All HIV meds, except for Fuzeon (since
it is injected), can cause nausea. The
following medications seem to be more
commonly associated with nausea:
cobicistat (a component of the
combination pill Stribild)
all protease inhibitors
Nausea may occur when starting a new
medication, but it usually subsides in four
to 14 days. Sometimes nausea can linger,
or pop up randomly. Taking HIV meds on
an empty stomach may cause nausea.
If vomiting occurs as a result of taking
HIV medications, it may prevent your
body from fully absorbing the meds into
your bloodstream, which can lead to drug
resistance. Vomiting can also cause you to
lose important nutrients, since anything
you recently ate or drank is coming right
back out. And if you're nauseated, you
may not eat or drink enough.
Severe vomiting can cause tears or
ruptures in your esophagus. This can
result in bleeding. If you notice blood
in your vomit, seek medical attention
promptly. The same HIV meds that cause
nausea can also cause vomiting, but
it appears to happen most often with
Trizivir and Zerit.
Nausea is the uncomfortable feeling like you are going to vomit.
WHAT IS IT?
Also known as
"queasiness" or "sour
stomach," nausea can
be severe or mild and
subside and return
until vomiting occurs.
Common types of nausea
are morning sickness
in women who are
pregnant, and motion
sickness from being in a
moving vehicle or a boat.
Nausea is common with
morphine treatment or
Vomiting is the throwing
up of undigested food
and is usually associated
Note One medication you
should take without food is Sustiva,
a component of the one-pill-a-day
regimen Atripla. Food can increase
blood levels of Sustiva, which may
increase central nervous system side
effects like dizziness, vivid dreams and
what some describe as a "cloudy" head.
up close & personal
Home: New York
CD4 Count: 938
Viral Load: 70
Job: Barber and student
WHEN ERIC WAS DIAGNOSED with HIV at age
22, he and his doctor thought it would be a while
before he started taking HIV meds. But when his
CD4 count dropped into the 300s in early 2010, they
decided it was time. From the options she gave him,
Eric chose Reyataz, Norvir and Truvadabecause
of the regimen's relatively few side effects. Besides
a bit of diarrhea his first week on meds, taking
them has been "just peachy; I have no complaints
He did soon realize, though, that in order for things
to stay peachy, he'd need to be on top of his diet. "It
was hard to adjust," he recalls. "Not only did I have
to worry about school and work; now I have to worry
about: Am I eating well? Am I sleeping well? Am I
eating enough vegetables? Enough fruits?"
Eric's meds are recommended to be taken with
food: "If I don't take the medication with a full meal,
sometimes I have nausea," he says. He can avoid
this symptom entirely by eating beforehand, and
drinking a full glass of water with his meds. When
nausea does occur, he finds that seltzer water helps.
"Fruit usually calms my stomach if I'm nauseated,"
he adds; "It's really refreshing."
"I don't feel well,
either mentally or
physically, when I
don't eat well."
How to Treat Nausea
Tip Be sure to
ask your doctor or
pharmacist if there
may be a possible drug
interaction between any
of these treatments and
the HIV meds you may
HERE ARE SOME basic suggestions that may help
Take ginger -- it's a natural herb that can quickly
remedy mild nausea. It comes in many different forms
including teas, ginger ale and chopped up ginger root.
Drink teas (especially ginger, peppermint or
Eat foods high in fiber.
Keep dry crackers by your bed and eat one or two
when you get up in the morning.
Eat smaller meals and snack more frequently. A mild
vegetable or chicken broth can be soothing for an
Avoid spicy, greasy, fried or strong-smelling foods.
Remove strong food odors from the house.
Eat meals sitting up.
Don't lie down immediately after eating.
Sip drinks slowly.
Avoid substances that irritate the stomach, such as
alcohol, aspirin, caffeine and tobacco.
Use meditation and relaxation techniques.
If you find you can't eat regular food, be sure to
take liquid meal supplements such as Ensure or other
Medical marijuana has been known to help people
on chemotherapy to ease their nausea and be able to
eat (see "What about marijuana?" for more details). The
prescription medication Marinol contains a synthetic
part of marijuana and can help with HIV-related
Antiemetics are medications designed to prevent
or relieve nausea and vomiting. Many are available
without a prescription, such as Benadryl, Dramamine,
Pepcid AC, Tagamet and Maalox. Others require a
prescription, such as Compazine, Reglan, Marinol
Antibiotics may be prescribed if you have been
diagnosed with an infection that is the cause of your
nausea or vomiting.
DR. DAVID WOHL University of North Carolina-Chapel Hill
Favorite Anti-Nausea Meds: Marinol, Phenergan, Zofran and sometimes Ativan.
Alternative Therapy: Ginger root.
HIV Meds Likely to Cause Nausea: Norvir (Kaletra has a relatively high dose of Norvir in it). Stribild has a Norvir-like drug in it that can also cause nausea.
HIV Meds Less Likely to Cause Nausea: Atripla, Complera, Edurant, Isentress and Tivicay.
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