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©2013 UpToDate ® Print Email Common side effects shared by antiretrovirals and antituberculosis medications Antiretrovirals Antituberculosis medications Hepatitis Nevirapine Ritonavir-boosted protease inhibitors Isoniazid Rifampin* Pyrazinamide Gastrointestinal distress All antiretrovirals (less common with lamivudine and emtricitabine) Fluoroquinolones Ethionamide (associated with taste alteration) Para-amniosalicylic acid Nephrotoxicity Tenofovir (renal tubular disfunction) Idinavir-ritonavir Aminoglycosides (nephrotoxic TB agents carry particular risk of potentiating lactic acidosis common to the NRTIs used in antiretroviral rollout regimens) Neuropsychiatric disorders Efavirenz (insomnia, drowsiness, vivid dreams) Cycloserine (headaches, tremor, seizure) Terizidone (mainly headache and seizures) Peripheral neuropathy Stavudine Didanosine Cycloserine Streptomycin Amnioglycosides Isoniazid (overcome with pyridoxine administration) Stavudine, didanosine, tenofovir, lamivudine and emtricitabine are NRTIs. Nevirapine and efavirenz are NNRTIs. Idinavir and ritonovir are protease inhibitors. Common global rollout antiretroviral regimens: (stavudine or zidovidine) + (lamivudine or emtricitabine) + (nevirapine or efavirenz) or (tenofovir or abacavir) + (lamivudine or emtricitabine) + (nevirapine or efavirenz). MDR: multidrug resistant; NNRTIs: nonnuceloside reverse transcriptase inhibitors; NRTIs: nucleoside reverse transcriptase inhibitors; TB: tuberculosis; XDR: extensively drug-resistant. * Rifampin induction of cytochrome P450 reduces serum levels of NNRTIs and protease inhibitors but is not therapeutically relevant for MDR/XDR TB. Modified with permission from: Shenoi S, Heysell SK, Moll AP, Friedland G. Multi-drug Resistant and Extensively Drug-Resistant Tuberculosis: Consequences for the Global HIV Community. Curr Opin Infect Dis 2009; 22:11. Copyright © 2009 Lippincott Williams & Wilkins.