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Questions  And Answers on Taking Antiretrovirals

  Why do certain drugs have to be taken with food and others taken on an empty stomach?

There are two main reasons these instructions are given:

a)  To make sure you absorb the proper amount of medication.

Drugs are large chemical structures that can be   sensitive to the conditions in the stomach. For example, indinavir is better absorbed on an empty stomach. High protein and  fat-containing foods can significantly lower the amount of indinavir that gets into the body. Therefore indinavirshould always be taken on an empty stomach or with a light, low-fat snack. 

In contrast, saquinaviris best absorbed if it is taken within 2 hours of a meal or a substantial (preferably high fat) snack. Drinking grapefruit juice can also increase the amount of saquinavir that is absorbed into your body.

Didanosine (ddI) is another drug that needs special   conditions in the stomach to be absorbed properly. It is destroyed by stomach acid, and therefore the didanosine tablets contain an antacid buffer. Didanosines hould always be taken on an empty stomach, since the presence of food might interfere with the action of the buffers. 

Always try to follow these instructions to make sure you absorb your medications properly.

b)  To reduce side effects involving the stomach.

Sometimes food can protect the stomach from    getting irritated. Therefore, some drugs such as ritonavir or zidovudine (AZT) may be taken with food to lower the risk of  stomach upset or nausea. However, if you  are notexperiencing any stomach side effects with these drugs, you can also take them without food if it will make your daily routine easier to follow. Ask your pharmacist if you are not sure about the food requirements for your medications.

Here are some ideas to help you meet the food requirements for your antiretroviral therapy. If your medication should be taken on or with: 

An empty  

Take your medication either 1 hour before meals, OR 2 hours after meals. 

Lots of  

Fill a one litre bottle with water  each morning and sip from it all day. 



If you have trouble eating full meals, try a snack or some fresh fruit and vegetables. You can also ask a dietician in case you want to try a can of Ensure, Advera or other meal supplements.

Low-fat snacks 

Some suggestions include: plain toast with jam, an apple and a glass of skim milk, cereal and skim milk, low fat pretzels, crackers, or plain popcorn.  

Fatty foods 

Try the following: crackers with cheese, egg on toast, bagel and cream cheese, potato chips, baked potato with sour cream, a donut, a chocolate bar, a hamburger, pizza, French fries, peanut butter, ice cream. 


Drink a cola (diet or non-diet) carbonated beverage, or a glass of orange, cranberry or apple juice.


Have half a grapefruit, or a glass of grapefruit juice (can be fresh or made from frozen  


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