POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: bubble on February 12, 2008, 03:02:39 pm
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I have been on Kaletra for about a year and a half. For a long time i had no stomach problems. Now I am taking 4 imodium every day just to have a semi-normal floating bowel movement....
Is there anything I can take OUT of my diet or ADD to my diet to help with this? Someone here once said that they were taking 8 imodium ADs a day! I feel like it is just a matter of time until I am taking a box a day!
Any suggestions will be appreciated at this point. I also heard acupuncture helps?
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Hey bubble,
Sorry to hear about your situation. I find that the only thing that keeps the rumblings at bay is to take my pills on a full stomach, every time. For some reason taking them with milk also improves the problem, even though my doc said dairy products would most likely help contribute to diarrhea. Even after all of the trial and error, I still have to add one or two imodium a day to stay somewhat 'normal'.
Hopfully someone else will have some better advice for you, I thought I would share what seems to work for me.
Pip
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My experience with Kaletra was the same. On another thread, I believe that someone mentioned having taken prescription strength immodium or similar anti-diarrheal as a way to better control diarrhea. For some reason, that never occurred to me and none of my docs ever suggested it. I don't know whether that is a long term solution. I tried diet changes, with lots of fiber (shredded wheat with bran, etc) in the morning, in particular, and over the counter immodium when I was desperate. Generally, I was not successful in controlling things. In such a situation one becomes very strategic in bathroom location and clothes planning. Pretty stressful. The best solution for me was getting off of Kaletra. My doc prescribed Isentress and I haven't had one bout of diarrhea since (2 months). My viral load has remained undetectable and CD4 have improved a bit. I feel like I have gotten my life back.
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Ok thanks....
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I'm kinda right on the edge, where changing diet made a difference. If I eat the wrong things life becomes quite unpredictable, but when I'm careful things are controllable without drugs. Generally I've moved away from grains toward more fibrous fruit and nuts and that seems to help also Here's some samples
Lettuce No Spinach Yes
White bread No Whole wheat Maybe Walnuts Yes Almonds Very Yes
And as Philly pointed out in some other Kaletra thread -- pain pills and (ahem) other opiates seem to calm things down too (or maybe it just feels that way)
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as Philly pointed out in some other Kaletra thread -- pain pills and (ahem) other opiates seem to calm things down too (or maybe it just feels that way)
Yes, opiates are known constipaters. Trying to get a doc to prescribe them is another thing.
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Hi there,
Anyone on a Kaletra Combivir cocktail? I started using them last month. I have had occasional bouts of diarrhea (nothing that has given me cause for concern yet). What worries me is that I am developing skin rash and do not know if this may be due to the drugs or dwindling immunity.
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I have been on Kaletra for about a year and a half. For a long time i had no stomach problems. Now I am taking 4 imodium every day just to have a semi-normal floating bowel movement....
Is there anything I can take OUT of my diet or ADD to my diet to help with this? Someone here once said that they were taking 8 imodium ADs a day! I feel like it is just a matter of time until I am taking a box a day!
Any suggestions will be appreciated at this point. I also heard acupuncture helps?
Hey, Bubble, I cannot offer any useful suggestions but given my situation I noticed your subject line, KALETRA, and your signature - your "reluctance." My t cells had dropped to 70 and I still refused meds until I got very ill last year. Then after much hemming and hawing and questions, my doctor advised ATRIPLA. It's been almost a year. I went undetectable in 30 days and exceeded 200 cd4 after about 8 months.
Recently I've begun to have sleep problems [read: 2 hours], so will go back to taking the pill in the afternoon and be utterly useless for an hour+, but my doctor recommended switching to Kaletra or Rayatez along with Truvada, which brought me to your kaletra post. Diarrhea?? Immododiums by the box??
Is there no hope for us?
I hope you find and answer.
Lowell
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Yes, opiates are known constipaters. Trying to get a doc to prescribe them is another thing.
Tincture of opium WILL be given in hardship cases. I have a friend on it. ADAP pays for it as well.
But we're talking people with severe, and DIAGNOSED, GI issues. I'm sure I could have gotten it at many points in my life. When you're up to 20 mg of loperamide each day they tend to pity you. In fact now that I think about it, I've had it suggested to me voluntarily but I didn't go that route. I vomit from opiates usually anyway.
