Positive Life NSW Blog

Switching it up! Is it time for a medication review?

Posted by on in Treatments

IMAGE: Medication bottle with a to-do list

Around a third of us living with HIV (PLHIV) change our drug regimen each year.

Sometimes this could be something we’ve asked for because we’ve heard of a new antiretroviral on the market. It might be part of a routine medication review with our doctor, or even initiated by your pharmacist. As increased HIV treatment choices become available and our knowledge of how to manage HIV and other health conditions continues to grow. It’s reasonable to ask, “is this the very best treatment for me at this time?” It’s always good to consider the options and take control!

When we’re first diagnosed with HIV, we usually don’t know the questions to ask about medication to find the treatments that suit our routine. 9-5 work life, night shift, gym bunny or party animal. Different lifestyles, along with our daily routine considerations, such as, medications that need to be taken with food affect your medication regimen. At the same time, our doctors usually don’t know us all that well either, so it’s not until we have a closer partnership with our doctors can we talk about what’s important to us and what suits us best.

There’s a few reasons for changing treatments or asking for a medication review. Sometimes it’s because of some undesirable side effects, or work commitments get in the way. Some medicines need to be taken with food and irregular meal times can mess with this. More of us are working full time now and juggling full schedules. Travel across different time zones can complicate things and changing meds to a simpler regimen or taking combination treatments (several medications in the one pill) might make more sense.

For many of us who live with several health conditions, a treatment review could benefit you by reducing the number of pills you’re taking. When you start a new medication, sometimes your body goes through some adjustments. There might be some temporary side effects. These usually resolve within a week or two of starting a new medication. If you’re having unpleasant side effects, bring these up with your doctor, sooner rather than later. It’s important you always talk about any side effects with your doctor or pharmacist.

Asking for a medication review could mean a welcome change of medication and bring relief. Ask your doctor to talk through any known side effects of the new medication, what the signs and symptoms would be and what you could do if you experience any. If you bring up the topic with a doctor and feel you’ve been dismissed or unheard, and this has happened on more than one occasion, it’s probably a sign to seek an alternate HIV doctor and ask for a referral. Friends living with HIV are often only too happy to share names of doctors they’re confident in and feel understood by. Your HIV doctor should always take you seriously and be able to listen and understand what you’re feeling or experiencing.

Sometimes your HIV doctor is the one recommending a change or medication review especially if they see changes in your test results. Sometimes HIV can develop resistance to a particular antiretroviral. In this case, most of us can easily change to another effective and tolerable HIV antiretroviral. Co-infections like hepatitis C, hepatitis B or medication for another medical condition can also interact with some HIV medications. This is why some people will be on different medication combinations.

Some of us who have had HIV treatment over many years, develop further health conditions on top of what we previously had. Examples of this can include altered kidney function readings or high blood pressure or Type 2 diabetes. Additional medications may have been added over time, resulting in a larger overall ‘cocktail’ of medications often referred to as polypharmacy. Multiple meds can increase the likelihood of drug interactions especially if you have four diagnoses or more. This kind of ‘pill burden’ is often a strong reason to ask for a medication review with your doctor. The time to have a review of your meds is whenever you start a new medication or at least every twelve months if you are taking a number of pills.

Medical advances happen all the time, and HIV antiretrovirals are constantly being refined and altered. These can lead to improved treatment options that manage inflammation better and other age related conditions. Perhaps a new formulation may be available, to reduce your pill burden, side-effect profile or interactions.

Some of us also take complementary therapies such as multi-vitamins, fish oil tablets, glucosamine or calcium for example and it’s a good idea to include these in a total medication review. Talk about these natural health products (NHPs) or complementary therapies with your pharmacist or general practitioner – not just your HIV meds. Sometimes there can be unexpected interactions with some NHPs like calcium, St. John's wort or Echinacea and some fish oils and it could mean you just need to take these at a different time to your HIV meds. If you are on a limited budget given the expense of supplements, fresh fruit and vegetables have shown to be as beneficial, unless your doctor or dietician specifically recommends the supplements.

All of us have individual circumstances. There is no ‘one size fits all’ approach to achieving the best outcome for each and every one of us. Raising these issues with your doctor and checking out if there’s some better options to juggle your meds mean you’re the one in control. You could find you feel a whole lot healthier with a switch to meds that do the job better. A real change for the better!

If you want any support or need to talk things over before talking with your doctor, you can call the Treatment Officers here at Positive Life on (02) 9206-2177 or freecall 1800 245 677, to run through any questions or thoughts on your mind.

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Guest Thursday, 09 July 2020

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