YOU ARE HERE:
Adherence
| Last updated: 06.01.05 |
Ensuring that you take your medication at the right time, in the right doses and in the right way is an important factor in the success of your anti-HIV treatments, and other medicines you may be prescribed.
For a medicine to work, you have to take to take it exactly as prescribed. Medicines are not all the same in the way the body uses them. Some medicines need to be taken with food and some must be taken between meals on an empty stomach. For other medicines, this does not matter. People who are taking medicines need to understand which of these kinds of medicine they have been given, and how they should fit into their daily living.
Missing doses, taking the wrong doses, or taking a drug in such a way that you absorb too little of it, may lead to the development of resistance to the drug .This could mean that you stop benefiting not only to the drug you have become resistant to, but similar drugs too.
The best response to anti-HIV drugs is seen in people who take every, or almost every dose. Missing just a few doses a month could severely impair your response.
Why adherence is important - resistance
HIV can develop resistance to a drug if the blood level of the drug is too low to stop it from reproducing. As HIV continues to reproduce, strains of the virus which are able to continue to reproduce despite the drug’s presence (drug resistant strains) gain a competitive advantage over the drug sensitive strains and form the basis of the new HIV population within the body.
For example if you develop resistance to the protease inhibitor indinavir, you may be resistant to other protease inhibitors, and people who become resistant to one NNRTI are usually resistant to all currently available drugs in this class. However, the risk of ‘cross- resistance’ varies from drug to drug and is not inevitable.
When you are prescribed a drug a doctor or pharmacist will tell you how many times a day to take it, and how to take it, for example whether it needs to be taken with food or on an empty stomach, and if there are any medicines which you shouldn’t take at the same time. These instructions have been worked out to ensure that you have an adequate amount of the drug in you at all times to fight the infection and stop resistance from emerging.
Practical issues
Virtually everybody taking anti-HIV medication will forget to take their medication from time to time. Rather than giving yourself a hard-time over forgetting to take your medication, use it as a learning experience. However, if you are frequently forgetting to take your medication, or are not taking your drugs because they are causing side effects, it is important to let your doctor know as soon as possible so you can get support and work out a treatment schedule which better suits your lifestyle or that you are better able to tolerate.
You should always be provided with written information about your treatments when you are prescribed HIV medication. Your pharmacist should be able to provide you with practical tips on how to remember to take your medication, and many HIV clinics and support services have special programmes to help people to take their medication.
Starting treatment a new treatment combination
You may wish to discuss with somebody how the treatments are going to impact on your life and to consider how you will be able to incorporate them into your daily schedule. When you start any new treatments, it is also important to make your doctor aware of any issues, such as recreational drug or alcohol use, which might impact on your ability to take your medication properly.