Anti-HIV Medications

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Factors to be considered in evaluating the relationships between drugs and diving:

•  The condition/illness/disease for which the medication is being given.
•  Any side-effects that could be dangerous underwater.
•  Any effects of the drug that alter consciousness or cause alteration   in decision-making ability.
•  Complex relationships between drugs, the individual, other medications, diet and the conditions for which the drugs are taken.

Legend:  Effects or side-effects adverse to diving

  Antisera

Single component drugs

  Immu Globulin,gamma (igg) (Intravenous (only) )
USES:
     This medication is used to provide protection (immunization) against Hepatitis A, measles, varicella and rubella infections. It may also be used to boost the body's natural immune response in persons with a compromised immune system.

SIDE EFFECTS:
     Muscle stiffness, redness, warmth, pain and tenderness may occur at the site of injection.  Fever, chills, headache, weakness and nausea may also occur.  Notify your doctor if you experience skin rash,swelling of the hands, feet or face or breathing trouble while takingthis medication.

PRECAUTIONS:
     Tell your doctor if you have any pre-existing illnesses, blood
     disorders or any allergies, including any drug allergies. This
     medication should be use only when clearly needed during
     pregnancy.

Single component drugs

  Delavirdine Mesylate (Oral )
USES:
     This medication is used in the treatment of infection with HIV (the virus that causes AIDS). It is used in combination with other HIV medications (antiretrovirals) in selected patients. No cure exists for HIV infection, and the illnesses associated with your disease (infections, etc.) may continue.

SIDE EFFECTS:
     Headache or nauseatrouble breathing, dizziness/fainting

USES:
This medication inhibits the replication of the HIV in patients with acquired immunodeficiency syndrome (AIDS) that are over 6 months of age and have advanced HIV infection. Such patients are usually intolerantor not responding to zidovudine (AZT).This medication is not a cure and has not been shown to reduce the frequency of HIV related illness.

SIDE EFFECTS:
     This medication may cause headache, cough,rash, weakness, loss of appetite, chills, fever, sore tongue or mouth, change of taste, muscle or joint pain or insomnia as your body adjusts to the medication. You may experience severe diarrhea, stomach pain, nausea, vomiting, tingling, numbness or pain in your hands or feet, yellowing of eyes or skin, unusual bleeding or bruising.

PRECAUTIONS:
     Be sure to tell your doctor if you have a history of pancreatic diseaseor tingling of the hands or feet (called peripheral neuropathy).  Food decreases the absorption of this drug. Follow your doctor's instructions exactly regarding how to use it. Avoid alcohol because it may worsen pancreatitis.

NOTES:
     Blood tests should be done routinely to monitor for anemia and to ensure it is working properly. This medication is very potent and
should not be shared with others.

HOW TO TAKE THIS MEDICATION:
Take this by mouth exactly as directed usually once or twice a day.
Follow your dosing instructions closely. May be taken with or
without food. This medication is often given in combination with
zidovudine (AZT) for best effects. Follow directions for taking
zidovudine carefully.

SIDE EFFECTS:
     Headache, nausea, vomiting, diarrhea, insomnia, change in appetite,dizziness, weakness or muscle aches may occur.  Notify your doctor if you experience a skin rash, fever, chills, stuffy nose, cough, stomach pain, severe weakness or tingling of the hands or feet while taking this medication.

PRECAUTIONS:
     Before taking this, tell your doctor if you have kidney disease,
pancreatic disorders, hepatitis B or any drug allergies. Lamivudine in combination with zidovudine should be used with extreme caution in children with pancreatitis.

DRUG INTERACTIONS:
     Tell your doctor of any nonprescription or prescription medication you may take including sulfamethoxazole- trimethoprim.

SIDE EFFECTS:
     Notify your prescriber immediately if a rash develops with or without itching, fever, blistering, sores in the mouth, pink eye (conjunctivitis),swelling, muscle/joint aches, yellowing of the skin or eyes, stomach pain, or tingling/numbness of the hands/feet. Nausea, headache, also may occur. Notify your prescriber if these problems persist.

SIDE EFFECTS:
     The most common side effect of this medication is peripheral
     neuropathy (nerve disorder). Symptoms of peripheral neuropathy are numbness, tingling, burning or pain of the hands or feet.

  Zalcitabine (Oral )
USES:
     This medication inhibits the replication of the human
     immunodeficiency virus (HIV) in patients with acquired
     immunodeficiency syndrome (AIDS) that have advanced HIV
     infection. This medication is not a cure and has not been shown to reduce the frequency of HIV related illness.

