Drug Side Effects Chart

From Project Inform

November 2003

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

This chart may not adequately reflect the percentages of side effects in women due to the limited number of women in many studies of these drugs.

The colors underneath each drug heading below indicate the rough percentage of people reporting each side effect for each drug. See key at the bottom of each section.

	Reported in > 15% of people in clinical studies		Reported in 5–15% of people in clinical studies		Reported in < 5% of people in clinical studies
(blank)	Side effect has not been reported	C	Reported only in children, or more commonly in children	‡	Potentially fatal side effect

Protease Inhibitors (PI)
Drug Effects on Lab Values
	APV	ATV	fos APV	IDV		LPV	NFV	RTV	SQV (hgc)	SQV (sgc)
Anemia (low red blood/hemoglobin count)
Leukopenia (low white blood cell count)
Neutropenia (low neutrophil count)
Thrombo- cytopenia (low platelet count)						C
Elevated Alkaline Phosphatase (liver)
Elevated Amylase (pancreas)
Elevated Bilirubin (liver)						C
Elevated Cholesterol
Elevated Creatinine (kidney)
Elevated Glucose (blood sugar)
Elevated Liver Functions
Elevated Triglycerides (cholesterol)
Drug Side Effects
	APV	ATV	fos APV	IDV		LPV	NFV	RTV	SQV (hgc)	SQV (sgc)
Abdominal pain
Altered taste
Anorexia (reduced appetite)
Arthralgia (joint pain)
Chills
Constipation
Depression
Diarrhea
Dizziness
Fatigue
Fevers
Headache
Insomnia (sleep problems)
Malaise
Menstrual Irregularities
Myalgia (muscle pain)
Nausea
Nephrolithiasis (kidney stones)
Neurological Symptoms
Neuropathy (pain/tingling in arms arms/legs/hands/feet)					C
Pancreatitis (inflammation of the pancreas)	‡	‡	‡	‡		‡	‡	‡	‡	‡
Paresthesia (numbness, prickling, tingling)
Rash	‡	‡	‡	‡			‡		‡
Seizures
Vomiting

APV = Amprenavir;     ATV = Atazanavir;      fosAPV = Fosamprenavir;     IDV = Indinavir;
LPV = Lopinavir + RTV;     NFV = Nelfinavir;     RTV = Ritonavir;
SQV(hgc) = Saquinavir hard gel capsule;   SQV(sgc) = Saquinavir soft gel capsule

	Reported in > 15% of people in clinical studies		Reported in 5–15% of people in clinical studies		Reported in < 5% of people in clinical studies
(blank)	Side effect has not been reported	C	Reported only in children, or more commonly in children	‡	Potentially fatal side effect

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Drug Effects on Lab Values
	DLV	EFV	NVP
Anemia (low red blood/hemoglobin count)
Leukopenia (low white blood cell count)
Neutropenia (low neutrophil count)
Thrombocytopenia (low platelet count)
Elevated Alkaline Phosphatase (liver)
Elevated Amylase (pancreas)
Elevated Bilirubin (liver)
Elevated Cholesterol
Elevated Creatinine (kidney)
Elevated Glucose (blood sugar)
Elevated Liver Functions
Elevated Triglycerides
Drug Side Effects
	DLV	EFV	NVP
Abdominal pain
Altered taste
Anorexia (reduced appetite)
Arthralgia (joint pain)
Chills
Constipation
Depression
Diarrhea
Dizziness
Fatigue
Fevers
Headache
Insomnia (sleep problems)
Malaise
Menstrual Irregularities
Myalgia (muscle pain)
Nausea
Nephrolithiasis (kidney stones)
Neurological Symptoms
Neuropathy (pain/tingling in arms/legs/hands/feet)
Pancreatitis (inflammation of pancreas)	‡	‡
Paresthesia (numbness, prickling, tingling)
Rash	‡	‡	‡
Seizures
Vomiting

DLV = Delavirdine; EFV = Efavirenz; NVP = Nevirapine

	Reported in > 15% of people in clinical studies		Reported in 5–15% of people in clinical studies		Reported in < 5% of people in clinical studies
(blank)	Side effect has not been reported	C	Reported only in children, or more commonly in children	‡	Potentially fatal side effect

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Drug Effects on Lab Values
	3TC	ABV	AZT	combivir	trizivir	ddC	ddI & ddI-EC	d4T	FTC	TNV
Anemia (low red blood/hemoglobin count)
Leukopenia (low white blood cell count)
Neutropenia (low neutrophil count)
Thrombocytopenia (low platelet count)			C
Elevated Alkaline Phosphatase (liver)
Elevated Amylase (pancreas)
Elevated Bilirubin (liver)
Elevated Cholesterol
Elevated Creatinine (kidney)
Elevated Glucose (blood sugar)
Elevated Liver Functions
Elevated Triglycerides (cholesterol)
Drug Side Effects
	3TC	ABV	AZT	combivir	trizivir	ddC	ddI & ddI-EC	d4T	FTC	TNV
Abdominal pain
Altered taste
Anorexia (reduced appetite)
Arthralgia (joint pain)
Chills
Constipation
Depression
Diarrhea
Dizziness
Fatigue
Fevers
Headache
Insomnia (sleep problems)
Malaise
Menstrual Irregularities
Myalgia (muscle pain)
Nausea
Nephrolithiasis (kidney stones)
Neurological Symptoms
Neuropathy (pain/tingling in arms/legs/hands/feet)
Pancreatitis (inflammation of pancreas)	‡	‡	‡	‡	‡	‡	‡	‡		‡
Paresthesia (numbness, prickling, tingling)
Rash	‡	‡		‡	‡	‡	‡	‡	‡	‡
Seizures
Vomiting

