Got Urticaria. On Complera. Prescribed Stribild And Suggested To Stop Complera. Complera Causes Urticaria?

Posted on Fri, 31 May 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 31 May 2013 Answered on

Sun, 23 Jun 2013 Last reviewed on

Question : I got urticaria 7 1/2 weeks into Complera. My doctor told me to stop taking it immediately just 4 days short of my next refill because of concerns this reaction may get worse or affect my XXXXXXX organs (besides skin). Question: Will going off medication for 4 days have any negative impact on my progress towards an undetectable status (virus load, RNA at 1400copies)? What in Complera causes urticaria? My doctor suggested I start new cycle with Stribild. Is Stribild a good choice giving I am treatment naive and medication profile is similar to Complera, relatively.

Answered by Dr. Sudarshan (18 hours later)

Hi,

Thanks for writing in.

Complera is emtricitabine / rilpivirine / tenofovir in oral tablet. This is an effective and well tolerated combination for HIV. Rash has been reported in at least 10% of treatment-naive patients treated with emtricitabine and tenofovir.

Getting off the medication for 4 days will not cause any problems for undetectable status.

You can start with stribild in new cycle as it is also safe and effective. It contains elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarat.

Also only urticaria is not an indication to change regimen of treatment. If the urticaria is not resolving and oral /genital /mucosal erosions are present then treatment should be changed. Also if other symptoms like fever, respiratory problems, blood abnormalities are present then treatment should be stopped.
If only urticaria is the problem it can be treated /controlled with anti allergic drugs.
However the final decision to change or continue complera depends on your doctor.

Hope this helps. I will be available for any further clarification.

Regards
DrSudarshan
MD
Dermatology

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sudarshan (5 hours later)

Thank you Dr. XXXXXXX In your reply you pointed "If the urticaria is not resolving...treatment should be changed". Although I'm taking an anti allergy drug Levocetirizine DIH 5mg, urticaria is not receding. Giving that Stribild also contains emtricitabine and tenofovir, isn't it going to continue causing the same symptoms?

Is urticaria also occurring inside my organs due to heightened level of the allergens present ( emtricitabine and tenofovir)?

Answered by Dr. Sudarshan (24 hours later)

Hi again,

As said previously the indications for changing the regimen would be severe rash >30% BSA, oral /genital lesions , maculopapular rash , systemic symptoms etc.

If you have only urticaria, drugs can be temporarily stopped and restarted under cover of antihistamines. .As correctly pointed by you urticaria can occur with stribild also. Therefore the final decision can be taken by your treating physician only.

Regards
DrSudarshan

Above answer was peer-reviewed by : Dr. Prasad