Which drugs cause which side effects?

The table below summarises the most common side effects associated with each HIV antiviral [1]A medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. drug currently in use in Australia. See the glossary if any of the terms used in the table (or elsewhere in this booklet) are unfamiliar to you .

Note: For all the drugs listed below the common or generic drug name is written first with the brand name in parentheses .

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

All drugs in this section can cause:

• Gastrointestinal (gut) problems + Liver toxicity [2]
• Elevated blood fats [3] + Lipoatrophy (loss of facial and limb fat)
• Lactic acidosis (high levels of lactic acid in the muscles and blood)

3TC or lamivudine (Epivir)

• Common : headache [4], fatigue [5], diarrhoea [6], abdominal pain, nausea [7], vomiting, rash [8].
• Less common : insomnia, hair loss (on the head).

Abacavir (Ziagen)

• Common: headache [4], rash [8], fever.
• Less common: nausea [7], vomiting, diarrhoea, fatigue [5], and lack of appetite [9].
• Rare: severe hypersensitivity reaction (fever, tiredness, nausea [7], vomiting, flu [10]A highly contagious and relatively common viral infection of the respiratory system, transmitted by infected droplets of moisture which may be spread through coughing and sneezing. Most people with flu recover but some go on to develop secondary infections such as pneumonia which may be fatal.-like symptoms, possible rash [8]) usually within six weeks of starting therapy (occurs in about 4% of people and may have serious health consequences). Never take abacavir again, if hypersensitivity reaction has occurred.

AZT or zidovudine (Retrovir)

• Common: nausea [7], vomiting, headache [4], insomnia, diarrhoea, muscle wasting.
• Less common: low levels of haemoglobin (anaemia [11]) or platelets (thrombocytopenia) in the blood, muscle pain [12].
• Long-term: loss of subcutaneous facial and limb fat (lipoatrophy).

d4T or stavudine (Zerit)

• Common: nausea [7], diarrhoea, abdominal pain, dizziness, fatigue [5], rash [8].
• Rare: pancreatitis (may have serious health consequences).
• Long-term: peripheral neuropathy [13], loss of facial and limb fat (lipoatrophy).

ddI, ddI EC or didanosine (Videx or Videx EC)

• Common: diarrhoea with ddI (but not with ddI EC), nausea [7], vomiting, rash [8].
• Rare: pancreatitis (may have serious health consequences), peripheral neuropathy [13].
• Long-term: loss of facial and limb fat (lipoatrophy).

FTC or emtricitabine (Emtriva)

• Common: nausea [7], vomiting, diarrhoea, abdominal pain, dizziness, weakness, rash [8].

Nucleotide Reverse Transcriptase Inhibitor (NtRTI)

Tenofovir (Viread)

• Common: nausea [14], vomiting, diarrhoea, dizziness, low blood phosphate levels.
• Rare: kidney problems [15] (may have serious health consequences).

NRTI & NtRTI Fixed Dose Combinations

3TC & abacavir (Kivexa)

• Side effects of this combined pill will be that of those listed in 3TC and abacavir (see separate entries).

3TC & AZT (Combivir)

• Side effects of this combined pill will be that of those listed in AZT and 3TC (see separate entries).
  Note: dose of AZT in Combivir is higher than AZT alone, which may accentuate AZT side effects.

3TC, abacavir & AZT (Trizivir)

• Side effects of this combined pill will be that of those listed in 3TC, abacavir and AZT (see separate entries).
  Note: dose of AZT in Trizivir is higher than AZT alone, which may accentuate AZT side effects.

FTC & tenofovir (Truvada)

• Side effects of Truvada will be similar to those listed in FTC and tenofovir (see separate entries).

