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aids and poppers&exctasy (POPPERS, ECSTASY, VIAGRA)

Sep 4, 2007

Hello my name is Demirhan, My lover is one of the hiv+ patient and I am trying to support him as what ever I can do anyhow the main subject is sometimes he use poppers(not everyday or not somuch)and also he use exctasy(so much) even when he takes exctasy not just one pill, during a night he take at least 3 pills that means he is hard exctasy user. Also sometimes he take viagra. All I wanna to ask u that if it is possible could u send me an e-mail which is gonna include all sade effects to using poppers and exctasy and also especially for the hiv+ people when they use these kind of things what will happen and howmuch damage these kind of drugs will effect their body and their illness? By the way what do u think about gonna use Bactrime(antibiotic)? Because everyday he use Combivir 2 pills in the morning at 08:00 and Kaletra 3 pills in the morning at 08:30 and everynight 2 pills Combivir at 20:00 and Kaletra 3 pills at 20:30, my question is how about Bactrime which is one of the antibiotic. Do u think that he should use it everyday regularly?

Thanks for your kind


Response from Dr. Frascino

Hi Demirhan,

Below I'll reprint some information from the archives that addresses your questions regarding poppers, ecstasy and Viagra. Please take note of the potentially very dangerous interaction between Viagra and poppers.

As for Bactrim, this is an antibiotic, which, in the setting of HIV/AIDS, is used most frequently for PCP (Pneumocystis carinii pneumonia) prophylaxis (prevention). PCP prophylaxis is recommended if the CD4 cell count falls below 200.

Good luck to you and your partner.

Dr. Bob

HIV and popper usage Jul 1, 2006

Hello Doctor...and thank you for considering my question. I have recently been using poppers more often. I continue to engage in low(er) risk sexual activity (condoms always, but not for receptive oral sex...and some receptive butt play but always gloved). Assuming that I do not change my behavior or take heightened risks with the popper use, would I physiologically more vulnerable to hiv from inhaling them? Also, the last time I used them I noticed a persistent scotoma which lasts for many hours...scary....can poppers make me go blind???! Yikes, I hope not....I really enjoy them, but nothing is worth compromising my health or eyesight. I look forward to you response...thanks again, Dr. Fascino!! (ps...My lover and I just got married in Canada last week...I just had to through that in (big smile!).

Response from Dr. Frascino


First off, congratulations newly weds! Steve (Dr. Steve in The Body's Tratamientos Forum) and I almost got hitched when they were handing out marriage licenses here in San Francisco. We had a date and time scheduled, but the California Supreme Court decided not to recognize or validate our 12-year relationship. Consequently we are still living in sin, but we did proceed with the scheduled wedding party. Called it our "Nearly-Wed Party."

Next, poppers . . . . I've addressed this topic a number of times in the past, so I'll just repost a question from the archives. See below. Poppers do not cause blindness. The basic worry is that poppers are not safe to be used with Viagra (and similar drugs). Viagra can also have effects on protease inhibitors. The combination of protease inhibitors + Viagra + poppers is particularly dangerous and must be avoided.

Stay safe. Stay well.

Dr. Bob

will Poppers make my hiv disease worse?

Sep 30, 2005

Dear Bob: Before anything I want to congratulate you because this site is becoming better and better everyday. I've been recomended to everyone who is and who is not POZ, all of them have had a lot of information from this site.. I speak spanish and some english so if I can help you in some way, I will do it just let me know.

Otherhand, I have a new partner but when he fucks me he became a little rude, (nice) but I can not relax enough so I've been using 1 or 2 smells from my Iron Horse poppers EVERY DAY! I HaVENT FEEL nothing since I started my treatment 6 years ago.. my viral load have been undetectable just a little problems with my Lipids (scondary effects from my meds) .. but away from that I could say I'm a healthy guy. Please give my your oppinion. is it too Bad?

Thanks a lot.

Response from Dr. Frascino


Thanks for your kind words. Regarding poppers, there really isn't any new information, so I'll just repost one of my answers form the archives that addresses your concerns.

Stay well.

Dr. Bob

Poppers and Meds Jul 1, 2005

Is it OK to use poppers while on HIV meds. I don't use them often but I have used them.



Response from Dr. Frascino

Hi Elvis,

Elvis??? The ELVIS???? You mean all those rumors really were true? You're alive???

Regarding the risk of poppers and HIV meds, the biggest concern would be if you consider baby blue Viagra (or Cialis or Levitra) one of your HIV meds! Combining poppers and Viagra can lead to dangerous drops in blood pressure. As for poppers and HIV disease in general, I'll repost one of my responses form the archives, as nothing has really changed since then, OK? Stay well. Stay cool, Elvis!

