Hello Dr. Henry, I am 22 yrs old and positive since April of last year. I started meds in September of 2008 (in a clinical trial for TMC 278 though I'm pretty sure I'm on the Truvada and Sustiva arm). For the last few months I have been having daily bouts of nausea, usually in the mornings. Some days are really bad, where I can hardly think or move because I feel like I may throw up. Is there anything I can do to reduce this nausea? I am a pot smoker but can not do this during the mornings when I work and when it is at it's worst. I usually skip breakfast and tend to eat late at night. Not sure if that plays a factor.

Please Advise, Nauseas Andrew

An evaluation for stomach problems may be worthwhile. I would request an evaluation before empiric use of a variety of anti-nausea meds which may control some of the symptoms you are having. Depending when you eat and take your meds you could be having high levels of the efavirenz or other medication that may be lessened by altering timing of meds, eating or sleep. KH