How to Cope With 6 Common Side Effects of Anti-HIV Drugs

Medically Reviewed By William C. Lloyd III, MD, FACS
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Side effects are common with anti-HIV (antiretroviral) drugs. The higher the dose, the more likely you are to experience them. Your chance of experiencing side effects also is higher if you have a small-framed body or your body tends to process drugs slowly. Taking your drugs on an empty stomach or with fatty foods or beverages, such as whole milk, can worsen side effects.

If you’re having trouble with side effects, try these steps to ease your discomfort:

1. Fatigue. Fatigue isn’t just being tired—it’s feeling weak and exhausted despite getting sleep. Some days, you might not even want to get out of bed. Check with your doctor to be sure your fatigue isn’t from anemia (low red blood cell count), which needs to be treated. Then try these ideas:

  • Aim for some exercise, both low-impact aerobic exercise (such as walking or biking) and resistance training (lifting light weights). Exercise can boost your mood, reduce your stress, and give you more energy.

  • Stay hydrated. Drink water instead of soda when you are thirsty, and especially before, during, and after exercising.

  • Eat healthy. Skip the junk food.

  • Reduce your workload, if possible.

  • Give your medication some time. Many people find that they’re tired when they start a new drug, but feel better in a few weeks.

2. Headaches.Your head may hurt when you start taking a new antiretroviral drug, and the pounding may get worse when you’re under stress. Talk to your doctor if you’re getting migraines, which may be more than a side effect. Here are ways to ease headache pain:

  • Take over-the-counter pain relievers, such as aspirin, acetaminophen, or ibuprofen. Ask your healthcare provider which is best for you.  

  • Give yourself a massage. Gently rub the base of your skull with your thumbs. You might want to try lying on a tennis or golf ball and gently moving your neck for a massage.

  • Lay low. Shut off the lights and lie down with a warm compress across your eyes and forehead.

  • Stay hydrated and eat healthy and frequently to help ease headache pain.

  • Make sure you’re well rested and don’t overdo it. It’s okay to say “no” when someone asks you do to something.

 3. Stomach upset. Many people experience diarrhea, nausea, and vomiting, side effects that can cause you to lose weight and feel weak. If your symptoms linger, talk to your doctor to be sure they’re not the result of another condition. In the meantime, these steps can help:

  • To ease diarrhea: Avoid high-fiber foods, such as whole-grain breads, beans, nuts, seeds, and gas-inducing vegetables, like broccoli and cauliflower. Try skipping dairy products, spicy foods, and greasy foods.

  • To ease nausea and vomiting: Eat foods cold or at room temperature. Try bland foods and stay away from strong cooking odors. Stay hydrated, but minimize queasiness by not drinking with meals; avoiding alcohol may help, too.

4. Rash. Itchy skin rashes are another common side effect. Talk to your doctor if your rash is severe or accompanied by a fever or blistering. To ease a rash:

  • Avoid hot water when bathing.

  • Use mild, fragrance-free cleansers.

  • Use a humidifier in your home.

  • Wear soft fabrics, such as cotton or jersey. Avoid itchy wool, especially next to your skin.

  • Keep itchy patches moist with petroleum jelly or moisturizer.

  • Stay hydrated.

5. Changes in appearance. Some anti-HIV drugs, particularly combination drugs, can cause unexpected changes in your body. You might lose weight in areas that make you look gaunt, such as your face, arms, legs, and buttocks. At the same time, you may gain weight around your stomach and torso. To combat these changes, you might try aerobic exercise, lifting weights, resistance training, and a healthy diet. Talk to your doctor about steroids, diabetes drugs, and other approved medications that may help combat body distortion, known as lipodystrophy.

6. Liver problems. Your liver releases enzymes to process the medicines you need to combat HIV. Too many enzymes can hurt your liver. People with hepatitis C, as well as HIV, have a higher risk of liver problems. To protect yourself:

  • Don’t drink alcohol, which can further damage your liver.

  • Talk to your doctor before taking any herbs or other alternative treatments. Some may harm your liver.

  • Get tested for hepatitis C and have your liver enzymes checked regularly.

Reducing Side Effects

You may be able to ease side effects by changing when you take your meds (morning or evening) and how (with or without food). If the side effects persist, ask your doctor about switching your drugs. Never stop any treatment on your own; instead, talk it over with your doctor to get the right adjustments for you. Your doctor has confronted these issues with many patients and will likely be able to recommend alternative therapy strategies that fight HIV yet allow you to enjoy an improved quality of life. Remember, problems don't solve themselves...you need to speak up.

Key Takeaways

  • HIV drugs have common side effects, but they often fade within a few weeks.

  • Self-care steps can ease side effects, such as fatigue, nausea, diarrhea, headaches, and rashes.

  • If symptoms don’t get better, or more serious ones start, talk to your doctor about changing the drug combination you’re taking.
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  1. Side effects. Aidsinfonet.org. http://www.aidsinfonet.org/fact_sheets/view/550

  2. Overview of antiretroviral drugs for HIV. Avert.org. http://www.avert.org/aids-drug-side-effects.htm

  3. Body distortion. CATIE. http://www.catie.ca/en/practical-guides/hiv-drug-side-effects/3-body-changes

  4. Water: Meeting Your Daily Fluid Needs. Centers for Disease Control and Prevention. http://www.cdc.gov/nutrition/everyone/basics/water.html

  5. Managing side effects of HIV medications. N.Y. Dept. of Health. http://www.health.ny.gov/publications/9408.pdf

  6. Tips for common side effects. Dept. of Veterans Affairs. http://www.hiv.va.gov/patient/drug-dosing-toolkit/side-effects-tips.asp
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 16
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