TABLE 418-2 -PRINCIPAL TOXICITIES OF ANTI-HIV DRUGS
| DRUG | SIDE EFFECTS |
| Nucleoside Reverse Transcriptase Inhibitors § | |
| Zidovudine | Anemia, neutropenia Malaise, fever, fatigue Headaches Myositis, myalgias Nausea, vomiting Insomnia Bluish nail pigmentation * |
| Didanosine | Sporadic pancreatitis Peripheral neuropathy Nausea, diarrhea Sporadic hepatitis Insomnia, irritability Retinal depigmentation (in children) Diabetes mellitus |
| Zalcitabine | Peripheral neuropathy Aphthous ulcers Esophageal ulceration Rash Sporadic pancreatitis |
| Stavudine | Peripheral neuropathy Elevated transaminases Anemia Arthralgias Sporadic pancreatitis |
| Lamivudine | Sporadic pancreatitis (more in children) Peripheral neuropathy Anemia, neutropenia |
| Abacavir | Hypersensitivity reaction (fever, rash, nausea, vomiting) |
| Non-Nucleoside Reverse Transcriptase Inhibitors | |
| Nevirapine | Rashes (can be severe) Elevated transaminase levels Hepatitis |
| Delavirdine | Rashes (can be severe) Headaches |
| Efavirenz | Rashes (can be severe) Elevated transaminase levels Central nervous system symptoms |
| Protease Inhibitors | |
| Indinavir | Nephrolithiasis Nausea Headache Malaise, dizziness Blurred vision Metallic taste Hyperbilirubinemia Elevated transaminases Hyperglycemia |
| Ritonavir | Nausea, vomiting Diarrhea Paresthesias Hepatitis Elevated transaminases Malaise, fatigue Elevated triglycerides Elevated uric acid Hyperglycemia |
| Saquinavir | Nausea, vomiting Diarrhea Headaches Elevated transaminases Hyperbilirubinemia Hyperglycemia |
| Nelfinavir | Diarrhea Nausea Elevated transaminases Hyperglycemia |
§ Lactic acidosis with hepatic steatosis is a rare but potentially life-threatening complication of all NRTIs.
*Example shown on Color Plate E.
The diarrhea is believed to be from the buffered vehicle, especially in the powdered formulation, rather than the didanosine itself.
There are reports of increased bleeding episodes in hemophiliacs who were receiving HIV protease inhibitors. Fat redistribution and elevated triglyceride levels are reported with all the HIV protease inhibitors, but it is not clear if this is a direct drug effect.