Paracetamol and ARV's

Posted by Pozziepinoy on 6:48 AM

I usually encounter conversations between pozzies wherein there is a question whether to take paracetamol or not while taking ARV’s, when one feels sick of fever due to colds and flu. I know I don’t have a problem with taking it but I usually ask my doctor first.

From the very start I always advice my readers to ask their HIV doctors first before taking any medicine. However, it always comes up whenever one has a fever because of a cold. 
So I interviewed Ellen Domingo, one of the staff nurses of RITM-ARG over the phone about it. She said that usually, they don’t advice paracetamols during the trial period of 2 weeks from the start of taking ARV’s as they are monitoring each patient’s reaction to the ARV’s. After that period, patients can take paracetamols as deemed necessary as long as one has no sensitivity or allergic reaction to it.

Why should we be careful in taking medicines together with ARV’s in the first place?

Well, medicines can interact, or interfere with the way other medicines work. When this happens, there won’t be enough of a drug present in your blood for it to work properly. If this happens with anti-HIV drugs, it can risk the development of resistance. It can also lead to too much of a drug and which can produce more of a chance of side effects developing.

Interactions of medicines are one of the reasons why it makes very good sense for your HIV doctor to know about all the medicines and drugs you are taking.

There are interactions between some anti-HIV drugs and everyday, over the counter medicines that it’s important to be aware of. It always makes good sense to read the leaflet that comes with all medicines as this will include information about possible drug interactions.

So can we really take paracetamols if we have fever from colds and flu? 

There is no interaction between paracetamol and anti-HIV drugs, but it’s important to know that paracetamol should be used carefully if you have any liver problems.

Paracetamol is a common painkilling and anti-fever drug. It is an extremely effective drug that is used to relieve fever, headache and other aches and pains. It can also be combined with other painkillers to enhance their effect. In the United States, it is called acetaminophen.

It is available in tablet form from pharmacies, supermarkets and other shops. The standard dose is 500 to 1000mg, up to a maximum of 4g a day. It is also available as a liquid, suppositories or a solution for injection into a vein.

Paracetamol is safe for use in pregnancy and in children.

Large doses of paracetamol can cause liver failure and death within a few days. The risk of this occurring is enhanced by excessive alcohol consumption. Paracetamol poisoning can be treated using N-acetyl cysteine.

Paracetamol does not interact with any currently available protease inhibitors or non-nucleoside reverse transcriptase inhibitors (NNRTIs).

Risk of severe liver damage (i.e. a peak ALT more than 1000 IU/L):
Based on the dose of paracetamol ingested (mg/kg body weight):
  • Less than 150 mg/kg - unlikely
  • More than 250 mg/kg - likely
  • More than 12 g total - potentially fatal
So there. An HIV person who has fever from colds and flu can take paracetamol. Just watch out for its dosage. In case of a liver problem, ask your doctor first.

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