How do you get rid of the side effects of arvs?

October 9, 2025 •

5 min read

According to the National Institutes of Health, newer antiretroviral (ARV) regimens have significantly improved safety profiles compared to older drugs, with most side effects being mild and manageable. Learning how do you get rid of the side effects of arvs is essential for maintaining treatment adherence and a high quality of life while living with HIV.

Quick Summary

Managing antiretroviral side effects involves close communication with your healthcare team, making strategic dietary and lifestyle changes, and potentially switching medications. Relief for symptoms like nausea, diarrhea, and fatigue is often possible with targeted interventions, ensuring successful treatment.

Key Points

Consult your doctor before making changes: Never stop taking or alter your antiretroviral regimen without first speaking to a healthcare provider.
Manage common short-term side effects: Nausea, diarrhea, and fatigue often lessen over time and can be managed with specific dietary adjustments and self-care.
Address long-term issues proactively: Manage potential long-term side effects like lipodystrophy, metabolic changes, and bone density loss with lifestyle adjustments and specific treatments.
Use modern, better-tolerated drugs: Newer ARV regimens have significantly improved safety profiles and cause fewer side effects than older options.
Utilize supportive medications: Your doctor can prescribe additional medications, such as anti-nausea or anti-diarrhea drugs, to help manage specific side effects.
Communicate with your healthcare team: Keeping a record of your symptoms and openly discussing them with your provider is crucial for finding the most effective solution.

Understanding Antiretroviral Side Effects

Antiretroviral (ARV) therapy is a critical and effective treatment for managing HIV. While modern medications are generally well-tolerated, side effects can still occur, particularly when starting a new regimen. Most of these temporary side effects, such as nausea or headaches, subside within a few weeks as your body adjusts. However, some individuals may experience more persistent issues that require a different management approach. It is crucial to remember that your healthcare team has extensive experience addressing these challenges and is your best resource for personalized advice. Never stop taking your medication without consulting your doctor, as this can lead to drug resistance and treatment failure.

Short-Term Side Effects and Immediate Relief

Many common side effects that appear when starting a new ARV regimen are temporary and can be managed effectively with simple adjustments to your diet or routine. By addressing these symptoms proactively, you can make the initial treatment period more comfortable and increase your chances of successful adherence.

Nausea and Vomiting

Digestive upset is one of the most common complaints, but several strategies can help reduce the discomfort.

Eat smaller, more frequent meals: Instead of three large meals, try eating five or six smaller portions throughout the day to avoid overwhelming your stomach.
Choose bland foods: Opt for crackers, toast, rice, and bananas (the 'BRAT' diet).
Avoid certain foods: Greasy, spicy, or fatty foods can worsen nausea. Cold foods can also be easier to tolerate than hot, odorous ones.
Stay hydrated: Sip on clear fluids like water, ginger ale, or herbal tea throughout the day, especially if you vomit, to prevent dehydration.
Consider anti-emetics: If nausea persists, your doctor may prescribe anti-sickness medication.

Diarrhea

Diarrhea can be a significant side effect, but proper hydration and dietary adjustments can help.

Hydrate constantly: Drink plenty of water and electrolyte-rich fluids, like broth or sports drinks, to replace lost minerals.
Follow the BRAT diet: Bananas, rice, applesauce, and toast can help firm up stools.
Increase soluble fiber: Products containing psyllium (like Metamucil) can help absorb water and add bulk.
Avoid dietary triggers: Limit or eliminate foods that can worsen diarrhea, including spicy foods, acidic citrus, excess caffeine, and dairy products.
Ask about medication: Your doctor may recommend an anti-diarrheal medication like loperamide (Imodium).

Fatigue and Headaches

Feeling tired or experiencing headaches can be common as your body adjusts to medication.

Rest and relaxation: Schedule extra rest and avoid overexertion during the initial weeks of treatment. Practicing good sleep hygiene is also beneficial.
Stay hydrated and nourished: Drink plenty of fluids and maintain a healthy, balanced diet.
Use OTC pain relievers: For headaches, over-the-counter pain relievers like acetaminophen or ibuprofen may be effective, but consult your doctor first.

Rash and Skin Issues

Some ARVs can cause a rash, which can be a mild nuisance or, in rare cases, a sign of a serious reaction.

Gentle skin care: Use mild, fragrance-free soaps and moisturizers. Avoid long, hot baths and harsh chemicals.
Wear soft fabrics: Choose soft, breathable materials like cotton to prevent skin irritation.
Stay hydrated: Drinking plenty of fluids can help with dry skin.
Seek medical attention for severe symptoms: Contact your doctor immediately if a rash is severe, blistering, or accompanied by fever, as this could indicate a serious hypersensitivity reaction.

Long-Term Side Effects and Comprehensive Strategies

While newer ARVs have a much better safety profile, some long-term side effects can still occur. These often require a combination of medical and lifestyle management.

