Human immunodeficiency virus (HIV) medications have come a long way in recent years in terms of improving quality of life and outcomes. However, the large number of drugs that need to be taken by those who are HIV-positive can still present some concerns, particularly in how they interact with other medications that a patient might need.
There are dozens of medications currently used to treat HIV infection, and they work by preventing the virus from functioning in different ways. Combinations of several drugs, called “cocktails,” are particularly effective because they disable the viral life cycle at multiple different stages, ensuring long-term suppression of the virus. While these medications are not currently able to completely remove the virus from all the cells of the body, they are able to prevent the virus from continuing to replicate, which results in very low levels of virus in the blood and bodily fluids. Long-term suppression of viral activity allows the body to maintain a healthy immune system and function normally.
We expect most people living with HIV to do well on treatment and to live long and healthy lives totally free from the complications of HIV/AIDS. Still, interaction with other medications is possible so it's important to understand what can be done.
What You Should Know About Potential Medication Interactions
Many prescribed medications have interactions with foods and with other drugs, and HIV drugs are no exception.
Medication interactions can raise or lower the levels of drugs in the body and bloodstream. When these interactions cause higher levels of drugs, the risk of their associated side effects can also rise. When interactions cause lower levels of drugs, there's a risk that the medications will not have their desired therapeutic effect. Most drug interactions are not fatal or imminently dangerous, but they must be monitored nonetheless to make sure that unpleasant side effects are minimized while therapeutic effects are consistently maintained.
The majority of drug interactions involving HIV therapies are considered mild or moderate in nature. However, there are some drug interactions—for instance, with antacid medications used to treat reflux or gastritis—that can seriously affect the levels of HIV drugs in the bloodstream.
It’s important to know whether your HIV medication must be taken with food and whether it is safe to use antacid medicines with your HIV medication. If you are on other prescription medications, both your doctor and your pharmacist can help ensure that there are no drug interactions requiring alterations of your regimen.
How to Avoid Drug Interactions
HIV doctors and pharmacists frequently use technological systems and pharmaceutical references to alert them to potentially important drug interactions when they start patients on new medications or refill ongoing prescriptions. It's important for patients to maintain close communication with their doctors, particularly when their medications are changed or when their lifestyles—eating habits, for example—change dramatically.
It is also important to talk with your healthcare team, about any vitamins, over-the-counter supplements and medications or herbal products you might be considering taking before you start them, as these may also have interactions.
In many cases, drug interactions do not necessitate discontinuation of any medications, but when modification of the regimen is necessary for safety reasons, there are usually excellent alternatives that doctors can recommend to avoid further interactions. It is extremely rare to we face clinical situations in which we must choose to leave one condition or another untreated due to drug interactions.
To stay aware of potential drug interactions, there are several things that patients themselves can do:
- Always keep an updated list of active medications, and review this regularly with your doctor and your pharmacist.
- Review with your doctor the way in which you take your medications, including what foods you take with your medications and what time of day you take them.
- When you meet new doctors or specialty physicians, take a list of your active medications with you so that doctors unfamiliar with your care plan can anticipate the impact of any new medication they might recommend.
- Alert your doctor when you make a significant change to the way you eat or live.
- Keep track of recurring or persistent symptoms that you think might be related to your medications. Your doctor might be able to identify the relationship between these symptoms and one of the medications you are taking.
