Q and A

Question

Will alcohol make my HIV meds less effective?

I am confused about alcohol and whether it is advisable to drink when I am on meds. I am on atazanavir, ritonavir & Truvada and since starting my meds (5 months ago) I havent had a drop of alcohol. I have wanted to take care of myself (as I have always in the past) and not put unnecessary burden on my body and liver esp now that I am on these heavy burdensome drugs.

However, I now really want to have a drink – not a lot, but a drink now and again. am I allowed to? I read a lot of confliciting articles – some say dont drink at all and other say yes you can have a drink. I feel that I should not have anything and I really need to look after myself even more now but I would like to have a drink with dinner or when out with friends.

What guidelines are there? and, more importantly, will it make my meds less effective?

many thanks for your help, support & advice

Answer

Thanks for your questions that are important for lots of people.

The reason for some of conflicting articles you have read are likely to be related to how much someone might drink.

On the one hand, there is no direct interaction between HIV meds and alcohol. Unlike some other recreational drugs, alcohol doesn’t increase or decrease levels of HIV drugs. It is fine to take your meds with a beer, or to have a few drinks over dinner with friends.

Guidelines for HIV-positive people are therefore the same as for the general population.

Here is a link to information about UK recommendations.

Here is a link to an online calculator to see how much you drink.

The NHS recommends:

  • Men should not regularly drink more than 3-4 units of alcohol a day
  • Women should not regularly drink more than 2-3 units a day

‘Regularly’ means drinking this amount every day or most days of the week.

However, while your HIV meds work just as well with or without a drink, you might not work as well :)

Lots of studies have linked routine or heavy alcohol use with a risk of lower adherence – missing doses of your meds – and this then increases the risk of drug resistance and treatment failure.

For some people and in some communities, alcohol is such a significant social problem that alcohol use is an exclusion criteria for accessing HIV treatment.

I’d also add a comment to your reference to HIV drugs being ‘liver burdensome drugs’. This is a common misconception and often scares people from using treatment that is actually very safe.

You liver is built to filter all sort of toxicities. This includes toxicities from medicines, herbs, alcohol, cigarette smoke and food etc. It is usually a good study organ. Although HIV drugs, like any medicine, have the potential in some people to affect the way your liver functions, for most people they have little or no impact.

Routine monitoring on treatment includes checking liver enzyme levels (usually LFT or AFT) and very few people need to switch or stop treatment because of liver problems. When problems develop, these are almost exclusively in people who also have viral hepatitis infections (especially HepB or HepC) or where heavy alcohol use has caused problems.

57 comments

  1. Josh Peasegood

    Hi Gato, you can continue taking PEP alongside coffee and energy drinks.

    What is in you’re pre-workout? There is caution if your pre-work out contains creatine and your PEP includes tenofovir. If this is the case it would be recommended to not continue taking your pre-work out while you are on PEP.

  2. Gato

    I have read some articles saying you shouldn’t take coffee or energy drinks while on PeP am somehow confused.
    Someone help can I take coffee,pre-work out or energy drinks while on PeP? Thanks.

  3. Josh Peasegood

    Hi Zifikile, yes you can drink alcohol while using PEP. It is important to drink within normal, recommended safe limits. This link explains the healthy ranges of drinking alcohol in the UK is: https://www.nhs.uk/live-well/alcohol-support/calculating-alcohol-units/?tabname=alcohol-facts It is important to not drink too much. This can lead to forgetting to take PEP and will reduce its effectiveness.

  4. Zifikile

    I had sex with someone who’s HIV positive without knowing. Can i drink alcohol while am taking pep?

  5. Roy Trevelion

    Hi Felix,

    Smoking is not likely to affect PEP. But there are some HIV meds that can interact with cannabis. Please see this link to the HIV drug interactions website.

    Taking your meds an hour late is likely to be fine. You can aim for 9pm and take them within an hour either way.

  6. Felix

    Can i smoke cigarette and marijuana while on PEP for HIV prevention after exposure

    I usually take my meds 9pm before bedtime but in like two ocassions i took them an hour late is this really a problem ?

  7. Roy Trevelion

    Hi Alisha,

    Finding out that you are HIV positive can be tough.

    But for all the difficulties, HIV can also bring positive experiences.

    And the chance to learn about HIV and treatment can help you feel more in control of your health. It can help you have better health by being more confident with your doctor.

    These are the key points from the intro to the guide to HIV treatment called ART in Pictures. There’s lots of info in this that can help us live with HIV. Please have a look.

    Best wishes, Roy

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