Dr. Bob

poppers and hiv :Jan 19, 2004


dr. bob, i remember reading a while back a posting on this site about the use of poppers and its effect on the immune system, but i can't find the posting. could you comment on this? also, any general remarks you can make about the use of poppers is appreciated. thanks!

Response from Dr. Frascino


Sure, I'll repost my previous comments (see below). You can also search the archives of this site for any topic by simply typing in a keyword, such as "poppers," and hitting the "search" tab. Try it. You'll like it! (No, not poppers, the archives search function. Then again, there is the possibility you'll like both! )

Dr. Bob


Dr. Bob:

This probably isn't quite the right forum, but none of the others seem any more appropriate, and when it comes to sex, I can bank on a helpful and laugh-inducing answer from you. So, for those of us who are positive (diagnosed 3 months ago), what is the deleterious effect of poppers. Or is there even a deleterious effect? In other words, if they're especially bad for folks with HIV, how bad? Hasta Lavista, Babee

My Response:


"Hasta Lavista Babee?" Arnold, is that you??? First you wanted to know about the long-term side effects of excessive steroid uses, and now you're wondering about poppers.

OK, OK, here's what we know. "Poppers" is the common name for a variety of chemical compounds in the alkyl nitrite family (including isobutyl nitrite, butyl nitrite, and amyl nitrite). So why the clever nickname poppers? Well, we (doctors) prescribed amyl nitrite for patients with certain kinds of heart conditions. The prescription medication came in containers that were snapped open or "popped" to release the vapors, which were then inhaled. We no longer use this medication but non-prescription amyl nitrite is now made and sold illegally. Today most poppers are either isobutyl or butyl nitrite sold in small brown bottles often labeled as "video head cleaner," "room deodorizer," or "leather cleaner." Anyone who has ever taken a whiff of this stuff probably realizes that the thought of using it as a "room deodorizer" is laughable. Does anyone really want their room to smell like a cross between dirty gym socks and spoiled Limburger cheese? OK Arnold, so maybe you do . . . . Moving on. I should point out that the exact contents of these "little brown bottles" is not known, and that they have not been safety tested. So what are the effects? Poppers are used by sniffing the vapors from the open bottle. The effects are felt within a few seconds and last several minutes. Poppers cause muscles around blood vessels to relax, making your heart speed up to pump more blood. The oxygen-rich blood reaching the brain produces a "rush" sensation. Poppers also cause muscles in the anus and vagina to relax, and that's why they are often used during sex. So what's the risk? First off, contact with the skin can cause irritation and rashes. Extensive use can damage the lining of the nose and lungs. Some people experience headaches, vertigo (sensation of spinning or falling), and loss of their woody. (Oh no, where did you go?) Poppers are highly flammable. Keep them away from cigarettes, candles, and lighters. Medically speaking, there have been some studies suggesting that poppers may reduce immune system functioning for several days after use; and may be associated with more rapid progression of Kaposi's sarcoma. Because poppers cause blood vessels to open, it is easier to get infections, including some STD's and HIV. Poppers pose extra risks for HIVers, because they already may have suppressed immune systems. Risks are also greater for folks with heart problems, blood pressure problems, and pregnancy. Combining poppers with party drugs, like speed or cocaine, increases their risks. Combining poppers with Viagra can be lethal, as both cause blood pressure to drop. (Yes, deaths have been reported with this combination.) Other risks include impaired judgment. The incidence of unsafe sex appears to be associated with popper use. Finally, I must point out that possession of amyl nitrite without a doctor's prescription is illegal. Federal law bans the manufacture and distribution of butyl nitrite and related substances, although as a quick look on the Internet or at your friendly local neighborhood sex shop will confirm, this law is not being enforced.

So finally, is it worth the risk? Well, like riding a motorcycle without a helmet, or thinking an aging action hero can govern the state of California, it's a risk that only you can decide to take or not. I'm just here to provide the facts! Personally, I feel caution is warranted. Hope that helps!

Dr. Bob

Poppers: Large Cancer Increase and Immune Suppression in Animal Tests by John S. James

A new study found that mice injected with cancer cells were more than three times as likely to develop tumors if they inhaled isobutyl nitrite -- "poppers" -- and that when tumors did develop, they grew four times as rapidly in the inhalant-treated animals.(1) 75% of the mice receiving nitrite developed the tumors in this test, vs. 21% of the control mice (which received the same cancer cells but breathed only air instead). The amount of inhalant used -- 900 parts per million for 45 minutes a day -- was selected to approximate social use of the drug.

