Q and A

Question

Can I use herbs or supplements with Atroiza?

Can I use herbal formula with Atroiza. Its ingredients are eletherococcus senticocus, ginkgo biloba, sarsaparilla, guajava, mellisa officinalis, alchemilla vulgaris, discorea villosa tincture blend: Preservative: citric acid, methyl paraben?

Answer

Hi

i-Base are always cautious to say any herbal formulas are safe. This is because there are so few studies that look at drug interactions and because the contents of herbal formulas vary so much.

The efavirenz in Atroiza has the potential to interact with many drugs, herbs and supplements. This includes ginkgo biloba in your list, which might make your HIV meds less effective. See below for a detailed explanation.

Instead, we emphasise the consistent evidence from research that HIV medicines are so good that supplements are unlikely to make any difference – other than costing you money.

HIV meds (antiretrovirals) are the only proven way to reduce viral load and increase your CD4 count. There is no evidence showing that herbs or supplements have any impact.

Liver enzymes – inducing and inhibiting

An enzyme is a type of chemical that increases a process. For example, liver enzymes are one of the ways that chemicals in drugs and supplements can be cleared from your body.

There are lots of specific liver enzymes, categorised by letter and numbers. One of the main enzymes is called CYP3A4 (used by 90% of drugs), another is CYP2B6. (CYP stand for “cytochrome P450”).

The levels of these enzymes is not constant though. Sometimes drugs (or herbs or supplements) increase or decrease the levels of different enzymes. This makes things very complication.

Efavirenz is processed by both 3A4 and 2B6 (and also UGT1A1). But it also induces (ie makes more) of these enzymes. So any other drug that uses these enzymes will be cleared more quickly from the body. This means drug levels might become too low to be active.

In a similar way, if other drugs or supplements increase 3A4 or 2B6, efavirenz will be process more quickly. If the other drugs slow down (inhibit) these enzymes, efavirenz levels will be much higher. Higher levels can cause more side effects and serious toxicity.

As examples, ritonavir and grapefruit juice inhibit both these enzymes, increasing efavirenz levels. Ginkgo biloba extracts and St. John’s wort both induce these enzymes – and reduce efavirenz levels, making your HIV medicine less effective.

38 comments

  1. Roy Trevelion

    Hi Zuziwe,

    There is no evidence to support Promune being effective against HIV. The only drugs that work against HIV are antiretrovirals (ARVs). If you have a rash it’s important to see your doctor.

    Are you taking ARVs? What are they, and do you have access to your CD4 count and viral load?

  2. Zuziwe

    I’m starting to use promune pills and my skin is being a rash ?

  3. Roy Trevelion

    Hi Ps K,

    Procydin contains grape seed extracts and vitamins C and E. Promune contains amino acids and Sutherlandia frutescens plant extract. If you look at the Liverpool drug interactions website, it seems less likely that there will be drug interactions with Atroiza.

    However, taking Atroiza can keep HIV well under control and down to undetectable levels. This can give your immune system every chance to recover to stonger levels.

  4. Ps K

    Can someone who is HIV positive can take Atroiza with procydin and promune supplement?

  5. Lisa Thorley
  6. Olga

    Can I take SPECTRUM senior vitamins while I’m taking arv’s ODIMUNE

  7. Roy Trevelion

    Hi Tony,
    It’s great that your viral load has been undetectable since a month after starting Stribild. But have you talked to the doctor about your symptoms? Early HIV meds have been associated with muscle loss and fat gain. But these side effects are not usually associated with modern meds. And skin issues including rash should be shown to your doctor so they can see what it looks like.

    Please talk to your doctor about whether these symptoms are side effects of Stribild or have other reasons.

    You can ask if there’s another single once-daily tablet that might suit you better. You can ask if Triumeq would be okay, especially as this is a once-daily tablet that you take with or without food. Please check because it contains Abacavir. And the doctor should have already tested to see if this would be suitable for you.

    Here is the i-Base guide to Stribild.

  8. Tony

    I take Stribild , since diagnosis 16 months ago ! I have had all sorts of odd a normalities but no knowledge on cause . Loss of muscle, developed belly, lots of skin issues , itchy etc
    Is it the immune system or the med ?
    Have been U/D since a month after taking med and C D has been 530, now 427 !

  9. Roy Trevelion

    Hi Dehli,

    It’s good that you’ve started Tribuss. There are 2 antibiotics in Purbac and these are fine to take with Tribuss. Has the doctor given you Purbac to clear up an infection or to guard against one?

    You can ask your doctor to see if there are other antobiotics that are better for you to take. If you vomit them up you could be getting low doses that won’t work properly.

  10. Dehli

    I started my treatment of tributes last week the side effects are not that hectic but when I take purbac I always vomit and my appetite is getting lower.

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