Protease Inhibitors (PIs)

All drugs in this section can cause:

• Gastrointestinal (gut) problems
• Lipodystophy (including changes in body fat, elevated blood fats [3]—cholesterol and triglyceride—and blood sugar problems [16])
• Liver enzyme changes [2]

Amprenavir (Agenerase)

• Common: nausea [14], diarrhoea [6].
• Less common: tingling around the mouth, rash [8], headache [4], fatigue [5], fat accumulation in the abdomen.

Atazanavir (Reyataz)

• Common: headache [4], dizziness, nausea [14], abdominal pain, rash [8], diarrhoea [6].
• Less common: fever, jaundice (yellowing of the eyes and skin).

Darunavir (Prezista)

• Common: diarrhoea [6], nausea [14], headache [4].

Fosamprenavir (Telzir)

• Common: headache [4], dizziness, diarrhoea [6], nausea [14], vomiting, abdominal pain, rash [8], fatigue [5], tingling around the mouth, lipodystrophy.

Indinavir (Crixivan)

• Common: nausea [14], diarrhoea [6], liver problems [2], kidney stones [15], fat accumulation in the abdomen, elevated blood fats [3].
• Less common: night sweats, dry skin [8] including loss of hair (head and body), ingrown toenails, blood sugar problems [16], jaundice (yellowing of the whites of the eyes and skin).

Lopinavir/ritonavir (Kaletra)

• Common: diarrhoea [6], abdominal pain, headache [4], mild nausea [14].
• Less common: dry mouth, fat accumulation in the abdomen, elevated blood fats [3].
• Kaletra capsules include a small amount of ritonavir which may result in ritonavir-related side effects.

Nelfinavir (Viracept)

• Common: diarrhoea [6], nausea [14], vomiting.
• Less common: fatigue [5], headache [4], rash [8] (sometimes severe), fat accumulation in the abdomen.

Ritonavir (Norvir)

• Common: nausea [14], diarrhoea [6], vomiting, changes in taste sensation, numbness/tingling around the mouth, liver problems [2], menstrual (period) irregularities, fat accumulation in the abdomen.

Saquinavir soft gel (Fortovase)

• Common: diarrhoea [6], nausea [14], fat accumulation in the abdomen.
• Less common: night sweats.

Saquinavir hard gel (Invirase)

• Common: diarrhoea [6] (less so than soft gel), nausea [14].
• Less common: night sweats, fat accumulation in the abdomen.

Tipranavir (Aptivus)

• Common: diarrhoea [6], nausea [14], stomach cramps, lipodystrophy.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

All drugs in this section can cause:

• Gastrointestinal (gut) problems (less so than NRTIs or NtRTIs)
• Liver enzyme changes [2]
• Serious rash [8]

Efavirenz (Stocrin)

• Common: rash [8], dizziness, disorientation, vivid or unusual dreams, headache [4], fatigue [5], insomnia.
• Less common: liver problems [2].

Nevirapine (Viramune)

• Common: rash [8] (sometimes severe), fever, liver problems [2], headache [4], nausea [14].
• Less common: fatigue [5], sleepiness, muscle pains [12].
• Rare: Stevens-Johnson syndrome (very severe rash [8], fever, muscle pains [12], joint pains, if left unchecked may be fatal).

Delavirdine (Rescriptor)

• Common: fatigue [5], diarrhoea [6], nausea [14], liver problems [2], rash [8].

Entry & Fusion Inhibitors

T-20, enfuvirtide (Fuzeon)

• Common: Injection site reaction, respiratory tract infections.

Maraviroc (Selzentry, Celsentri)

(Not licensed in Australia. Available only on trial or as part of access scheme).

• Common: Cough, fever, dizziness, headache [4], lowered blood pressure.
• Rare: Liver problems [2], elevated blood fats [3].

Integrase Inhibitor

Raltegravir, MK-0518 (Isentress)

(Not licensed in Australia. Available only on trial or as part of access scheme)

• Common: diarrhoea [6], nausea [14], fatigue [5], headache [4], itching.
• Less common: constipation, flatulence, and sweating. Nausea [14] & vomiting