Managing Lipodystrophy

Lipodystrophy, or changes in body fat distribution, was a significant side effect of older ARVs. While less common now, it can involve fat loss in the face and limbs (lipoatrophy) or fat accumulation in the abdomen or neck.

Medication switch: Discuss with your doctor if switching to a newer ARV regimen is appropriate, as newer drugs are less likely to cause this issue.
Lifestyle changes: Regular aerobic and resistance exercises can help manage fat distribution. A healthy diet is also crucial.
Prescription treatments: The FDA-approved medication tesamorelin (Egrifta) can help reduce excess abdominal fat. Injections of fat or fillers can also treat facial fat loss.

Addressing Weight and Metabolic Changes

Some modern ARVs, including certain integrase inhibitors, have been associated with modest weight gain. This can increase the risk of heart disease and diabetes.

Healthy diet and exercise: Maintaining a balanced diet and exercising regularly can help manage weight and improve overall metabolic health.
Monitor cholesterol and blood sugar: Regular blood tests can track these levels. If they become elevated, medication like statins may be needed.

Protecting Bone Health

Bone problems, such as bone density loss (osteoporosis), are a potential long-term risk for people with HIV.

Supplements: Ensure adequate intake of calcium and vitamin D through diet or supplements.
Exercise: Weight-bearing exercises like walking or weightlifting help strengthen bones.
Stop smoking: Smoking can worsen bone loss.

How ARV Side Effects Have Evolved: A Comparison

To understand the progress in HIV treatment, comparing the side effect profiles of older and newer ARV regimens is insightful.


Feature	Older Regimens (e.g., Zidovudine, Efavirenz)	Newer Regimens (e.g., INSTIs, TAF)
Tolerability	Often poor, with frequent and severe side effects.	Generally very good, with fewer, milder side effects.
Fatigue/Anemia	Commonly caused by bone marrow suppression, particularly with zidovudine.	Less common, with improved bone marrow safety.
Lipodystrophy	Significant risk, especially with older drugs like stavudine and zidovudine.	Significantly reduced risk due to different drug mechanisms.
Renal Issues	Older drugs like tenofovir DF posed a higher risk of kidney problems.	Newer versions like tenofovir alafenamide (TAF) have a better renal safety profile.
CNS Effects	Efavirenz was known to cause dizziness, insomnia, and mood changes.	Generally less prominent, though some INSTIs can cause insomnia or anxiety.
Weight Gain	Not a primary concern for many older drugs.	Modest weight gain observed with some modern INSTIs and TAF.
Cardiovascular Risk	Some protease inhibitors increased the risk of heart disease long-term.	Lowered risk with modern regimens; risk more tied to weight gain.

Working with Your Healthcare Team

Effective communication with your healthcare provider is the cornerstone of managing ARV side effects. Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information will help your doctor determine the best course of action. Your provider may suggest adjusting the timing of your medication (e.g., taking a certain pill before bed to avoid daytime dizziness) or, if side effects are severe or persistent, switching to a different combination of drugs. There is a wide variety of effective and well-tolerated modern ARV options available today.

Conclusion: Prioritizing Your Health and Adherence

Navigating ARV side effects is a manageable part of HIV treatment, thanks to modern medicine and proactive strategies. While initial discomfort is common, many symptoms can be relieved through simple lifestyle and dietary adjustments. For more persistent or severe issues, your healthcare provider can offer targeted medical solutions, including supportive medications or switching your regimen. The most important step is maintaining open and honest communication with your medical team and never stopping treatment prematurely. By prioritizing your health and adhering to your prescribed therapy, you can successfully manage HIV with minimal disruption to your quality of life.

Visit NIH HIVinfo for more details on managing antiretroviral therapy side effects.

Frequently Asked Questions

For many people, the most common side effects of ARVs, such as nausea or headaches, are temporary and tend to go away within a few weeks as your body adjusts to the medication.

To combat nausea, try eating smaller, more frequent meals, and focus on bland foods like the 'BRAT' diet (bananas, rice, applesauce, toast). Avoid spicy, greasy, or fatty foods.

It is important to always check with your healthcare provider before taking any new medications, including over-the-counter products, to ensure they do not interact with your ARVs.

Lipodystrophy is a change in body fat distribution. Treatment can involve switching to a newer ARV regimen, making lifestyle changes, using specific medications like tesamorelin, or cosmetic procedures.

Yes, if side effects are severe or persistent, your doctor may recommend switching to a different ARV regimen. Modern medications offer many effective and better-tolerated alternatives.

Signs of a severe allergic reaction can include a rapidly spreading or blistering rash, fever, and swelling of the face, lips, or tongue. Seek immediate medical attention if you experience these symptoms.

Managing fatigue can involve getting plenty of rest, staying hydrated, eating a balanced diet, and engaging in light exercise, like walking, to boost your energy levels.