SIDE EFFECTS:
      Notify your doctor if you experience numbness, tingling, a burning or shooting pain of the extremities, severe stomach pain or heartburn, nausea, vomiting, sore throat, skin rash, pain in swallowing or fast or difficult breathing. This medication can affect the blood causing severe anemia and decreased blood cell counts requiring blood transfusion.

NOTES:
     Blood tests should be done routinely to monitor for anemia and to ensure it is working properly.

  Zidovudine (Oral )

USES:
     This medication inhibits the growth of the human immunodeficiency virus (HIV).

SIDE EFFECTS:
      Notify your doctor immediately if you experience fever, chills, sore throat, unusual tiredness, weakness,(anemia), lack of coordination, unusual bleeding or bruising, abdominal discomfort or difficulty breathing.

Drugs with multiple components

  Didanosine/Calcium Carbonate (alk)/Magnesium Salt(ant) (Oral )

USES:
     This medication inhibits the replication of the human immunodeficiency virus (HIV) in patients with acquired immunodeficiency syndrome (AIDS) that are over 6 months of age and have advanced HIV infection. Such patients are usually intolerantor not responding to zidovudine (AZT).This medication is not a cure and has not been shown to reduce the frequency of HIV related illness.

SIDE EFFECTS:
     This medication may cause headache, cough, rash, weakness, loss of appetite, chills, fever, sore tongue or mouth, change of taste, muscleor joint pain or insomnia as your body adjusts to the medication.
 

PRECAUTIONS:
     Be sure to tell your doctor if you have a history of pancreatic diseaseor tingling of the hands or feet (called peripheral neuropathy). Also mention if you have a history of kidney disease, liver disease, phenylketonuria or are on a sodium restricted diet. 

USES:
     This medication inhibits the replication of the human
     immunodeficiency virus (HIV) in patients with acquired
     immunodeficiency syndrome (AIDS) that are over 6 months of age and have advanced HIV infection. Such patients are usually intolerantor not responding to zidovudine (AZT).This medication is not a cure and has not been shown to reduce the frequency of HIV related illness.

SIDE EFFECTS:
     This medication may cause headache, cough,rash, weakness, loss of appetite, chills, fever, sore tongue or mouth, change of taste, muscle or joint pain or insomnia as your body adjusts to the medication. Inform your doctor if these symptoms persist or become worse.
     Notify your doctor immediately if you experience severe diarrhea, stomach pain, nausea, vomiting, tingling, numbness or pain in your hands or feet, yellowing of eyes or skin, unusual bleeding or bruising.

PRECAUTIONS:
     Be sure to tell your doctor if you have a history of pancreatic disease or tingling of the hands or feet (called peripheral neuropathy). Also mention if you have a history of kidney disease, liver disease or are on a sodium restricted diet. Breast feeding is not recommended. Check with your doctor if you think you are pregnant. Food decreases the absorption of this drug. Follow your doctor's instructions exactly regarding how to take it. Avoid alcohol because it may worsen pancreatitis.

USES:
This medication inhibits the replication of HIV in patients with AIDS that are over 6 months of age and have advanced HIV infection. Such patients are usually intolerant or not responding to zidovudine (AZT).This medication is not a cure and has not been shown to reduce the frequency of HIV related illness.

SIDE EFFECTS:
     This medication may cause headache, cough,rash, weakness, loss of appetite, chills, fever, sore tongue or mouth, change of taste, muscle or joint pain or insomnia as your body adjusts to the medication. Inform your doctor if these symptoms persist or become worse.
     Notify your doctor immediately if you experience severe diarrhea, stomach pain, nausea, vomiting, tingling, numbness or pain in your hands or feet, yellowing of eyes or skin, unusual bleeding or bruising.

PRECAUTIONS:
     Be sure to tell your doctor if you have a history of pancreatic disease or tingling of the hands or feet (called peripheral neuropathy). Also mention if you have a history of kidney disease, liver disease, phenylketonuria or are on a sodium restricted diet.

NOTES:
     Blood tests should be done routinely to monitor for anemia and to ensure it is working properly. This medication is very potent and
     should not be shared with others.

SIDE EFFECTS:
     Headache, nausea, diarrhea, dizziness, sleep problems may occur. If these persist or worsen, notify your doctor promptly. Report promptly any muscle pain, stomach pain or tingling and numbness.

