I am on a combo of atazanavir, ritonavir, nevirapine, and tenofovir, i think the atazanavir is the cause of horrific reflux, i can only eat porridge and yoghurt and drink protein shakes, any other food stuff leaves me in agony and sometimes i end up vomiting it back up, i tried ranitadine but had awful side effects. any suggestions would be grateful thanks james

Of your current drugs the ritonavir is usually the most irritating to the stomach. If you have significant reflux then often a more potent acid reducer (such as proton pump inhibitor) is needed. In that case atazanavir may not be the best drug since its effectiveness may be compromised when administered with potent acid reducing agents. Getting an endoscopy and/or H pylori evaluation often can be helpful. I would also have some concern about using nevirapine and atazanavir/ritonavir regarding a negative drug interaction (possibly a good indication for checking blood levels of atazanavir). KH