Preventing medication resistance.

Antiretroviral medications are made to keep a virus from growing and spreading. If the virus changes (mutates), the medication may stop working as well. This is called resistance and is a serious problem. It is important to keep resistance from happening.

Antiretroviral therapy (ART) medication resistance means at least one of the medications taken to keep HIV viral load low isn’t working as well as it should. If that happens, the viral load may go up and the CD4 count may go down. CD4 cells are important to help fight infection. If this happens, you have a bigger chance of 1) getting an infection and 2) spreading it to others.

Resistance can happen in a few different ways. Sometimes, when a person has been taking the same drug for a long time, it can stop working well. But resistance is more common when treatment is stopped for any reason, even for a short time. Your doctor may stop medication if you’re having certain side effects. More often, it happens if you forget to take your medications, skip doses or don’t take it as directed. It is very important that you take your ART, and other medications, as directed. This means taking them at the right dose and at the right time.

Not taking your ART as directed can lead to:

• Levels of your medication in your blood getting too low.
• The virus mutating and not responding to the medication(s).
• A higher viral load and lower CD4 cell count.
• The need for your doctor to change your treatment plan. Remember, a new treatment plan might be harder for you to take. It might have more, or new, side effects.

Juggling ART therapy and your busy life can be hard. You’ll get the most from your medications when you stick to your treatment plan. This means that managing your medications has to become part of your daily life. To help, here are some tips:

• Talk to your doctor. Know exactly why you are taking each medication and what to do if you miss a dose.
• Use a pill box. Keep it where you can easily see it. Your doses can change so make sure the pill box is filled for the right dose on the right day.
• Take your medications at the same time you do other routine things. For example, when you brush  your teeth, eat breakfast, go to bed, etc.
• Set your phone alarm to remind you to take your medications. You can also check out the CVS Specialty^® app to help manage your medications and stay on track.
• Ask someone you trust to help you remember to take your medications.
• Keep extra doses in your purse, at work, etc., in case you won’t be home in time to take your medications.
• Talk to your doctor or pharmacist if you have side effects that bother you or don’t go away. They can tell you ways to help reduce or manage them. Don’t skip any doses because of the side effects.
• Some medications should be taken according to when you eat. For example, some need to be taken with food to work their best. Others may work best when taken on an empty stomach. That usually means taking them one or two hours before you eat or one or two hours after you eat.
• Refill your medications before you run out.
• Make sure you tell your health care provider what other medications you are taking. This includes any other prescription medications, over-the-counter medications and supplements. 
• Talk to your health care team if you are forgetting to take your medications or have trouble taking them right. Check out the CVS Specialty app to help manage your medications and stay on track.
• Talk to others living with HIV to get more ideas of things that may be helpful to you. 

CVS Specialty can help you stay on track and get the best outcomes from your HIV treatment plan, including managing side effects. Call us at 1-800-237-2767 to speak to a pharmacist or nurse specially trained in caring for HIV and sexual health.