Unlikely but report promptly any persistent sore throat, fever,
yellowing eyes or skin, fatigue, rapid breathing, confusion, any hair loss, unusual increase in amount of urine or seizures. Very unlikely but report promptly any unusual bleeding or bruising. Seek immediate medical attention if an allergic reaction occurs. Symptoms include skin rash, difficulty breathing, hives or itching.

  Antivirals, Hiv-Specific, Protease Inhibitors

Single component drugs

  Indinavir Sulfate (Oral )
USES:
     This medication belongs to a class of drugs called protease inhibitors and is used, in combination with other drugs, to treat Human Immunodeficiency Virus (HIV) infection.

SIDE EFFECTS:
     The most common side effects are nausea, abdominal pain,
headache, diarrhea, vomiting, weakness, insomnia, acid stomach and altered sense of taste. Less common side effects include constipation, gas, anxiety, cough, blurred vision and dizziness. Inform your doctor if these should persist or worsen. Inform your doctor immediately if you experience back or flank pain, blood in the urine, heart palpitations, chills, rash, fever, unusual fatigue or thirst or increased urination.

 NOTES:
     This medication does not cure HIV. Patients treated with indinavir may continue to acquire "opportunistic" infections associated with HIV. This medication also does not prevent transmission of HIV to others through sexual contact or blood.

      Nelfinavir Mesylate (Oral )
USES:
     This medication belongs to a class of drugs called protease inhibitors and is used, in combination with other drugs, to treat HIV infection.

SIDE EFFECTS:
     The majority of side effects are mild. Diarrhea, stomach pain, nausea, dizziness or gas might occur. If these continue or are bothersome, notify your doctor. Unlikely but report persistent sore throat, rash, yellowing of the eyes or skin, vision
problems, unusual fatigue or increased urination or thirst. Very unlikely but report immediately any allergic reaction while taking this medication. Symptoms includedifficulty breathing, itching, or fever.

NOTES:
     This medication does not cure HIV infection. Patients treated with nelfinavir may continue to acquire "opportunistic" infections
associated with HIV. This medication also does not prevent
transmission of HIV to others through sexual contact or blood. Do
not share this medication with others.

      Ritonavir (Oral )

USES:
     This medication belongs to a class of drugs called protease inhibitors and is used, either alone or in combination with other drugs, to treat Human Immunodeficiency Virus (HIV) infection.

SIDE EFFECTS:
     The most common side effects areweakness, loss of appetite,
nausea, vomiting, diarrhea, altered taste, stomach pain
and numbness or tingling of mouth, hands or feet. Less common side effects include blurred vision, dizziness, headache, loss of coordination, muscle or joint pain and drowsiness. Inform your doctor if these should persist or worsen. Inform your doctor immediately if you experience chills, a rash, rapid heart rate, increased urination, unusual thirst, unusual bleeding or bruising (blood in the urine or stool), severe stomach pain or shortness of breath.

NOTES:
     This medication does not cure HIV. Patients treated with ritonavir may continue to acquire "opportunistic" infections associated with HIV. This medication also does not prevent transmission of HIV to others through sexual contact or blood.

SIDE EFFECTS:
     Nausea, stomach upset, muscle or joint pain, cough or diarrhea may occur. If these symptoms continue or become severe, inform your doctor. Notify your doctor if you experience confusion,incoordination, severe weakness, depression, skin rash, unusual bleeding or bruising, stomach pain, hearing or vision difficulty, fever, chills, increased urination, thirst, unusual fatigue, persistent sore throat or yellowing of the eyes or skin.

USES:
     This is a protease inhibitor type of antiviral medication used in the treatment of human immunodeficiency virus (HIV) infection.

SIDE EFFECTS:
     Nausea, stomach upset, muscle or joint pain, cough or diarrhea may occur. If these symptoms continue or become severe, inform your doctor. Notify your doctor if you experience confusion,  incoordination,severe weakness, depression, skin rash, unusual bleeding or bruising, stomach pain, hearing or vision difficulty, fever, chills, increased urination, thirst, unusual fatigue, persistent sore throat
or yellowing of the eyes or skin.

PRECAUTIONS:
     Before taking this, tell your doctor if you have liver disease, diabetes, blood disorders or any allergies. This may make you more sensitive to the sun than usual. Avoid sun exposure. Use a sunscreen and wear protective clothing when outdoors.

Single component drugs

  Somatrem (Intramuscular (only; Repository; Etc.) )

USES:
     This medication is a growth hormone. It is used to stimulate growth in children who do not produce enough growth hormone of their own.

SIDE EFFECTS:
     Headache, fatigue or muscle pain may occur. If these symptoms continue or become bothersome, inform your doctor. Notify your doctor if you experience hip pain, knee pain or unusual weakness while taking this medication.

