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Managing side effects of anti-HIV medications

What are side effects?

A medication is usually prescribed for a specific purpose—this is called its therapeutic use. However, sometimes the medication may cause symptoms that it is not intended to cause. These symptoms are known as side effects.

Side effects can be mild or serious and can affect different people differently. Side effects may be different in people of different sexes or races. Some side effects last for just a few days, and others may continue for as long as you are on the medication or even after you stop the medication.

Sometimes it is hard to tell whether the symptoms you experience are from side effects of a medication you are taking or from HIV itself or other infections. Sometimes the symptoms may be caused by a combination of all of these factors.

What types of side effects are there?

In general, side effects can be grouped as short or long term.

Short-term side effects are unpleasant symptoms that occur soon after starting a medication (from immediately after taking the medication to within the first few weeks). Many people have to go through an adjustment period when they start a new medication. This period may last 4-6 weeks. If your body adapts to the medication, the side effects usually become less severe over time. Some side effects may persist into the long term.

Common short-term side effects from anti-HIV medications include:

1. fatigue
2. headaches
3. nausea and vomiting
4. diarrhea
5. skin rash
6. peripheral neuropathy (pain, burning or numbness in the hands, legs or feet)
7. changes in menstrual periods

Long-term side effects include symptoms that continue for as long as you are on the medication, as well as symptoms that only start to appear after you have been on the medication for a long period of time (a few months or even years). These are usually due to the long-term effect of the medication that affects the way different parts of your body function.

Common long-term side effects include:

1. changes in body shape (lipodystrophy)
2. changes in fats and sugar level in the blood (high cholesterol, diabetes)
3. changes in bones (bones become weaker and more fragile, increasing the risk of fracture, some bone tissues may die)
4. sexual dysfunction
5. depression
6. peripheral neuropathy

What can I do about side effects?

The key to coping with side effects is knowing what to watch out for and having a plan to respond if a problem occurs.

Before starting a new medication, be sure to ask your doctor or pharmacist:

1. What are the common side effects of this drug (both short- and long-term)?
2. What are the most dangerous side effects?
3. When will the side effects start?
4. How long will these side effects likely last?
5. Can I do anything to prevent the side effects?
6. What can I do to deal with these side effects?
7. When should I call the doctor or stop taking the medication?

After starting your medication, it would help to:

1. keep track of when and how you take the medication
2. keep track of how you feel each time you take the medication—whether the symptoms are worse, staying the same or getting better with each dose

Different ways to manage side effects may include:

1. changing the way the medication is taken (for example, with or without food)
2. changing the time the medication is taken
3. taking other medications or complementary therapies to control the symptoms. Note that it is important to tell your doctor and pharmacist
4. about all the non-prescription drugs, including complementary therapies, that you are taking so they can work with you to avoid any potential harmful drug interactions.

For more details on specific side effects and their management, refer to the separate Fact Sheets under “Health Concerns” on:

1. Bone problems
2. Depression
3. Diarrhea
4. Lactic acidosis
5. Lipodystrophy
6. Peripheral neuropathy
7. Sexual problems
8. Wasting

Do not stop taking any of your medications or reduce the dose without talking to your doctor or pharmacist. Doing so may allow your virus to become resistant to the medication, which could lead to treatment failure. Before side effects make you skip or stop your medications, talk to your doctor about how to best deal with them.