There are many possible interactions between recreational drugs (including alcohol) and your HIV medication.
A lot is not fully understood about the different possible interactions but we do know that they can often cause serious complications, and sometimes fatal overdoses, as one drug acts with another to increase its levels in your blood.
The risk of an interaction could be higher when someone has just started to take HIV medication. In these first weeks and months the body is getting used to processing them, so adding a recreational drug at this time could have added risks.
This is an introduction to the most common interactions known but it is by no means exhaustive. If you have any concerns you should talk to your HIV doctor who can talk through the risks with you.
- Protease inhibitors + acid, ecstasy, GHB, GBL, ketamine, crystal meth, speed, Viagra and other erection drugs. Taking these drugs at the same time as protease inhibitors (especially Ritonavir) can raise levels of the recreational drug to dangerous levels. The most serious problems are thought to happen with ecstasy and GHB.
- Efavirenz (Stocrin) + acid, ecstasy, GBH, GBL, ketamine. It is possible that taking these drugs at the same time as Efavirenz (Stocrin) may raise levels of the recreational drug in the body.
- Abacavir + acid. It is possible that taking acid at the same time as Abacavir (found in the tablets Combivir, Kivexa and Ziagen) may raise levels of acid in the body.
- Protease inhibitors + anabolic steroids. This combination may raise levels of steroids in the body, increasing the risk of side-effects. Steroids and protease inhibitors can both raise cholesterol levels.
- Cannabis + protease inhibitors. It is possible that taking cannabis at the same time as protease inhibitors may raise levels of cannabis in the body. On the other hand, when taken with Efavirenz (Stocrin) or Nevirapine cannabis levels may be lower.
- Protease inhibitors + Viagra and poppers. Taking Viagra and protease inhibitors can raise the levels of Viagra. It is recommended to have only a half dose of the erection drug. Taking poppers, Viagra and protease inhibitors together can mean a dangerous drop in blood pressure.
- Methadone + Abacavir. Taking Methadone and Abacavir can cause the Methadone to leave the body faster than it normally would. It can also slow down the absorption of Abacavir into your bloodstream.
- Methadone + Efavirenz (Stocrin)/Protease Inhibitors. In this case the HIV drugs might reduce the levels of Methadone in your body, resulting in the need for an increased dose.
- Alcohol + Abacavir/Protease Inhibitors. Alcohol use with either of these can raise their levels in the blood and chronic alcohol use can reduce the effectiveness of drug therapy.
- Nicotine, cocaine and crack. No known dangerous interactions with anti-HIV drugs.