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Missing doses or stopping antiviral therapy

It is strongly advised that individuals on an antiviral regimen should not miss any doses of their medications. Unfortunately, life is such that doses often are missed. Reasons for missing doses range from just forgetting to take the medication, leaving town without the medication, or because of a medical emergency, such as the need for urgent surgery. For example, after an appendectomy for acute appendicitis, a patient may not be able to take oral medication for up to several days. When a dose is missed, the patient should contact his or her physician without delay to discuss the course of action. The options in this situation are to take the missed doses immediately or simply resume the drugs with the next scheduled dose.

Although every missed dose increases the chance that the virus will develop resistance to the drugs, a single missed dose should not be cause for alarm. On the contrary, it is an opportunity to learn from the experience and determine why it happened, if it is likely to happen again, and what can be done to minimize missing future doses. Furthermore, if a patient cannot resume medication for a limited time, such as in a medical emergency, there still is no cause for alarm. In this circumstance the patient can be assured that as long as all medications are stopped simultaneously and then restarted in the future; the risk of developing drug resistance is small. Nevertheless, stopping is associated with some risks of developing drug resistance and those who wish to stop therapy for any one of a number of reasons, should discuss this with their health care provider in advance to establish the best strategy for safely accomplishing this.