Side Effects

What Are Side Effects?

Side effects are what a medication does to you that you don't want it to do. Medications are prescribed for a specific purpose, such as to treat HIV. Anything else the drug does is a side effect.

Some side effects are mild, like a slight headache. Others, like liver damage, can be severe and, in rare cases, fatal. Some go on for just a few days or weeks, but others might continue as long as you take a medication, or even after you stop. Some occur within days or weeks of starting a drug. Others may only show up after months or years of therapy.

Who Gets Side Effects?

Modern antiretroviral medications are very well tolerated and only rarely cause serious side effects. While some people taking antiretroviral medications (ARVs) can have side effects. Some people (such as those with liver or kidney disease) may body processes drugs more slowly than normal, and could have higher drug levels in their systems and have increased risk of ore side effects.

Some side effects become worse if the drug is taken on an empty stomach. Others may increase if the drug is taken with fatty food or drink such as whole milk.

Each medication comes with information on its most common side effects. Don't assume that you will get every side effect that's listed! Most people have few or only minor side effects when they take their ARVs as directed.

How to Deal With Side Effects

There are several steps you can take to prepare yourself to deal with side effects. Learn about the normal side effects for the medications you're taking. The InfoNet fact sheets list common side effects for each drug.

  • Talk to your health care provider about what side effects to expect. Ask when you should get medical attention because a side effect goes on too long, or has gotten severe.
  • Find out if you can treat mild side effects with home remedies or over-the-counter medications.
  • In some cases, your health care provider can write you a prescription for something you can take to deal with a side effect if it gets severe.
  • Stock up! If you're having stomach problems, make sure you have plenty of food that you like to eat and that's easy on your stomach.
  • Do not stop taking any of your medications, or skip or reduce your dose, without talking to your health care provider! Doing so can allow the virus to develop resistance (see Fact Sheet 126), and you might not be able to use some ARVs. BEFORE side effects make you skip or reduce doses, talk to your health care provider about changing drugs!

Which Side Effects Are the Most Common?

When you start antiretroviral therapy (ART), you may get headaches, hypertension, or a general sense of feeling ill. These usually improve and disappear over time.

Fatigue (Fact Sheet 551): People with HIV can feel tired at least part of the time. It's important to find the cause of fatigue and treat it accordingly.

Anemia (Fact Sheet 552): is caused by having low red blood cell counts andcan cause fatigue. Anemia increases your risk of getting sicker with HIV infection. Routine blood tests can detect anemia, and it can be treated.

Digestive Problems: Many drugs can make you feel sick to your stomach. They can also cause nausea, vomiting, gas, or diarrhea. Home remedies include:

  • Instead of three big meals, eat smallee amounts, more often.
  • Eat mild foods and soups, not spicy.
  • Ginger ale or ginger tea might settle your stomach. So can the smell of fresh lemon.
  • Exercise regularly.

Don't skip meals or to lose too much weight! Marijuana (see Fact Sheet 731) or the prescription drug dronabinol can reduce nausea. Be careful with over-the-counter or prescription nausea drugs. They may interact with your ARVs.

Gas and bloating can be reduced by avoiding foods like beans, some raw vegetables, and vegetable skins.

Diarrhea (Fact Sheet 554) can range from a small hassle to a serious condition. Tell your health care provider if diarrhea goes on for more than a few days or if it's serious. Drink lots of liquids.

Lipodystrophy (Body Shape Changes, see Fact Sheet 553) includes fat loss in arms, legs and face; fat gain in the stomach or behind the neck. People who start ARVs with low CD4 counts have increased risk of lipodystrophy.

High levels of fats and sugar in the blood (Fact Sheet 123), including cholesterol, triglycerides and glucose. These can increase the risk of heart disease (Fact Sheet 652) or stroke.

Skin Problems: Some medications cause rashes. Most are mild and temporary, but in rare cases they indicate a serious reaction. Talk to your health care provider if you have a rash. Other skin problems include dry skin or hair loss. Moisturizers help some skin problems.

Peripheral Neuropathy (Fact Sheet 555) is a painful condition caused by nerve damage. Neuropathy normally starts in the feet or hands; it can also be caused by other medical conditions.

Mitochondrial Toxicity (Fact Sheet 556) is damage to structures inside the cells. It might cause neuropathy or kidney damage, and can cause a buildup of lactic acid in the body.

Osteoporosis (Fact Sheet 557) bone problems are common in people living with HIV. Bones can lose their mineral content and become brittle. Get enough vitamin D and calcium from food or, if needed, supplements. Reducing tobacco, and weight-bearing exercise like walking or weight lifting can be helpful.

The Bottom Line

Some people who take ARVs have side effects. However, don't assume you will get every side effect you hear about!

Get information on the most common side effects and how to treat them. Read the InfoNet fact sheets on individual drugs and their side effects. Stock up on home remedies and other items that can help you deal with side effects.

Be sure you know when to go back to your health care provider because a side effect may have gone on too long or gotten severe.

Don't let side effects keep you from taking your medications! Do not assume that taking ARVs means you have to put up with the side effects. If you can't deal with them, if they continue for more than a few weeks, or they affect your quality of life, talk to your health care provider about changing your drugs.