The group of heartburn medicines I am referring to is called Proton Pump Inhibitors (PPIs). This medication class includes drugs such as Propulsid, Aciphex, Nexium, Prevacid, Prilosec and Protonix. PPI’s treat acid reflux, GERD, and heartburn by blocking the mechanism that secretes acid into the stomach. Less acid means less reflux, heartburn and stomach erosion or ulceration. For those who suffer from those problems, these drugs are lifesavers.
However, for those people taking Reyataz for their HIV infection, PPIs can have harmful effects. Here’s how. While doing their job of decreasing acid secretions in the stomach, PPIs also decrease the blood levels of Reyataz. Decreased blood levels allow HIV to reproduce, causing increased HIV viral loads as well as mutations and resistance to Reyataz. Just like poor adherence gives HIV a chance to flourish and mutate, the same can be said about decreased Reyataz levels due to PPIs. And as we all know, HIV mutation and resistance makes choosing a treatment regimen more difficult and can limit the available medication choices when HIV becomes resistant to specific drugs and classes of drugs. If you are taking Reyataz you should not be taking the following PPIs:
- Propulsid
- Aciphex
- Nexium
- Prevacid
- Prilosec
- Protonix
This includes both prescription doses as well as those doses you can buy over the counter (e.g., Prilosec OTC).
What Can be Taken Instead of PPIs?
So what can be done for those people who need medication for their GERD or heartburn? There are alternatives.
- H2-receptor antagonists – like PPIs, these medications prevent stomach acid secretion but in a different manner. This class includes medications such as Zantac, Tagamet, and Pepcid. While they also decrease levels of Reyataz if taken together, studies have found that taking them twelve hours apart will not result in a significant decrease in Reyataz levels.
- Antacids – these over the counter medications (e.g., Maalox, Mylanta, Tums) must be taken at least two hours apart from Reyataz. The problem with antacids is that often they are not potent enough to relieve the symptoms of GERD or heartburn in people who previously needed PPI’s.
If you are getting ready to start a regimen containing Reyataz and are taking those PPIs mentioned above, either over the counter or prescription strength, talk to your doctor before starting your Reyataz. Never change your heartburn medication without first discussing your choices with your doctor. With his or her help, you should be able to find the medicine you need to control your heartburn or GERD and still get the full benefits from your Reyataz containing regimen.
