NAPWA

Symptoms

A ‘queasy' and ‘rising' unpleasant feeling in the stomach making you feel weak and look pale. Nausea is often accompanied by loss of appetite and may or may not lead to vomiting. Left unmanaged it can lead to weight loss.

Causes

Nausea is a known side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. of many HIV antiviralA medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. drugs. Most nucleosides and protease inhibitors can cause gastrointestinal (gut) problems including nausea, vomiting and diarrhoea. Some other drugs used by people with HIV, including antibiotics such as Bactrim, can also cause these problems.

Complementary & Supportive Therapy

Herbal teas: Ginger and chamomile teas may help. Ginger ( Zingiber officinale ) is warming (it improves circulation) and may ease digestive problems. Chamomile ( Anthemis nobilis ) can help settle the stomach. Ginger can be taken as tablets or eaten as crystallised ginger.

Acupuncture: This can assist, as can acupressure wristbands that apply pressure to points above the wrists.

Foods: Try to keep eating—bland, light and palatable foods are best. Dry mashed potato and white rice may be easiest to manage. Choose cool foods (sandwiches, salads, dairy desserts) over hot, spicy, fatty, or strong-smelling foods (e.g. curries, cabbage, fried foods). Salty foods such as cracker biscuits and soups may also help. Avoid becoming dehydrated, particularly when vomiting. Maintain a good fluid intake. Water or sports drinks can be frozen and taken slowly as ice blocks.

Herbs: Slippery Elm ( Ulmus fulva ) may soothe and lubricate the lining of the gut. The active ingredient in cannabis (THC) helps some people to control nausea (and improve appetite).

Medical & Drug Treatment

Check with your pharmacist to see which of your antiviral drugs can be taken after food to reduce the irritation to the stomach lining. Some medications need to be taken after food or on an empty stomach. Prescription anti-nausea medications such as prochlorperazine (e.g. Stemetil, Stemzine) and metoclopramide (e.g. Maxolon) can be very effective for drug-related nausea. Domperidone (e.g. Motilium) is also effective. Your doctor will advise which anti-nausea medication is best suited for you.

Special Precautions & Considerations

• Stick to any food restrictions recommended for your medications to ensure they are absorbed properly. If this is difficult ask your doctor or a dietician for advice.
• Skipping meals can worsen nausea. Eating small amounts throughout the day may be easier than managing three full-sized meals.
• Some foods and smells can bring on or worsen nausea. Try to avoid odours which you know make you feel nauseated. If food aromas cause nausea, try cooking meals in bulk and freezing portions for later use, microwaving prepared meals or preparing meals that do not require cooking such as sandwiches and salads.
• Vomiting can dramatically reduce absorption of your drugs. If you cannot keep food and medications down for more than a couple of hours, and this occurs often and repeatedly over a day or so, see your doctor immediately.
• Cannabis may interact with protease inhibitors (and other HIV antiviral drugs) although the degree varies widely between individuals and is unlikely to have any short-term clinicalPertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. consequences. Smoking marijuana, especially over long periods of time, may create health problems of its own. Possession and use of cannabis and its derivatives is illegal in Australia. The laws in South Australia, the ACT and the Northern Territory require police to impose minor on the spot penalties or cautions rather than prosecutions for possession or use of small quantities of cannabis. Trials of cannabis, to assess its medicinal use, have been proposed in NSW but had not commenced at the time of going to print.

Managing side effects