Nausea and vomiting

Nausea is a word for the feeling of wanting to vomit or be sick. Most people with HIV will experience nausea and vomiting at some time.

Nausea and vomiting can have many different causes, commonly stomach problems such as diarrhoea, infections, pregnancy, travel sickness or emotional problems such as anxiety. They are also common side-effects of HIV treatment and some of the other drugs that people with HIV sometimes need to take.

HIV treatment and feeling sick

Many anti-HIV drugs can make you feel sick.

NRTIs that have feeling or being sick as a possible side effect are abacavir (Ziagen, also in the combination pills Kivexa and Trizivir), AZT (Retrovir, also in the combination pills Combivirand Trizivir),  d4T (Zerit), FTC (Emtriva, also in the combination pills Atriplaand Truvada). Tenofovir (Viread, also in Atripla and Truvada) works in a very similar way to NRTIs and some people have reported feeling sick when taking this drug.

Protease inhibitors, particularly those that are 'boosted' by a small dose of ritonavir have also been reported to cause sickness.

The integrase inhibitor raltegravir (Isentress) can cause nausea.

Some of the drugs used to treat infections commonly seen in people with HIV also cause nausea, including, cidofovir/Vistide, foscarnet/Foscavir, ganciclovir/Cytovene, intravenous pentamidine/Pentam, co-trimoxazole/Septrim and clarithronycin/Klaricid.

If nausea is accompanied by other symptoms, then it’s important to find out the reasons. If it is due to drug side-effects you may want to discuss with you doctor what if you can cope with the feeling of sickness or being sick, or if it so unpleasant you’d like to change treatment.  

Some drugs, e.g. AZT, can be taken with food to cut the risk of feeling sick. So it's a good idea to talk to your HIV pharmacist or doctor about this to clarify which foods can be eaten with your medication, and which to avoid.

 

Anti-sickness medicines

Medicines are available to help reduce sickness. They are sometimes called anti-emetics. Your doctor can prescribe them if you need them. They are taken as either tablets or by injection.

Your doctor may give you anti-sickness medicines if you are starting a new medicine that has nausea and vomiting as a side-effect. These side-effects usually go away after a few weeks so you might not need to take them for very long.

Some of the anti-sickness medicines include metoclopramide, prochlorperazine, perphenazine, trifluoperazine, chlorpromazine, domperidone, granisetron, ondansetron, tropisetron and nabilone. They can have their own side-effects, such as feeling drowsy, and your doctor or pharmacist should tell you about these.

 

Some things you can do to cope with nausea and vomiting

• Eat small, frequent meals throughout the day rather than two or three large meals.
• Don’t eat liquid and solid food at the same meal. Space them at least one hour apart.
• Avoid eating greasy, fatty, fried or spicy food. Instead choose bland tasting food.
• Try dry food such as toast, crackers, cereal, and fruit and vegetables that are bland or soft.
• Salty food such as crackers, pretzels and popcorn can help reduce nausea. Carry a packet with you when you leave the house.
• Don’t lie flat for at least an hour after you eat.
• Eat food cold or at room temperature – hot food can worsen nausea.
• Herbal tea (e.g. peppermint or chamomile) or root ginger can help settle upset stomachs.