PAGE 11
HIV NUTRITION UPDATE
VOLUME 9, ISSUE 5
MEDWATCH:
Nucleoside/tide Reverse Transcriptase Inhibitors (NRTIs)
By  Stuart Katsh, MS, RD

(Return to page 10)
 

Other Selected Adverse Drug Effects

1. Zidovudine (see the Sept/Oct 1996 HIV ReSource Review): Gastrointestinal (GI) disturbance (primarily nausea, sometimes with vomiting), headaches, insomnia, anemia and bone marrow suppression. Anemia may need to be treated medically, but education on foods that are rich in iron may help treat it. Nausea is typically the worst during the first month of treatment. Studies of pregnant HIV-positive women document that this medication can lower HIV transmission to the infant at the time of delivery. During the first month of treatment, Zidovudine is best taken on an empty stomach due to nausea and vomiting. After the early nausea has subsided there are no food restrictions.
 
 

2. Zalcitabine: painful stomatitis, pancreatitis and a high likelihood of peripheral neuropathy are most notable. This medication is not commonly used today.

3. Stavudine (see the March/April 1997 HIV ReSource Review): This agent can cause peripheral neuropathy (decreasing the dose by one-half may help if this occurs), lactic acidosis, and lipoatrophy. Side effects can also include headache, diarrhea, nausea, appetite loss, and vomiting. Neuromuscular weakness and pancreatitis is not as common as the other side effects. Zerit can be taken with or without food.

 
 
 
 
 
 


 
 
 
 
 

 

4. Tenofovir (see the Jan/Feb 2002 HIV Nutrition Update): Tenofovir is generally well tolerated. Side effects can include headache, GI upset (nausea, vomiting, gas, etc.), nephrotoxicity (especially in those patients at risk for renal compromise) and an increase in the levels of liver function laboratory test results (especially for hepatitis B patients after stopping Tenofovir treatment). Bone density tests for patients who are at risk for or have a history of osteopenia or osteoporosis can be helpful. A diet and lifestyle that promotes healthy bones is prudent. Supplementation with calcium and vitamin D has not been studied but may be beneficial. A meal high in fat (40- 50%) will increase drug bioavailability, but is not essential to achieve therapeutic levels. 

 
 



 
 
 
 
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8/15/2005