ABV=Abacavir; Combivir = AZT + 3TC; Trizivir = AZT + 3TC + ABV
FTC=Emtricitabine; TNV = Tenofovir

	Reported in > 15% of people in clinical studies		Reported in 5–15% of people in clinical studies		Reported in < 5% of people in clinical studies
(blank)	Side effect has not been reported	C	Reported only in children, or more commonly in children	‡	Potentially fatal side effect

Entry Inhibitors (EIs)
Drug Effects on Lab Values
	T20
Anemia (low red blood/hemoglobin count)
Leukopenia (low white blood cell count)
Neutropenia (low neutrophil count)
Thrombocytopenia (low platelet count)
Elevated Alkaline Phosphatase (liver)
Elevated Amylase (pancreas)
Elevated Bilirubin (liver)
Elevated Cholesterol
Elevated Creatinine (kidney)
Elevated Glucose (blood sugar)
Elevated Liver Functions
Elevated Triglycerides
Drug Side Effects
	T20
Abdominal pain
Altered taste
Anorexia (reduced appetite)
Arthralgia (joint pain)
Chills
Constipation
Depression
Diarrhea
Dizziness
Fatigue
Fevers
Headache
Insomnia (sleep problems)
Malaise
Menstrual Irregularities
Myalgia (muscle pain)
Nausea
Nephrolithiasis (kidney stones)
Neurological Symptoms
Neuropathy (pain/tingling in arms/legs/hands/feet)
Pancreatitis (inflammation of pancreas)
Paresthesia (numbness, prickling, tingling)
Rash	‡
Seizures
Vomiting

T20 = Enfuvirtide

	Reported in > 15% of people in clinical studies		Reported in 5–15% of people in clinical studies		Reported in < 5% of people in clinical studies
(blank)	Side effect has not been reported	C	Reported only in children, or more commonly in children	‡	Potentially fatal side effect

Other Side Effect Warnings

All Anti-HIV Drugs

Changes in body fat distribution, called lipodystrophy, have been associated both with HIV infection and anti-HIV therapy. A warning about lipodystrophy is now included in the label information for all anti-HIV drugs.

All Nucleoside Analogs

A build-up of lactic acid in the body (lactic acidosis) and severe liver enlargement (hepatomegaly) with fatty liver (steatosis), including fatal cases, have been reported with using NRTIs alone or in combination. Fatal lactic acidosis has been reported in pregnant women who took d4T (stavudine, Zerit) and ddI (didanosine, Videx) with other anti-HIV drugs. The combination of d4T and ddI should be used with caution during pregnancy.

AZT

AZT (zidovudine, Retrovir) has been associated with low neutrophil counts (neutropenia) and severe reductions in red blood cells (anemia), particularly in patients with advanced HIV disease. Prolonged use of AZT has been associated with muscle weakness (myopathy).

Abacavir

Fatal hypersensitivity reactions have occurred in up to 8.5% of people taking abacavir (Ziagen). People with fever, skin rash, fatigue, nausea, vomiting, diarrhea, abdominal pain, and/or respiratory symptoms are advised to call their doctor immediately and stop using abacavir if directed, as soon as a hypersensitivity reaction is suspected. Once abacavir treatment is stopped, it should be permanently discontinued as a more severe reaction may recur within hours if it is restarted and may include life-threatening symptoms and death.

d4T/ddI

Fatal and non-fatal inflammation in the pancreas (pancreatitis) has occurred with the combination of d4T and ddI. Neither d4T nor ddI should be used in people with suspected or confirmed pancreatitis.

Enfuvirtide

Nearly 100% of people using enfuvirtide (T20, Fuzeon) will have injection site reactions including redness, inflammation, pain and hardening of the skin.

Antibiotics
Drug Effects on Lab Values
	Anti-MAC			Anti-PCP			Anti-CMV			Anti- fungal
	Azithro- mycin	Clarithro- mycin	Rifa- butin	Bactrim/ Septra	Dapsone	Aero. Penta- midine	Cidofovir	Gancy- clovir (IV)	Fos- carnet	Flucon- azole
Anemia (low red blood/ hemoglobin count)
Leukopenia (low white blood cell count)
Neutropenia (low neutrophil count)
Thrombo- cytopenia (low platelet count)
Elevated Alkaline Phosphatase (liver)
Elevated Amylase (pancreas)
Elevated Bilirubin (liver)
Elevated Cholesterol
Elevated Creatinine (kidney)
Elevated Glucose (blood sugar)
Elevated Liver Functions
Elevated Triglycerides (cholesterol)
Drug Side Effects
	Anti-MAC			Anti-PCP			Anti-CMV			Anti- fungal
	Azithro- mycin	Clarithro- mycin	Rifa- butin	Bactrim/ Septra	Dapsone	Aero. Penta- midine	Cido- fovir	Gancy- clovir(IV)	Fos- carnet	Flucon- azole
Abdominal pain
Altered taste
Anorexia (reduced appetite)
Arthralgia (joint pain)
Chills
Constipation
Depression
Diarrhea
Dizziness
Fatigue
Fevers
Headache
Insomnia
Malaise
Menstrual Irregularities
Myalgia (muscle pain)
Nausea
Nephrolithiasis (kidney stones)
Neurological Symptoms
Neuropathy
Pancreatitis									‡
Paresthesia (numbness, prickling, tingling)
Rash	‡	C ‡	‡	‡	‡	‡	‡			‡
Seizures
Vomiting	C	C

	Reported in > 15% of people in clinical studies		Reported in 5–15% of people in clinical studies		Reported in < 5% of people in clinical studies
(blank)	Side effect has not been reported	C	Reported only in children, or more commonly in children	‡	Potentially fatal side effect