ART. What are side effects? Side effects are the feelings of discomfort that occur when one starts taking ART drugs.

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ART Drug Side Effects What are side effects? Side effects are the feelings of discomfort that occur when one starts taking ART drugs. Side effects usually go away after your body gets used to ART. It might take your body some time to get used to ART. This period usually lasts about four to six weeks, but may last longer. Side effects usually go away after your body gets used to ART. There are simple things you can do to lessen many side effects. Some side effects may be a sign of more serious problems. It is important to tell your doctor about all side effects. 1

1 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Headache Rub the base of your head with your thumbs & your temples gently. Rest in a quiet, dark room with your eyes closed. Place cold cloths over your eyes and forehead. Your vision becomes blurry or unfocused. Aspirin or paracetamol does not stop the pain. Avoid things with caffeine such as coffee, strong tea, and some sodas. You have frequent or very painful headaches. Take 2 tablets paracetamol every 4 hours with food. 2

Side Effect Headache What to do Rub the base of your head with your thumbs & your temples gently. Rest in a quiet, dark room with your eyes closed. Place cold cloths over your eyes and forehead. Avoid things with caffeine such as coffee, strong tea, and some sodas. Take 2 tablets paracetamol every 4 hours with food. Visit your doctor for consultation. Go to the Clinic if: Your vision becomes blurred or unfocused. Aspirin or paracetamol does not stop the pain. You have frequent or very painful headaches. 3

2 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Dry Mouth Rinse your mouth with clean warm water and salt. You also have spots on your tongue or in your mouth. SALT Avoid sweets You have trouble swallowing food. Avoid things with caffeine such as coffee, strong tea and some sodas. 4

Side Effect Dry Mouth What to do Rinse your mouth with clean warm water and salt. Avoid sweets Avoid things with caffeine such as coffee, strong tea and some sodas. Visit your doctor for consultation Go to the Clinic if: You also have spots on your tongue or in your mouth. You have trouble swallowing food. 5

3 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Skin Rash Wash often with unscented soap and water If the side effects persist, visit your doctor for consultation Keep the skin clean and dry Use calamine lotion for itching Avoid the sun when you have a rash 6

Side Effect Skin Rash What to do Wash often with unscented soap and water Keep the skin clean and dry Use calamine lotion for itching Avoid the sun when you have a rash Visit your doctor for consultation Go to the Clinic if: If the side effects persist, visit your doctor for consultation 7

4 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Diarrhoea Eat small meals more times a day There is blood in the diarrhoea. Eat easy to chew foods bananas, rice You have diarrhoea more than 4 times a day. Drink lots of clean boiled water. Take Oral rehydration salts (ORS) You also have fever. Avoid spicy or fried foods. You are thirsty but cannot eat or drink properly 8

Side Effect Diarrhoea What to do Eat small meals more times a day, rather than fewer large meals Eat easy foods bananas, rice Drink lots of clean boiled water. Take Oral rehydration salts (ORS) Avoid spicy or fried foods. Go to the Clinic if: There is blood in the diarrhoea. You have diarrhoea more than 4 times a day. You also have fever. You are thirsty but cannot eat or drink properly 9

5 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Anaemia Eat fish, meat, chicken You have been tired for 3-4 weeks, and you are feeling more and more tired. Spinach, asparagus, dark leafy greens, and lima beans. If both of your feet are swelling Take iron tablets Signs that you have anemia include pale (white) palms and fingernails. 10

Signs that you have anemia include pale (white) palms and fingernails. Side Effect Anaemia What to do Eat fish, meat, chicken Spinach, asparagus, dark leafy greens, and lima beans. Take iron tablets Go to the Clinic if: You have been tired for 3-4 weeks, and you are feeling more and more tired. If both of your feet are swelling 11

6 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Feeling Dizzy If you feel dizzy, sit down until the feelings go away. If the side effects persist, visit your doctor for consultation Try not to lift anything heavy or move quickly. These sides effects may occur when taking efivarenz(efv). They usually goes away after a few weeks. Take EFV right before you go to sleep. 12

These sides effects may occur when taking efivarenz (EFV). They usually go away after a few weeks. Side Effect Feeling Dizzy What to do If you feel dizzy, sit down until the feelings go away. Try not to lift anything heavy or move quickly. Take EFV just before you go to sleep. Go to the Clinic if: If the side effects persist, visit your doctor for consultation 13

