Food requirements for anti-HIV medications

Mareike Günsche | www.aspect-us.com

Key points

  • Many anti-HIV medications do not have any food interactions or requirements.
  • Some medications need to be taken with food to be most effective.
  • Efavirenz should be taken on an empty stomach.

Many anti-HIV medications can be taken with or without food. However, some of them need to be taken with food to be the most effective. You might also be told to take your medication with food if you have certain side effects.

What works for you might not work for someone else. Let your doctor know if you have any preferences or concerns about food restrictions. This will help them work out a treatment that’s right for you.

Taking HIV medication with food

Some HIV medications need to be taken with food. This is because food helps them to be absorbed effectively or reduces side effects such as nausea. Some people worry this will affect the time they can eat meals, but you usually don’t need to eat a full meal with your medicine. A large snack, such as a bowl of cereal or a piece of toast, is often enough.

However, if you take rilpivirine (Edurant, also in Eviplera, Juluca, and Odefsey), you must take it with a main meal.

You might also be concerned about people seeing you take medications while you’re eating meals. However, you can usually take your tablets just before or after eating if they need to be taken with food.

You can always ask your HIV clinic team about how much food you need to eat with your medication, and when you need to eat it.

Some people want to break up their tablets so they can add them to their food. However, you shouldn’t chew, crush, or split your tablets unless your doctor or pharmacist tells you it’s safe to do so. Many HIV medications can’t be taken in this way.

Which anti-HIV medications should be taken with food?

When you are prescribed your medication you should be given written information about how to take it. This should include information about dietary (food) restrictions. Ask your doctor, pharmacist, or dietitian if you would like more information about your diet and anti-HIV medication.

Below is a list of food requirements for anti-HIV medications. The medications are in alphabetical order based on their ‘generic’ name. The generic name is based on the ingredients that are in the medication. Most medications also have a ‘brand’ name. This is the name given to the medication by the company that sells it. Brand names are listed in the second column.

The information here is about medication that you take by mouth. This includes pills you swallow, tablets you add to water (dispersible tablets), and liquid medications. If you take your medication as an injection there are no food restrictions. 

The information below is based on how the medications are licensed in Europe and the UK.

Image

Generic name

 

Brand name

Requirements

Notes

abacavir

Ziagen

Take with or without food

 

abacavir with lamuvidine

Kivexa

Take with or without food

 

atazanavir 

Reyataz

Take with food

This makes sure your medication is absorbed properly.

atazanavir with cobicistat

Evotaz

Take with food

This makes sure your medication is absorbed properly.

bictegravir, emtricitabine, and tenofovir alafenamide

Biktarvy

Take with or without food

 
 

cabotegravir (pills)

Vocabria

Take with or without food

When taken at the same time as rilpivirine pills, cabotegravir pills should be taken with a meal.

cobicistat

Tybost

Take with food

This makes sure your medication is absorbed properly.

darunavir

Prezista

Take with food

Take within 30 minutes of eating. This makes sure your medication is absorbed properly.

darunavir with cobicistat

Rezolsta

Take with food

Take within 30 minutes of eating. This makes sure your medication is absorbed properly.

darunavir, emtricitabine, and tenofovir alafenamide with cobicistat

Symtuza

Take with food

This makes sure your medication is absorbed properly.

dolutegravir

Tivicay

Take with or without food

If you have some resistance to integrase inhibitors, you will be asked to take it with food.

dolutegravir and rilpivirine

Juluca

Take with a main meal

This makes sure your medication is absorbed properly.

dolutegravir with lamivudine

Dovato

Take with or without food

 

dolutegravir, abacavir, and lamivudine

Triumeq

Take with or without food

 

doravirine

Pifeltro

Take with or without food

 

doravirine, lamivudine, and tenofovir disoproxil

Delstrigo

Take with or without food

 

efavirenz

Sustiva

Take on an empty stomach

See the section 'Can I take efavirenz with food?' below for more information

efavirenz, emtricitabine, and tenofovir disoproxil

Atripla

Take on an empty stomach

See the section 'Can I take efavirenz with food?' below for more information

elvitegravir, emtricitabine, and tenofovir alafenamide with cobicistat

Genvoya

Take with food

This makes sure your medication is absorbed properly.

elvitegravir, emtricitabine, and tenofovir disoproxil with cobicistat

Stribild

Take with food

This makes sure your medication is absorbed properly.

emtricitabine

Emtriva

Take with or without food

 

etravirine

Intelence

Take with or after a meal

This makes sure your medication is absorbed properly.

 

fostemsavir

Rukobia

Take with or without food

 

lamivudine and zidovudine 

Combivir

Take with or without food

Taking with food may reduce nausea.

lamivudine 

Epivir

Take with or without food

 
 

lenacapavir (pills)

Sunlenca

Take with or without food

 

lopinavir with ritonavir

Kaletra

Take with or without food 

If you’re taking the oral solution (liquid) it should be taken with food.

maraviroc

Celsentri

Take with or without food 

 

nevirapine

Viramune

Take with or without food

 

raltegravir

Isentress

Take with or without food

 

rilpivirine (pills)

Edurant

Take with a main meal

This makes sure your medication is absorbed properly.

rilpivirine, emtricitabine, and tenofovir disoproxil

Eviplera

Take with food

This makes sure your medication is absorbed properly.

rilpivirine, emtricitabine, and tenofovir alafenamide

Odefsey

Take with a main meal

This makes sure your medication is absorbed properly.

ritonavir

Norvir

Take with food

This can help to reduce nausea.

tenofovir alafenamide and emtricitabine

Descovy

Take with or without food

 

tenofovir disoproxil

Viread

Take with food

This makes sure your medication is absorbed properly.

tenofovir disoproxil and emtricitabine

Truvada

Take with food if possible

This makes sure your medication is absorbed properly.

zidovudine

Retrovir

Take with or without food

Taking with food may reduce nausea.

Can I take efavirenz with food?

It’s recommended that the anti-HIV drug efavirenz is taken on an empty stomach to reduce any side effects. This means waiting for two hours after you eat something before you take your medication. You should then wait at least one hour after taking your medication before you eat again. Many people find it helpful to take efavirenz just before they go to bed.

Some people do choose to take efavirenz with food. If you take it with food, you should avoid taking it at the same time as a high-fat meal. This is because a high-fat meal will mean the amount of medication in your system is too high and this could make side effects worse.

Efavirenz used to be sold under the brand name Sustiva. It’s also available in a combination pill with emtricitabine and tenofovir disoproxil which used to be sold under the brand name Atripla.

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Acknowledgements

Thanks to Silma Shah for her advice.