PAGE 4
HIV NUTRITION UPDATE
VOLUME 7, ISSUE 3
FOOD - DRUG INTERACTIONS IN HIV/AIDS: PART TWO

 		 (Continued from page 3)

Drugs can cause changes in bowel function leading to constipation or diarrhea. Narcotic agents such as codeine and morphine (MS Contin, MSIR) cause a nonproductive increase in smooth muscle tone of the intestinal muscle wall, thereby decreasing peristalsis and causing constipation. Drugs with anticholinergic effects decrease intestinal secretions, slow peristalsis and cause constipation. The atypical antipsychotic clozapine (Clozaril), tricyclic antidepressant amitriptyline (Elavil) and antihistamine diphenhydramine (Benadryl) cause constipation and possibly impaction. Deaths have been reported as a result of severe impaction with clozapine use.
 

 

 
 
 
 

 
Destruction of intestinal bacteria leads to diarrhea (Table 5), possibly due to an overgrowth of C diff causing pseudomembranous colitis. Some drugs are used to inhibit intestinal enzymes, such as the diabetic drugs acarbose (Precose) or miglitol (Glyset), which are alpha-glucosidase inhibitors. 
 
 
TABLE 5. SELECTED DRUGS THAT CAN CAUSE DIARRHEA 
Antibiotics Amoxicillin (Amoxil) Amphotericin B (Abelcet, Ambisome, Amphotec, Fungizone)  Amphotericin B (Abelcet, Ambisome, Amphotec, Fungizone) 
Atovaquone (Mepron) Azithromycin (Zithromax) Cefdinir (Omnicef)
Cephalexin (Keflex) Cefuroxime (Ceftin Zinacef) Cefixime (Suprax)
Clindamycin (Cleocin) Clofazimine (Lamprene) Levofloxacin (Levaquin)
Linezolid (Zyvox) Meropenem (Merrem I.V.)  Metronidazole (Flagyl)
Penicillin Quinine Sulfate (Quinine)  Rifampin (Rifadin)
Pyrimethamine (Daraprim) Tetracycline Hcl (Achromycin-V, Sumycin) Ampicillin
Antivirals Amprenavir (Agenerase)  Didanosine (Videx) Lopinavir (Kaletra)
Nelfinavir (Viracept) Ritonavir (Norvir) Stavudine (Zerit) Foscarnet (Foscavir)
Antineoplastics Aldesleukin/Interleukin-2 (Proleukin) Capecitabine (Xeloda) Carboplatin (Paraplatin)
Fluorouracil (5-Fu) (Adrucil) Imatinib Mesylate (Gleevec) Irinotecan (Camptosar)
Mitoxantrone (Novantrone) Methotrexate (Methotrexate, Rheumatrex) Paclitaxel (Taxol)
Oral Hypoglycemics Acarbose (Precose) Metformin (Glucophage) Miglitol (Glyset)
Gastrointestinals Lactulose (Chronulac) Casanthranol & Docusate Sodium (Peri-Colace) Orlitstat (Xenical)
Misoprostol (Cytotec) Magnesium Magonate (Milk Of Magnesia)
Sorbitol Metoclopramide Hcl (Reglan)  Metoclopramide Hcl (Reglan) 
Antigout Colchicine (Colchicine)

 
 
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12/1/2002