7 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Hair loss Protect hair from damage don t use dye, straightening, braiding, or cornrows. If the side effects persist, visit your doctor for consultation Don t buy products that promise to grow hair back. They don t work. 14

These sides effects may occur when taking efivarenz (EFV). They usually go away after a few weeks. Side Effect Hair Loss What to do Protect hair from damage don t use dye, straightening, braiding, or corn-rows. Don t buy products that promise to grow hair back. They don t work. Go to the Clinic if: If the side effects persist, visit your doctor for consultation 15

8 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Tingling or pain in hands or feet Wear loose-fitting shoes and socks The tingling does not go away or gets worse. Keep feet uncovered in bed. Walk a little but not too much. Soak feet in warm water/massage with cloth soaked in warm water The pain is preventing you from being able to walk. Try ibuprofen to reduce pain and swelling (you can take up to 400 mg every 8 hours with food. Do not take for more than two days without talking to the clinic.) 16

Side Effect Tingling or pain in hands or feet What to do Wear loose-fitting shoes and socks Keep feet uncovered in bed. Walk a little but not too much. Soak feet in warm water/massage with cloth soaked in warm water Try ibuprofen to reduce pain and swelling. (You can take up to 400 mg every 8 hours with food. Do not take for more than two days without talking to your doctor.) Go to the Clinic if: The tingling does not go away or gets worse. The pain is preventing you from being able to walk. 17

9 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Nausea and Vomiting Ask your doctor if you can take ART drugs with food You have sharp pains in stomach. Eat lots of small meals rather than big meals Take sips of clean, boiled water, weak tea, or Oral rehydration salts (ORS) until the vomiting stops. You also have fever. There is blood in the vomit. Vomiting lasts more than a day. Avoid spicy or fried foods. You are very thirsty but cannot eat or drink properly 18

Side Effect Nausea and Vomiting What to do Take ART drugs with food Eat lots of small meals rather than big meals. Take sips of clean, boiled water, weak tea, or Oral rehydration salts (ORS) until the vomiting stops. Avoid spicy or fried foods. Go to the Clinic if: You have sharp pains in stomach. You also have fever. There is blood in the vomit. Vomiting lasts more than a day. You are very thirsty but cannot eat or drink properly The Nausea and Vomiting does not go away or gets worse. 19

10 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Unusual or bad dreams Try to do something that makes you happy and calm right before you go to sleep. If you can t sleep for several nights. Avoid alcohol and street drugs as these will make things worse. These sides effects may occur when taking efivarenz. They usually goes away after a few weeks. Avoid food with a lot of fat. 20

These sides effects may occur when taking efivarenz (EFV). They usually go away after a few weeks. Side Effect Unusual or bad dreams What to do Try to do something that makes you happy and calm just before you go to sleep. Avoid alcohol and street drugs as these will make things worse. Avoid food with a lot of fat. Go to the Clinic if: If you can t sleep for several nights. 21

11 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Feeling Tired Get up and go to bed at the same time everyday You feel too tired to eat or move. Get a little exercise You cannot swallow or eat enough to keep strong Keep easy to make foods for when you are too tired to cook 22

Side Effect Feeling Tired What to do Get up and go to bed at the same time everyday Get a little exercise Keep easy to make foods for times when you are too tired to cook Go to the Clinic if: You feel too tired to eat or move. You cannot swallow or eat enough to keep you strong 23

12 ART Drug Side Effects Side Effect What to do Go to the Clinic if: Feelings of sadness or worry. Talk about your feelings with others. You have serious, sad or very worrying thoughts. You are thinking about killing yourself. These side effects may occur when taking efivarenz. They usually go away after a few weeks. You are very aggressive or very scared. 24

These side effects may occur when taking efivarenz (EFV). They usually go away after a few weeks. Side Effect Feelings of sadness or worry What to do Talk about your feelings with others. Go to the Clinic if: You have serious, sad or very worrying thoughts. You are thinking about killing yourself. You are very aggressive or very scared. 25

13 ART Drug Side Effects You are not alone! Remember, over a million people around the world take ART everyday, you too can take them successfully. 26

Notes 27

14 Notes ART Drug Side Effects 28

Development of this document was made possible by funding from Pfizer Health Literacy Grant. Printing was made possible through funding by United States Agency for International Development through Family Health International s IMPACT Project, Cooperative Agreement HRN-A0097-00017-00 Design and production by Sunburst Communications, info@sunburstnet.com 29

Antiretroviral Therapy: Managing the Side Effects This booklet is designed to help you detect and understand how to deal with side effects. 30