22.4 ARV side-effects and how to manage them
Every drug can have side-effects, which means unwanted effects that result when taking the drug for treatment. ARV drugs can have multiple side-effects, some of which are common, and others which are rare. The most common side-effects of ARV drugs are shown in Table 22.2. You may need to advise patients when some of these occur, or refer them to a nearby health centre or hospital if serious side-effects arise.
Table 22.2 The most common side-effects of ARV drugs used in the first-line regimen.
|Very common side-effects||Potentially serious side-effects||Side-effects occurring later during treatment|
Counsel patients about these and suggest ways they can manage them; also be prepared to help manage them when patients seek care at home.
Warn patients, and tell them to seek care urgently (or refer them urgently) if these occur.
Advise patients to seek care at a health centre or hospital.
|Stavudine (d4T)||Refer urgently:||Changes in fat distribution of the body:|
|Refer as soon as possible:|
|Nevirapine (NVP)||Refer urgently:|
|Zidovudine (AZT or ZDV)||Refer urgently:|
|Efavirenz (EFV)||Refer urgently:|
Note that side-effects such as nausea, vomiting and diarrhoea are very common with many ARV drugs, especially in the first 2–3 weeks of treatment. If a patient has nausea, you should advise him/her to take the tablets with food (or just after eating food). Patients who develop diarrhoea should be advised to drink more fluids, including oral rehydration salts, eat small and frequent meals, and avoid spicy foods. If the nausea, vomiting or diarrhoea worsens, the patient should be referred to a health centre or hospital as soon as possible.