Question
Are supplements a problem with integrase inhibitors?
30 October 2024. Related: All topics, Drug interactions, Supplements and herbs.
Hi there. There appears to be conflicting information about taking supplements with ARVs?
When I was 1st diagnosed in 2018, initially I was on Descovy and raltagravir. I was advised NOT to take any supplements, probably this time my viral load was in the millions. However, quite quickly I became undetectable and onto Biktarvy. I seem to have initial blips when first blood test done at 6 monthly intervals , effectively sometimes above 50 copies, but under 200.
I take my ARV religiously at the same time every morning 8.30 am. Any supplements would be about 8 pm. My last test showed a blip and will have to go back in a couple of weeks for 2nd blood test. But have been told in the interim not to take any supplements.
I thought someone living with HIV would benefit from vitamin supplements but it’s looking like apparently not?
Answer
Hi there
Thanks – low level viral load blips can often happen.
This is where viral load is detectable but still less than 200 copies.mL.
As this has happened several times, your clinic might just want to see whether the supplements are making any difference.
The main interaction is between integrase inhibitor and aluminium, calcium and magnesium rather than supplements in general. The details of each drug are included at this link and vary slightly for each drug.
All HIV meds:
https://i-base.info/guides/category/arvs
Biktarvy:
https://i-base.info/guides/13752
However, as you separate the doses by 12 hours it shouldn’t be having any interaction.
In general, supplements are only recommended if your doctor recommends this because of a deficiency. Otherwise, a balanced healthy diet is fine and supplements are not needed and are unlikely to do anything.
Hello Kevin and thanks for getting in touch.
I disagree with your pharmacist (so does Liverpool university: https://www.hiv-druginteractions.org).
Biktarvy should not be taken at the same time as magnesium.
Taking one in the morning and the other at night is the right thing to do.
Well done for that.
Taking Biktarvy with food will help you absorb it better but it is not mandatory.
My pharmacist read the drug interactions database and told me to take biktarvy and magnesium along with food at the same time. However, I take magnesium as a sleep aid right before bed, and it seems to put me in a deeper and more sustained sleep. So, I am taking biktarvy in the morning around 7AM, and Magnesium at night around 9PM. Would this present any problem?