VA National Clinical Public Health Programs — HIV/AIDS

www.hiv.va.gov

URL: http://www.hiv.va.gov/vahiv?page=treat-effects-print&pp=pf



Side Effects Guide

Overview

Almost all medicines have side effects, including medicines for HIV. Always let your doctor know if your side effects are severe, especially if you are finding it difficult to stay on your treatment plan.

The following is information on some common side effects and tips on how to deal with them.

Anemia

Anemia means you have a low red blood cell count. The red blood cells take oxygen to different parts of the body, and when your body is short of oxygen, you feel tired.

Many people with HIV have anemia at some point. HIV can cause it; so can some of the anti-HIV drugs.

To see if you have anemia (a symptom of anemia is feeling tired, fatigued, or short of breath), your VA health care provider can do a simple blood test. If you are anemic, food or other medicines can help.

Quick Tips: Anemia

First, find out if you have anemia. If you are short of breath or tired and the tiredness doesn't go away after getting rest, ask your doctor whether you should get tested for anemia.
If you find out you have anemia, your doctor will prescribe a treatment according to the cause of the anemia. Some of these treatments include:
- changing medications,
- taking iron, folate, or vitamin B12,
- or changing your diet.

Diarrhea

Diarrhea is common in people with HIV, and it can be caused by some anti-HIV medicines. Diarrhea can range from being a small hassle to being a serious medical problem. Talk to your VA health care provider if diarrhea goes on for a long time, if it is bloody, if it is accompanied by fever, or if it worries you.

When you have diarrhea, always be sure to replace the fluids you have lost by drinking ginger ale, broth, herbal tea, or water.

You can also ask your doctor about taking medicines to help with your diarrhea.

Quick Tips: Diarrhea

What to try:

Try the BRATT diet (bananas, rice, applesauce, tea, and toast).
Eat foods high in soluble fiber. This kind of fiber can slow the diarrhea by soaking up liquid. Soluble fiber is found in oatmeal, grits, and soft bread (but not in whole grain).
Try psyllium husk fiber bars (another source of soluble fiber). You can find these at health food stores. Eating two of these bars and drinking a big glass of water before bedtime may help your diarrhea.
Ask your doctor about taking calcium pills.
Drink plenty of clear liquids.

What to avoid:

Stay away from foods high in insoluble fiber, such as whole grains, brown rice, bran, or the skins of vegetables and fruits. These kinds of foods can make diarrhea worse.
Avoid milk products.
Don't eat too many greasy, high-fiber, or very sweet foods.
Don't take in too much caffeine.
Avoid raw or undercooked fish, chicken, and meat.

Dry mouth

Certain HIV medicines can cause dry mouth, making it difficult to chew, swallow, and talk.

Treating dry mouth can be simple--start by drinking plenty of liquids during or between meals. If your dry mouth is severe or doesn't go away, talk to your doctor about prescribing a treatment for you.

Quick Tips: Dry mouth

Rinse your mouth throughout the day with warm, salted water.
Carry sugarless candies, lozenges, or crushed ice with you to cool the mouth and give it moisture.
Try slippery elm or licorice tea (available in health food stores). They can moisten the mouth, and they taste great!
Ask your VA doctor about mouth rinse and other products to treat your dry mouth.

Fatigue

Many people feel tired, especially when they are stressed or their lives are busier than usual. Symptoms of being tired can include: having a hard time getting out of bed, walking up stairs, or even concentrating on something for very long.

If the tiredness (or fatigue) doesn't go away, even after you have given your body and mind time to rest, this tiredness can become a problem. It can get worse if you don't deal with it.

Talk with your VA health care provider if your fatigue is not going away or is becoming too hard to deal with. The more information you can give your doctor about how you are feeling, the more likely the two of you will be able to come up with the right treatment for your fatigue.

Quick Tips: Fatigue

Get plenty of rest.
Go to sleep and wake up at the same time every day. Changing your sleeping habits too much can actually make you feel tired.
Try to get some exercise.
Keep prepackaged or easy-to-make food in the kitchen for times when you're too tired to cook.
Follow a healthy, balanced diet. Your VA health care provider may be able to help you create a meal plan.
Talk to your doctor about the possibility that you have anemia. Anemia means that you have a low red blood cell count, and it can make you feel tired.

Hair loss

Many people lose their hair as they get older, or when they are going through a very stressful time in their lives.

You can also lose your hair from taking certain medications, including those used to treat HIV.

Quick Tips: Hair loss

To stop any more hair loss, stay away from doing such things as dyeing, perming, and straightening your hair.
If losing your hair is very upsetting for you and causing anxiety, you may want to talk to you doctor about whether you can try something like Rogaine, which is a medicine that helps your hair to regrow.
Since stress can make hair loss worse, try to reduce stress and anxiety in your life.

