Combivir

[auc09]

Hello I ran into an incident last night and ended up having unprotected sexual intercourse with a stipper.  I started the first dose of Combivir last night and was wondering if the side effects get too bad and I cannot take it for the full 28 days, what I should do.  They cannot get any other PEP prophylaxis treatments besides the Combivir and was really worried about the side effects of this medication, as I am already feeling nauseated.  I know this is a very potent drug and nothing to play around with, but very worried about contracting something.  The girls here are tested before they arrive and are cleared through our physicians here on the island.  I know the chances are lower but do not want to take the chance.  For the nausea can you take zofran on a daily basis with this medication.  
-What are your recommendations for taking this medication?
-Do you recommend a PEP for this incident?
-How dangerous is this drug?
-Can you clear the virus if you do not go the entire 28 days?
-Is this drug known to cause Lipoatrophy?
-Can you just take the drug once a day for 30 days?

Thank you for all of your help

[Edward W Hook, MD]

I am not aware of medicnation inteactions with the medicines yo mention but I woudl ask my pharacist here in the U.S. to be sure.  I suggest you do the same.

Unless there are other reasons to do so, I would not check liver enzymes while on combivir for a month.  If you have abdominal pain or other problems rather than obaining testing on your own, you should discuss the situation with a doctor who can examine you.  EWH

[auc09]

Ok thank you and I completely understand where your coming from, but the only doctor on the island is not from the U.S. and cannot really answer my questions about the medications.  I am sorry to bother you again, but was wondering if you know of any complications of taking Adderall, Finasteride, Atenolol, and Combivir together.  I am not asking for your approval to take my current medications together, but the only doctor on the island is from another country and does not really provide much information.  I am a U.S. citizen and this is why I am contacting you b/c this is your specialty.  I have done a lot of research on the drug, but want to make sure that there have not been any known complications with these drugs taken together.  
-Is one supposed to check their Liver enzymes and CBC weekly or monthly while taking Combivir???

Again Thank You for your help, but any other guidance with this would be very much appreciated.  Thank you for taking the time to speak with me about this Dr Hook.

[Edward W Hook, MD]

Welcome to the Forum.  I am not sure that I would have recommended PEP for you but you have already made the decision.  Decisions about PEP are a personal decision in which one should consider the likelihood that infection will occur, the likelihood of drug side effects, one's personal anxiety and the cost of the drugs (expensive, typically in the neighborhood of $1000).   Since you chose to pursue PEP, please hold the person who prescribed it accountable for all that goes with it (i.e. follow-up, managing side effects, answering your questions, etc).   We do not practice medicine on this site and the question you are asking are, at least in part, management questions.  I will comment briefly:

1.  the recommendation for PEP is to take the medication twice daily for the next 28 days.
2.  I would consider it carefully.   It would be better to have your partner tested.  If she was negative, I would not recommend PEP.
3.  Major side effects are nausea and fatigue.  This should be discussed with the doctor who prescribed your PEP or whomever will be following you..
4.  the recommendation is to take the medication for the full 28 days.
5.  One month of PEP with combivir is not likely to cause lipoatrophy.  

I hope these comments help you. EWH