PRECAUTIONS:
     This medication is for use in children only. It should not be used in adults or during pregnancy. Tell your doctor if you have a history of tumors, other illnesses or any allergies especially to benzyl alcohol.

DRUG INTERACTIONS:
     Tell your doctor of any over-the-counter or prescription medication you may take.

NOTES:
     Laboratory tests will be done routinely while taking this medication to evaluate its effectiveness and prevent side effects. Keep all doctor's appointments and laboratory visits so your therapy can be monitored closely. It may be necessary to see your doctor several times a week.

SIDE EFFECTS:
     Headache, fatigue or muscle pain may occur. If these symptoms continue or become bothersome, inform your doctor. Notify your doctor if you experience hip pain, knee pain or unusual weakness while using this medication. Unlikely but report development of a  limp, joint pain, unusual increased urination or thirst. Very unlikely but report change in the appearance or size of any mole, severe stomach pain, vomiting or vision problems.

PRECAUTIONS:
     Tell your doctor if you have a history of tumors (cancer), any allergies, especially drug allergies, diabetes, thyroid problems or back problems (scoliosis). This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is unknown if this drug is excreted into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS:
     Tell your doctor of any over-the-counter or prescription medication you may take especially glucocorticoids (e.g., prednisone, hydrocortisone).

NOTES:
     Laboratory tests will be done routinely while using this medication to evaluate its effectiveness and prevent side effects. Keep all doctor's appointments and laboratory visits so your therapy can be monitored closely. It may be necessary to see your doctor several times a week.

  Hematinics,other

Single component drugs

  Epoetin Alfa (Injection (mult. Rt., Not Iv, Im, Or Id))
USES:
     This medication stimulates the body to make red blood cells It is
used in the treatment of anemia associated with chronic renal failure or anemia caused by AZT in HIV-infected persons.

SIDE EFFECTS:
     This medication is generally well tolerated. Headache, nausea,
muscle aches, diarrhea and cough may occur. Inform your doctor if these symptoms become bothersome. Notify your doctor if you develop any of the following while taking this medication: rapid heartbeat, shortness of breath, hives, itching, skin rash or irritation   at the injection site.

PRECAUTIONS:
     This drug should be used in pregnant or nursing women only if clearly needed. Discuss the risks and benefits of this therapy with your doctor. Tell your doctor if you have ever had blood clots, heart or blood vessel disease, high blood pressure, seizures or problems with your bones. This drug may not work if you have sickle cell anemia.

DRUG INTERACTIONS:
     Your doctor should know if you are using androgens (nandrolone), desmopressin or probenecid.

NOTES:
     It is important to follow recommended dietary guidelines while taking this medication. Eating foods rich in iron may be recommended. Such foods include raisins, figs, meat, eggs, vegetables, iron-fortified cereals.

     Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert(TM) at 1-800-854-1166. In Canada call 1-800-668-1507. 

Single component drugs

  Aldesleukin (Intravenous (only) )

USES:
     Aldesleukin is an anticancer medication used to treat kidney cancer in selected patients. It has also been used with success in the treatment of Kaposi's sarcoma, colorectal cancer and other
lymphomas.

SIDE EFFECTS:
     Fever, chills, itching or stomach upset may occur the first several days as your body adjusts to the medication. Other side effects include dry skin, muscle aches, diarrhea, mouth sores, dizziness, headache, weight gain, swelling of the hands or feet. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop chest pain, a rapid heartbeat, jaundice, depression, mental confusion, skin rash, weakness, fatigue, unusual bleeding or bruising or breathing trouble while taking this medication.
     This medication can cause blood disorders. Laboratory tests will be done to monitor for this and other possible side effects.

PRECAUTIONS:
     This medication should be used only if clearly needed during
pregnancy. Discuss the risks and benefits with your doctor. Since
small amounts of this medication are found in breast milk, consult
your doctor before breast-feeding. Tell your doctor if you have any
pre-existing kidney disease, heart disease, liver disease, lung disease, seizure disorder, infections, thyroid disorder or if you have any allergies.

DRUG INTERACTIONS:
     Tell your doctor of any over-the-counter or prescription medication you may take especially corticosteroids, indomethacin, medication for blood pressure, depression, anxiety or other anticancer medication.

NOTES:
     This medication is usually administered in a hospital setting where your condition can be monitored closely and laboratory tests will be done periodically to guide therapy.

     Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert(TM) at 1-800-854-1166.
     In Canada call 1-800-668-1507. 

  Somatostatic Agents

Single component drugs

  Octreotide (Injection (mult. Rt., Not Iv, Im, Or Id))
USES:
     This medication treats severe watery diarrhea associated with certain types of tumors. It is also used to reduce excessive amounts of growth hormone.

SIDE EFFECTS:
     Nausea, loose stools, vomiting, constipation, stomach upset, gas, bloating, dizziness, headache, lightheadedness, fatigue, flushing, dry mouth or drowsiness may occur. Pain and irritation have been reported at the injection site. If these symptoms continue or become bothersome, inform your doctor. Notify your doctor if you experience severe stomach pain, rectal spasm, tremor, palpitations, breathing trouble, chest pain, muscle cramps or numbness while taking this medication. Use caution operating machinery,diving or performing tasks requiring alertness if this drug makes you drowsy or dizzy.

PRECAUTIONS:
     Tell your doctor if you have kidney disease, diabetes, any other illnesses or any allergies.

DRUG INTERACTIONS:
     Tell your doctor of any over-the-counter or prescription medication you may take especially cyclosporine.

NOTES:
     Laboratory tests will be done routinely while using this medication to evaluate its effectiveness and prevent side effects.

     Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert(TM) at 1-800-854-1166.
     In Canada call 1-800-668-1507. 

SIDE EFFECTS:
     Nausea, loose stools, vomiting, constipation, stomach upset, gas, bloating, dizziness, headache, lightheadedness, fatigue, flushing, dry mouth or drowsiness may occur. Pain and irritation have been reported at the injection site. If these symptoms continue or become bothersome, inform your doctor. Notify your doctor if you experience severe stomach pain, rectal spasm, tremor, palpitations, breathing trouble, chest pain, muscle cramps or numbness while taking this medication. Use caution operating machinery, diving or performing tasks requiring alertness if this drug makes you drowsy or dizzy.

PRECAUTIONS:
     Tell your doctor if you have kidney disease, diabetes, any other
     illnesses or any allergies.

DRUG INTERACTIONS:
     Tell your doctor of any over-the-counter or prescription medication you may take especially cyclosporine.

NOTES:
     Laboratory tests will be done routinely while using this medication to evaluate its effectiveness and prevent side effects.

     Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert(TM) at 1-800-854-1166.
     In Canada call 1-800-668-1507. 

  Steroid Antineoplastics

Single component drugs

  Megestrol Acetate (Oral )
USES:
     Megestrol is one of a group of drugs also known as female
hormones. This drug is used to treat certain types of cancer of the breast and uterus usually in addition to surgery or radiation therapy. It is also used for certain other conditions of the male and female reproductive systems, and to stimulate appetite and weight gain.

SIDE EFFECTS:
     This medication can cause changes in appetite, thirst or weight,
diarrhea, constipation, frequent urination, swelling of ankles or feet,  increased rate or difficulty breathing or some loss of scalp hair. If these become severe or troublesome, inform your doctor. Notify your doctor if you experience changes in vaginal bleeding pattern or discharge, severe or sudden vision changes, headache, loss of coordination, slurred speech, shortness of breath, weakness or numbness in arms or legs, pain in stomach, side, chest, groin, arm or leg, especially in the calf, or skin rash or itching.

PRECAUTIONS:
     Before taking megestrol tell your doctor of all illnesses you may have including liver disease, depression, incomplete abortion, unusual vaginal bleeding, suspected pregnancy, blood clotting problems and of any allergies. Contraceptive (birth control) measures are recommended for use in men and women while taking this medication. Megestrol is not recommended for use during pregnancy. Consult your doctor before taking this drug. This drug is excreted into breast milk. As the effects on the infant are unknown, breast-feeding while taking this drug is not recommended.

NOTES:
     Regular doctor visits are important to see how well the medication is working and to check for any side effects including blood sugar.

     Your condition can cause complications in a medical emergency. For information on enrollment call Medic Alert(TM) at 1-800-854-1166. In Canada call 1-800-668-1507.

Disclaimer
(No representations are made that in any  way offer a diagnosis, treatment or cure for any illness or condition, either discussed or implied. Answers to questions are offered as information only and should always be used in conjunction with advice from your personal diving physician. Every effort has been made to present accurate and substantiated information.   This is not an endorsed treatment guideline. You may find some of the contents  contrary to your understanding. I take no responsibility for any conceivable consequence which might be related to any visit to this site.)
This page is written and maintained by
Ernest S Campbell, MD, FACS

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