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Drug Interactions and HIV/AIDS

May 22, 2018

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Drugs and Other Substances That May Interact With HIV Medications

There is a long list of prescription, over-the-counter, complementary, and recreational drugs that may have major interactions with HIV medications. Food can also change the way HIV drugs are absorbed (soaked up) by the body. Below are a few examples:


Birth Control Pills

Birth control pills containing ethinyl estradiol (a form of estrogen) can interact with HIV drugs. This can make the birth control pills less effective and increase the chances of pregnancy. If your HIV drugs affect the levels of your birth control pills, talk with your provider about switching to or adding another form of birth control.


Complementary Therapies

Many people living with HIV use complementary therapies such as vitamins or herbs. While most of these have not been studied with HIV drugs, St. John's Wort (an herbal anti-depressant) has been shown to affect the levels of some HIV drugs. St. John's Wort and garlic supplements should not be taken with any PIs or NNRTIs. Other supplements such as calcium or iron can inhibit the absorption of integrase inhibitors, such as elvitegravir or dolutegravir, which are medicines commonly used to treat HIV. It is important to tell your health care provider if you take any vitamins, herbs, or supplements.


Recreational Drugs and Alcohol

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There have been reports of overdoses, some fatal, caused by taking recreational drugs, also known as street, party, or club drugs, and HIV drugs. Interactions between the following street drugs and boosting agents (Norvir and Tybost) are particularly dangerous:

  • Crystal methamphetamine (meth, crystal, speed, crank, no doze)
  • MDMA (ecstasy, E, X)
  • Mephedrone (meow meow, white magic, m-cat)
  • Ketamine (vitamin K, special K, K, kit kat)

Alcohol affects body processes and is often responsible for drug interactions. Combining alcohol and certain HIV drugs like Videx can put you at risk for developing pancreatitis (inflammation of the pancreas). In general, though it is safe to drink socially and take your HIV medicines.


Methadone and Buprenorphine

Methadone and buprenorphine can interact with many HIV drugs. These drugs are used as opioid substitution therapy to treat opioid addiction. It is important to tell the health care provider at your opioid treatment program and your HIV health care provider what you are taking. This way, they can make sure that you get enough methadone or buprenorphine to prevent withdrawal symptoms, and enough HIV drugs to fight the virus effectively.


Other Types of Drugs That May Interact With HIV Drugs

There are certain classes of drugs to treat different medical conditions that are more likely to interact with HIV drugs. Not all drugs in these classes will cause problems. If you take any of the following types of drugs, talk to your health care provider about the specific drugs you take and whether there are any possible interactions. Note: this is not a complete list; other classes of drugs may also cause interactions.

  • Antianxiety drugs (a class of drugs called benzodiazepenes; also known as benzos, and including Valium and Xanax)
  • Antifungal drugs
  • Antibiotics
  • Antacids
  • Antihistamines (allergy medications)
  • Opioid-based pain killers (narcotics)
  • Drugs to treat:
  • Drugs that:
    • Increase bowel activity
    • Thin the blood


Food

Any pills that you take go through your stomach. What you eat can affect how much of your drugs get into your system. Most drugs are absorbed faster if your stomach is empty. For some drugs, this is a good thing, but it can also cause more side effects. Some drugs need to be taken with food so that they are broken down more slowly, or to reduce their side effects. Others should be taken with fatty foods because they dissolve in fat and are absorbed better. Check your drug labels and follow the food instructions carefully. If you have any questions, it is important to ask your health care provider or pharmacist.


Taking Care of Yourself

People living with HIV often have to take many different drugs. Sometimes taking more than one medication can cause drug interactions. This can lead to the drugs not working as well or an increased risk of side effects.

Because there are so many possible drug interactions with HIV drugs, it is very important for you and your health care provider to go over all your medications, including over-the-counter, prescription, street drugs, and complementary therapies, even if you only use them occasionally. Your health care provider may need to adjust the doses of your drugs or change the drugs you currently take.

To get the best results, it is a good idea to:

  • Keep a list of all your drugs and ask your health care provider to review it for possible interactions
  • Give a copy of your drug list to all of your health care providers
  • Discuss all your medical conditions with your health care provider
  • Each time you are prescribed a new medication, check with your health care provider to see if it can be combined safely with your other therapies
  • Review the information that comes with each medication (the "package insert"), ask for this information for each drug that you are taking
  • Have all your prescriptions filled at one pharmacy
  • Learn about all the possible side effects of your drugs
  • Learn how, when, and with what to take your drugs
  • Do not stop or change your drugs without talking to your health care provider
  • Report any side effects to your provider

[Note from TheBody: This article was created by The Well Project, who last updated it on May 14, 2018. We have cross-posted it with their permission.]

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
 

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