Prescribing and dispensing ARVs

Clinical description

• ARVs should be taken after the same number of hours every day (e.g., every 12 or every

hours). Most ART regimens can be taken in the morning, at noon or at night and it does not matter if they are taken before, after or with food.

o DTG (regimen 12, 13, 14, 15) can disturb sleep and should therefore preferably be taken in the morning.

o EFV (regimen 4 and 5) can cause dizziness, especially in the first 4 weeks. This is less troublesome when taken before bed.

• Missing a dose: what to do if a patient remembers to take his ARVs late? If the patient

remembers:

o Less than half-way to the next scheduled dose: take the missed dose immediately and take the regular next dose at the normal time.

o More than halfway to the next scheduled dose: skip the missed dose and take the regular next dose at the normal time.

• Dispense ARVs only in the original sealed container.
• Only the patient or his registered guardian/treatment supporter is allowed to collect ARVs.
• In an emergency, patients are allowed to collect ARVs from any ART clinic in Malawi following

special rules (see below).