Does alcohol affect side effects from protease inhibitors?
There are no big interactions between alcohol and HIV drugs (ARVs). This means that alcohol doesn’t increase the drug levels of PIs, so that the side effects linked to PIs shouldn’t increase if you also drink alcohol.
One exception, might be with indinavir (Crixivan), buit due to a different mechanism.
Becasue indinavir is cleared by your kidneys, you need to drink an additional 1.5 – 2 litres of water every day to reduce the risk of indivavir crystal blocking your kidneys. As alcohol dehydrates the body, anything more than 1 or 2 drinks could increase the risk of kidney toxicity, unless you drink even more water to balance this.
The main caution with alcohol and HIV meds, is related to adherence. If you miss or are late with any of your medication – either evening doses because you forget, or morning doses because you oversleep, then your risk of getting resistance to the drugs increases, This would stop the drugs working.
So long as your adherence remain perfect, alcohol will not interact with your HIV drugs or cause you to have more side effects,
For people who drink heavily, this risk of resistance is so serious that In many countries, doctors will not give HIV treatment to people who drink heavily.
NB – Alcohol can alter your mood and this might overlap with the side effects associated with the NNRTI efavirenz (Sustiva, Stocrin). If you get side effects from efavirenz, then be more careful with your use of alcohol. Alcohol can increase feelings of anxiety or depression.