Other laboratory tests found that isobutyl nitrite did not increase growth of the tumor cells; instead it suppressed certain immune functions, including cytotoxic T lymphocyte (CTL) activity, and the killing of tumor cells by macrophages -- which was reduced 86% by 5 days exposure to the inhalation. Previously published work by the same team(2) found that immunity in the mice recovered within 14 days of stopping the inhalant. (The current paper suggested that permanent damage might still be done if immune suppression allowed cancer, KS, or HIV itself, to become established.)

This is the first study showing directly that nitrite inhalant can promote tumor growth. Previously, epidemiological studies had found that use of poppers is associated with KS, and also is an independent risk factor for infection with HIV (suggesting that poppers may increase the risk that exposure to HIV will lead to infection). KS is believed to be caused by a different virus, HHV-8, that presents little risk unless the immune system is suppressed by other factors. (The tumor cells used in this research were not KS, but they were a well-known cell line used in animal tests to measure immune suppression.)

Comment Malignancies are a major and increasing problem in AIDS, and it will be important to find out if use of poppers is contributing to their higher incidence. One way to research this question would be to ask whether or not patients with lymphoma or other malignancies are more likely than others to have used these drugs.

References 1. Soderberg LSF. Increased tumor growth in mice exposed to inhaled isobutyl nitrite. Toxicology Letters, 1999; volume 104, pages 35-41.

should i stop taking ecstasy Dec 31, 2005

hello im from israel and im sorry if i have spelling mistakes..

i am a new positive and i have cd4-851 (37%) and vl - 9890 my doc said that i dont need to take med for now. i wanna know if i taking ecstasy or special k can b more harmfull for me then if i were negetive. i know that taking these things while taking drugs 4 hiv is dangeruse. but im not taking drugs yet. shuold i stop using ecstasy or special k?

Response from Dr. Frascino

Hello Israeli Guy,

You are correct: using club drugs, like ecstasy or special K, while on HIV medications is indeed very dangerous, due to drug interactions.

Is taking these drugs "more harmful" because you are HIV positive if you are not on HAART yet? Your question, as stated, implies club drugs are harmful whether or not you are HIV positive. Once again, I concur. Are they "more harmful" just because you're positive is difficult to answer. Since these drugs are illegal and also since it would be unethical to conduct a clinical trial on just how harmful (or more harmful) they are in HIV-positive folks, I cannot give you a direct answer, other than to say they are unquestionably harmful.

Ecstasy is an amphetamine with both stimulant and hallucinogenic properties. It increases heart rate, blood pressure and consumption of oxygen by the heart muscle. It increases the risk of dehydration, seizures, kidney failure, heart failure and death. Regular use causes lasting damage to brain cells, resulting in impaired memory, disrupted sleep, depression and anxiety.

Special K is ketamine, a short-acting general anesthetic often used in veterinary medicine. It causes dreamlike hallucinatory effects. Low doses produce a mellow, colorful experience, whereas higher doses create an "out of body" or "near death" experience, loss of consciousness, delirium, amnesia, seizures and even, in some cases, fatal respiratory collapse. When combined with alcohol, there is a risk of falling asleep or collapsing, and then vomiting and possibly choking on one's own vomit.

Should you stop using ecstasy or special K? Yes, I would definitely stop, whether or not you are HIV infected. The ultimate decision is yours; however, your chances of successfully coexisting with HIV are significantly decreased if you choose to continue using.

Good luck. Stay well.

Dr. Bob

viagra Jan 2, 2007

you have made mention of using viagra in other posts but I have read that using viagra can have serious effects on your hiv meds--care to elaborate??

Response from Dr. Frascino


Drug-drug interactions are common with HIV meds and I strongly recommend everyone discuss possible drug interactions with their HIV specialist whenever a new medication (or even an over-the-counter product) is added to their regimen. Regarding Viagra, some HIV drugs can inhibit the enzymes that metabolize Viagra, thereby increasing Viagra blood levels. These drugs include protease inhibitors, particularly ritonavir. Folks taking PIs are generally advised to cut the dose of Viagra to 25 mg and use it no more often than every other day. Other HIV drugs are inducers of the enzymes that metabolize Viagra and consequently could decrease Viagra blood levels. These drugs include efavirenz (Sustiva, Stocrin) and nevirapine (Viramune). However, this effect is not felt to be clinically significant.

Generally speaking and taking into account the Viagra dose reduction for certain protease inhibitors, taking Viagra and HIV medications together is usually felt to be safe. But do remember not to mix Viagra and nitrates/nitrites (poppers), as this can lead to a dangerous drop in blood pressure.

Dr. Bob

Family Dream
Accidentally used HIV sibling's toothbrush

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