Headaches

The most common cause of headaches is tension or stress, something we all have from time to time. Medications, including anti-HIV drugs, can cause them, too.

Headaches usually can be taken care of with drugs you can buy without a prescription, such as aspirin. You can also help to prevent future headaches by reducing stress.

Quick Tips: Headaches

For on-the-spot headache relief, try some of these suggestions:

Lie down and rest in a quiet, dark room.
Take a hot, relaxing bath.
Give yourself a "scalp massage"--massage the base of your skull with your thumbs and massage both temples gently.
Check with your doctor about taking an over-the-counter pain reliever, such as aspirin.

To prevent headaches from happening again, try the following:

Avoid things that can cause headaches, like chocolate, red wine, onions, hard cheese, and caffeine.
Reduce your stress level.

Nausea and vomiting

Certain medications used to treat HIV can cause nausea. They make you feel sick to your stomach and want to throw up. This usually goes away a few weeks after starting a new medication.

Call your doctor if you vomit repeatedly throughout the day, or if nausea or vomiting keeps you from taking your medication.

Quick Tips: Nausea and vomiting

What to try:

Eat smaller meals and snack more often.
The BRATT Diet (bananas, rice, applesauce, tea, and toast) helps with nausea and diarrhea.
Leave dry crackers by your bed. Before getting out of bed in the morning, eat a few and stay in bed for a few minutes. This can help reduce nausea.
Try some herbal tea--such as peppermint or ginger tea.
Sip cold, carbonated drinks such as ginger ale or Sprite.
Open your windows when cooking so the smell of food won't be too strong.
Talk with your VA health care provider about whether you should take medicine for your nausea.
If you do vomit, be sure to "refuel" your body with fluids such as broth, carbonated beverages, juice, or popsicles.

What to avoid:

Avoid things that can upset the stomach, such as alcohol, aspirin, caffeine, and smoking.
Avoid hot or spicy foods.
Don't eat too many greasy or fried foods.
Don't lie down immediately after eating.

Pain and nerve problems

HIV itself and some medications for HIV can cause damage to your nerves. This condition is called peripheral neuropathy. When these nerves are damaged, your feet, toes, and hands can feel like they're burning or stinging. It can also make them numb or stiff.

You should talk to your VA doctor if you have pain like this.

Quick Tips: Pain and nerve problems

Massaging your feet can make the pain go away for a while.
Soak your feet in ice water to help with the pain.
Wear loose-fitting shoes and slippers.
When you're in bed, don't cover your feet with blankets or sheets. The bedding can press down on your feet and toes and make the pain worse.
Ask your doctor about taking an over-the-counter pain reliever to reduce the pain and swelling.

Rash

Some medications can cause skin problems, such as rashes. Most rashes come and go, but sometimes they signal that you are having a bad reaction to the medication.

It's important that you check your skin for changes, especially after you start a new medication. Be sure to report any changes to your VA health care provider.

Quick Tips: Rash

Avoid extremely hot showers or baths. Water that is too hot can irritate the skin.
Avoid being in the sun. Sun exposure can make your rash worse.
Keep medications such as Benadryl on hand in case you develop a rash. Ask your doctor for suggestions.
Try using unscented, non-soapy cleansers for the bath or shower.
A rash that blisters, or involves your mouth, the palms of your hands, or the soles of your feet, or one that is accompanied by shortness of breath, can be dangerous: contact your doctor right away.

Weight Loss

Weight loss goes along with some of these other side effects. It can happen because of vomiting, nausea, fatigue, and other reasons.

Talk with your VA health care provider if you're losing weight without trying, meaning that you're not on a reducing diet.

Quick Tips: Weight Loss

Be sure to keep track of your weight, by stepping on scales and writing down how much you weigh. Tell your doctor if there are any changes.
Create your own high-protein drink by blending together yogurt, fruit (for sweetness), and powdered milk, whey protein, or soy protein.
Between meals, try store-bought nutritional beverages or bars (such as Carnation Instant Breakfast, Benefit, Ensure, Scandishake, Boost High Protein, NuBasics). Look for ones that are high in proteins, not sugars or fats.
Spread peanut butter on toast, crackers, fruit, or vegetables.
Add cottage cheese to fruit and tomatoes.
Add canned tuna to casseroles and salads.
Add shredded cheese to sauces, soups, omelets, baked potatoes, and steamed vegetables.
Eat yogurt on your cereal or fruit.
Eat hard-boiled (hard-cooked) eggs. Use them in egg-salad sandwiches or slice and dice them for tossed salads.
Add diced or chopped meats to soups, salads, and sauces.
Add dried milk powder, whey protein, soy protein or egg white powder to foods (for example, scrambled eggs, casseroles, and milkshakes).