one minute I couldnt take the anxiety and pulled back to find that the condom had been ripped and pulled down to the base of the pennis leaving the entire penis exposed. I was extremely upset but he seemed to be feigning surprise. I asked him if he came and he said no, but there really isnt any way for me to be sure. I asked him to drive me home and on the way back we were passing by the hospital and I told him to drop me off there instead. After a seven hour wait in the emergency room I recieved my first dose of combivir.
I am a 21 year old gay male and at the time of exposure my status was negative. My partner was a 45 year old gay male whose status I can not be sure of although he insisted he was negative. I was in the receptive role and insisted on using a condom. I could tell from his behavior that he was unaccustomed to using condoms although he did not complain verbally. He put the condom on with his penis in position underneath me where I couldnt see. I became worried because it didn't feel like there was a condom on and after about one minute I couldnt take the anxiety and pulled back to find that the condom had been ripped and pulled down to the base of the pennis leaving the entire penis exposed. I was extremely upset but he seemed to be feigning surprise. I asked him if he came and he said no, but there really isnt any way for me to be sure. I asked him to drive me home and on the way back we were passing by the hospital and I told him to drop me off there instead. After a seven hour wait in the emergency room I recieved my first dose of combivir.
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