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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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HIV and Beta-Blockers
Aug 18, 2010

I'm not on HIV meds yet as my CD4 has been around 700-800 and vl less than 15,000. My HIV doc did put me on Atenolol due to slightly high bp and resting pulse around 100, but mainly for the panic attacks I was having. It has really worked. My bp is usually like 100 over 60 with a pulse in the 60's. It has really helped with the panic attacks. However, after starting the Atenolol, I have huge, dry stools that hurt so bad to pass. It usually causes me to bleed when I use the bathroom. When I've talked to others on that med, they say they've heard it can cause constipation, but they don't have this problem. I drink about 5 bottles of water a day. Everyone just says to increase my fiber.

It made me wonder whether HIV itself can cause this issue. I'm just blaming it on the Atenolol, because it started after beginning that med. Besides all the pain, I'm worried this will cause hemmoroids. Or, I could get some infection from an open wound where feces is. I like that I never have loose stools anymore, but this is not good. My stools are so large, hard, and dry that the toilet paper is usually clean--except for the blood.

I'm just wondering if you'd think this is unrelated to HIV and only due to the Atenolol. I take 50mg a day, so maybe I could cut down to 25mg and get the same benefits. Or, just increase fiber?? By the way, I was just reading a study that long-term use of beta-blockers may cause health problems like diabetes. Do you know anything about this? I realize this isn't a question directly related to HIV, but everything affects HIV.

Response from Dr. Henry

Constipation is not a common problem due simply to untreated HIV infection but is common in general population. From the details you provide seems likely to be related to the atenolol. Measures you mention are worth pursuing to improve situation as would possible switch to another BP med if continues. Generall health/GI evaluation may also be in order if problem doesn't improve. KH

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