Question
Will alcohol make my HIV meds less effective?
6 July 2011. Related: All topics, Drug interactions, Living with HIV long-term.
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.
Hi I’m HIV reactive reading point 20.73. What does this mean?
A few drinks are usually fine – but moderation is alwasy good. If your meds include efavirenz, it is better to take them before you go to sleep,, rather than before drinking. The main worry about drinking is that you might forget you meds. With efavirenx though, the side effects of meds can exagerate the modd changes with alcohol – so please be careful.
Can i have few drinks during the weekends only after taking my meds? Eg: I take my meds @ 20HO0 & ater that can i drink few beers?
Please talk to your doctor or health adviser about this. This should include a caution about oral contraceptives as some of these are less effective for women on efavirenz, due to a drug interaction.
Which family planning methods should I used iam not happy with the condom only iwant to double up I’m on tribuss
Hi Chilufya
Please contact a doctor or nurse at your clinic.
They will want to know about this so that they can help.
They should also be able to look at why you were having trouble and provide support for the future.
I have been skipping my medication for some time and i have lost track of my original schedule, what must i do?
Hi,
Thanks for your message. You are right that it would be more accurate to say there are no clinically significant interactions expected between ARVs and alcohol . Lots of foods, medications, drinks and so on may have an interaction with HIV meds without having any clinical significance. Generally people are worried about whether their treatment will be affected, rather than whether there is an interaction without consequences on the success of treatment.
“On the one hand, there is no direct interaction between HIV meds and alcohol.”
That’s wrong. There is an interaction between ethanol and abacavir. Drinking alcohol will increase the concentration of abacavir, but it is assumed that the increase isn’t clinically significant.
http://aac.asm.org/content/44/6/1686.long
Plus it wasn’t recommended to use amprenavir (Agenerase) oral solution with alcoholic beverages. But since nobody uses Agenerase since 2005 this is a little obsolete.
Please see this similar question and let me know if you have any further questions.