HIV MEDICATIONS
Not every drug out there interacts with HIV meds! That said, many substances (including MDMA) have not yet been researched for interactions. We can only provide information based on current research, so there might well be interactions we don’t know about yet.
If you’re curious about potential interactions, it’s a great idea to have a chat with your doctor or (even better) a HIV specialist. Here are some things we do know:
Antiretroviral medications can have variable impacts on the effects of certain substances including weed, benzos, Ketamine and some opioids including Oxycontin, leading to increased OR decreased sensitivity. Be aware and alert that your substance might impact you differently when you’re on medication.
Some ODTP including methadone and buprenorphine should not be mixed with certain HIV medications. Do not take both of these medications before seeking specialist medical advice.
HIV Meds + Stimulants:
Some research has suggested that stimulants such as methamphetamines, amphetamines and cocaine can impact the function and efficacy of HIV medications. In combination with HIV meds, stimulants may:
Aggravate HIV-associated neurocognitive disorders
Impact inflammatory and oxidative systems
Impact coronary health
Research has also found that protease inhibitors such as Cobicistat can increase concentrations of stimulants in the body, which amplifies effects (both positive and negative) so best to be aware of possible sensitivity, and an increased risk of toxicity.
Stenosis (narrowing of blood vessels) can be a side effect of long term stimulant use.
As certain HIV medications, including Lamivudine, Stavudine and Zidovudine can also increase risk of stenosis, be aware of this compounded risk.
Research has also identified potential kidney function issues for long-term stimulant users – this could be particularly relevant for people taking Efavirenz, Etravirine, Nevirapine, and Rilpivirine.
Anyone on HIV meds who is using stimulants regularly should chat with a HIV specialist about possible interactions.
HIV Meds + GHB:
Some research has suggested that the interactions between protease inhibitors and GHB could increase toxicity significantly, as did the interactions between GHB and Delavirdine and Efavirenz. Chat to your specialist if these interactions are relevant for you!
HIV Meds + Ketamine:
Some research suggests that combining ketamine with Ritonavir, Lopinavir or Cobicistat can lead to epigastric pain and hepatobiliary disorder, which affects the pancreas and surrounding areas.
HIV Meds + Opioids:
Protease inhibitors and other HIV drugs (including Efavirenz or Etravirine) can amplify the effects of heroin and other opioids. Be aware and educate yourself about signs of overdose, don’t use alone and always carry Naloxone.
Nevirapine significantly increases the symptoms of opioid withdrawals, so best to chat with a healthcare professional before quitting.
A note on PrEP and PEP
The interactions between PrEP, PEP and illicit substances have not been well researched. We recommend speaking to your doctor or specialist and regularly checking the Liverpool HIV drug interactions checker online regularly for the most up to date information.
Link here: Liverpool HIV Interactions
Also check out this link to QPP website: Queensland Positive People
