Q and A

Question

Can I take HIV medication with my Asthma medication?

Hello,

I have recently been tested HIV positive and am not yet on ARVs. My CD4 count is 425 and my viral load is 125,000.

I have asthma. I am currently on Seretide 50/500 and inhale twice daily to prevent any asthma attacks. Seretide contains fluticasone and salmeterol.

I also have allergic rhinitis and for this I use Flomist Nasal Spray – one puff every morning and evening into each nostril.

I also exercise regularly. I run approximately 25kms per week and I do weight training 5 times per week at the gym.

My asthma is under perfect control and I have not had an asthma attack in nearly 5 years.

My questions:

1. If I do eventually go on HAART, what is the most recent scientific evidence in regards to the interaction between ARVs and Seretide 50/500 as well as Flomist? Can these medications somehow cause side effects when used in conjunction with ARVs?

2. Do you think I should continue exercising the way I do? I want to preserve my CD4 count for long obviously but I am unsure the effects of running.

3. If I do eventually go on HAART, how does one normally take this medication? Must you take it each day at the same time and must you first have a meal before the time? If this is true, then obviously if you meet friends for breakfast for example on a Saturday morning, must I first eat at home in order to take the medication or can you take it on an empty stomach. Must you follow taking times very religiously?

Any advice would be appreciated.

Answer

Thank you for your question.

I will answer your questions based on the numbers you have given above.

1. Flomist is a generic form of fluticasone which is a steroid.  There are potential interactions between fluticasone, salmeterol and certain types of ARV.

All of the nukes or Nucleoside Reverse Transcriptase Inhibitors (NRTIs) have the potential to interact with both fluticasone and salmeterol. There is also a potential interaction with Delavirdine which is a non-nuke or a Non-Nucleoside Reverse transcriptase Inhibitor (NNRTI) but no interactions with the other NNRTIs.

There have been reports of interactions between inhaled fluticasone and ritonavir which is a protease inhibitor and is also used as a booster to other protease inhibitors. There have also been new drug interaction warnings for advair and severent (both contain salmeterol), they should not be combined with protease inhibitors.

Where there are potential interactions with ARVs this can either cause the medication to not work as it should or can cause bad side effects. When you reach the time to start your medication you should discuss all the possibilities of drug interactions with your HIV doctor.

2. Exercise is a good thing and will help to keep your body healthy especially if it is combined with a nutritious diet. Providing you are not exercising excessively, running should not affect your CD4 count.

3. When you reach the time to take HIV medication it is important that you find the regimen to fits in with your lifestyle. This way you are more likely to adhere to your treatment.

Some medications require that you take them with food, some require that you don’t eat for two hours before you take them and others can be taken with or without food. You should discuss this with your doctor when deciding which medication to start.

When you start medication it is important to think carefully about what time would be best suited to fit in with your lifestyle. Once you decide which time to take your medication you should try and take the medication within an hour either side of that time. For example, if you decide to take your medication at 9am you can take it anytime between 8am and 10am. The closer to the time you have decided to take your medication, the better it is. An hour either side will not affect the drug levels in your blood very much.

For further information please follow this link to the i-Base ‘Introduction to Combination Therapy’ guide.

2 comments

  1. Simon Collins

    Hi Mela

    Thanks – I have not heard or any links to asthma, but a few HIV meds, generally older ones, included monitoring for heart disease. This should be part of your routine HIV care though, so please ask your doctor about this.

  2. Mela

    Greetings I would like to find out if my arv treatment can make my asthma and heart disease worse?

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