Dear Dr. Henry,

Since I have been taking Isentress (Raltegravir) in my cocktail that comprises further: Prezista (Darunavir), Epivir (Lamivudine), Viread (Tenofovir) and TMC125, I suffer from an important increase in gas in my intestines. This with the occasional diarrhoea is of course very annoying. I am inclined to blame Isentress because a friend of mine who also takes Isentress has the same symptoms whilst he has entirely different meds to complete his cocktail. Have you heard of this aspect from some of your patients and if so: what do you advise them to do? I am not writing to you because of just the occasional discomfort, but it is becoming a real problem! I am looking forward to your suggestions and thank you as usual for your kind advise

Robert from Holland

Either the raltegravir or ritonavir/darunavir can increase gas production in some patients. Anti-gas drugs such as simethicone are occasionally helpful. Checking for lactose intolerance or other conditions is worthwhile. Some patients note decreased gas after increasing active yogurt consumption which can restore more normal gut flora that can be disturbed by HIV treatment and other drugs. KH