PEP and Prozac

[frank311]

Hi Doctor -

I am currently on PEP (Prezista, Truvada, Norvir).  I was wondering if taking Prozac while taking these drugs will lower the efficiency of the PEP drugs or interact in any way.

Thanks so much.

[Edward W Hook, MD]

While this is off the topic.  I have a sense that your OCD may be putting you at risk from repeated use of PEP.

More importantly and related to your question, I do not want to get between your doctor and you.  At the same time, stopping PEP does not make biological sense as the virus would be expected to start replicationg, if present, before the three days have passed.

I will have nothing more to say about this thread.  You need to work with your own doctor on these issues.  EWH

[frank311]

THank you doctor.  I also had a question re: PEP.  So I was placed on Prezista, Truvada, and Norvir and developed a rash from it that my MD says is from the medication.  I of course freaked out thinking it was an ARS symptom so he changed my regimen to Combivir and Insentress.  He initially wanted me to wait three days to restart (I have been on the previous combo since Jan 17th, so a little over a week).  He said that waiting three days wouldnt reduce the efficeiency of the PEP and i think he was afraid that since I am having a reaction i shoudl wait to introduce a new drug.  I have taken the drugs in Combivir before for PEP (I have rather sever OCD and doctors give me these drugs since they figure I cant deal with out them).  I had no problem witht he drugs in Combivir.  Do you think it is advisable to wait three days and begin or start new regimen ASAP?  I am afraid of having a violent allergic reaction to anythign now.

Thank you.

[Edward W Hook, MD]

There are no descriptions of this being a problem.  In fact, if persons are taking Isentress for their HIV, the beneficial effect of the HIV therapy is likely to reduce the risk for reactivation. I would not worry.  EWH

[frank311]

Hi Doctor-

I noticed on the pamphlet for Isentess that it could bring back old infections etc. Are there any links between Isentess and an increased likelihood of an HSV2 outbreak?
Thanks.

[Edward W Hook, MD]

Welcome to the Forum.  Your question is a good one as there are many medication interactions which can make drugs work less well or increase the risk of side effects. Fortunately, these are not common for most of the drugs used for PEP.  there are no interactions I am aware of between Prozac and the medications you mention.  

Parenthetically, one way to minimize the likelihood that uncommon medication interactions is to make sure that you are using the same pharmacy to get your prescriptions filled.  Pharmacists are supposed to (and typically do) comprehensively review new medications for possible interactions.  EWH