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. Alisha

    How Can Live With Hiv

  2. Roy Trevelion

    Hi Thitu,

    It’s a good idea to talk to your pharmacist again. Some PEP meds can be taken with or without food. But other meds need to be taken with food to help them work properly.

    Please let us know what meds you’re taking.

  3. Thitu

    Hi Good morning actually I’m on PEP treatment and I heard from pharmacist that should Taking pep medicines on an empty stomach means that you should take your pills 2 hours before you eat or 2 hours after you eat for make more effective
    Usually I Eat first and take the pills 2 hours later. For example i eat breakfast at 8 a.m., wait until 10 a.m. to take my pills. But today unfortunately I took my PEP pills before 2 hours is it make less effective of pep treatment,,, plz give me some advice and I feel so panic regarding to this issue

  4. Roy Trevelion

    Hi Jacky,

    Alcohol does not interact with the drugs in PEP. Taking a glass of whiskey or wine is fine. Sometimes taking too much alcohol can make you forget to take your meds. But it’s great that you’ve never missed a dose.

  5. Jacklyne

    Am jacky and i had a condom break with a stranger..I started on PEP treatments within 24hours..but av been taking a glass of whiskey or wine through out my 28day treatment…am am about to finish my dosage but av never missed a dosage everyday for 28days at the same time,does alcohol affect anything??

  6. Lisa Thorley

    Hi Punch,

    As long as your wife takes ARVs and her viral load is undetectable when she gives birth, then yes, it’s very possible to have a negative child. Please see here for more info: http://i-base.info/guides/pregnancy

    With regards to breastfeeding, guidelines relating to breastfeeding vary depending on where it is that someone lives. In the UK we don’t advice breastfeeding.

  7. Punch

    My wife is 2 months pregnant and she tested HIV positive yesterday. Hope it won’t affect the unborn child? And what are her chances of having an HIV negative child? Also, is breastfeeding advisable after birth?

  8. Roy Trevelion

    Hi Mukasa,

    Thanks for your comment. It’s good you’ve started ARVs. And great to hear that you’re encouraged too.

  9. MUKASA

    Am encouraged bse am 3 days old on ARVs but my fear was how to do away wiz beer,but at least now i know how to handle it

  10. Lisa Thorley

    Hi Kate,

    No this isn’t true. ARVs do not interact with alcohol.

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