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My experience with Kaletra was the same. On another thread, I believe that someone mentioned having taken prescription strength immodium or similar anti-diarrheal as a way to better control diarrhea. For some reason, that never occurred to me and none of my docs ever suggested it. I don't know whether that is a long term solution.
Yes, I've taken loperamide (that is what prescription strength imodium is called) for a decade, at time 20 mg/day which is 10 capsules. Most people only have to take 2 capsules though I think. My body has always freaked out abnormally from all of the PIs. Obviously it made sense to have a prescription when you're having to take that amount of it. I think the highest it goes over the counter is 1mg tablets, and you can imagine the cost of what would then be 20 capsules/day every month.
My suggestion with any extreme diarrhea issues is to document the frequency for your doctor in the form of a daily diary. If you just sporadically complain they'll just brush it off, or many will... you know they're clueless sometimes with these side effects plus so many people overly whine that the people really in need then get the shaft.
It's not like anyone is getting high and/or reselling imodium on the street corner.
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I vomit from opiates usually anyway.
I smoked some opium once and immediately vomitted. Of course, it's unknown if it happened because the drug was so pure or otherwise.
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i remember this.. Good ol' Kaletra.. . the doc perscribed Lomotil which helped.. You still need to find the root cause.. Lomotil works like Immodium. but it's only a "band aid" solution.
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Lomotil never worked for me. Immodium seems a much better choice. (for me, anyway)
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I hate to repeatedly pimp it, but I highly recommend combining Pancrecarb with immodium/lopermide. The latter just stops you up, but the former addresses absorption issues and should allow you to slightly decrease the loperamide. I've found that I have to use both of them, but like I said my GI tract is more fucked up than most people. For me it's not just the HIV meds, but the underlying HIV infection in my gut. I've taken countless stool tests and they're always clean. Since combining the two my digestive issues have improved markedly.
And no, I did not invent this therapy, my HIV clinic put me on it around 2005. ADAP covers it, at least here.
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I'm not on that combo but I heard a high fiber diet helps. I know it helps me since I don't remember the last time I had the runs. This stuff is great. I've been using it for years. http://www.metamucil.com/drmetamucil/products/drfibersure.shtml
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Apologies if what I'm going to say is not exactly helpful, but here's my experience:
Kaletra (w/ Truvada) boosted my health (93 T-Cells to 300!) but made me absolutely miserable for 2 years. I ate Immodium like Skittles and, except for the occasional normal BM and occasional constipation from a mega-dose, I was was hitting the bathroom 4 or 5 times a day with horrible diarrhea. After one night when I was several blocks from home, and in the grip of an emergency that had unspeakable results, I was fed up.
I'm on Reyataz/Truvada/Norvir now and feel like a human being again, instead of a walking poop factory.
(I am somewhat concerned due to some yellowness in my eyes, but I'm pretty sure that's from a night of excesses and having a cold.)
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Hi Bubble,
I will admit that I'm very new to this so my experience is limited. I'm on Truvada and Kaletra, and my ID warned me of the possible diarrhea. I did start experiencing some pretty loose bowel movements.
However, I found that eating a bowl of instant oatmeal and a banana for breakfast before taking my meds has helped, A LOT. I'm almost back to normal. A side benefit to the oatmeal is that it should help lowering elevated cholesterol levels associated with Kaletra.
There's a whole assortment of flavors, banana bread being my personal favorite, to choose from.
Hope it helps.
Leo
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(I am somewhat concerned due to some yellowness in my eyes, but I'm pretty sure that's from a night of excesses and having a cold.)
It's an effect of the Reyetaz. Entirely harmless. I went yellow for a few days on Reyetaz. I looked like a 6'4" gay banana.
MtD
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Yes, opiates are known constipaters. Trying to get a doc to prescribe them is another thing.
Um. Are you guys serious or is this a joke? It's hard to tell in this forum. You guys sit carefully on the border of telling people to use drugs and not taking a stand at all. I took Oxycontin after a surgery I had back in January and I was begging to get off of it. I was paranoid and scared. I slept for 16 hours out of the day. Opiates shouldn't be used for anything but physical pain, and even then there are other alternatives. Any excuse to get drugs in our systems, I guess. ::) And you guys thought my ideas were crazy. :-\ you guys are here recommending using Opiates as a remedy for diarrhoea. Why not just tell him to shoot up?
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you guys are here recommending using Opiates as a remedy for diarrhoea. Why not just tell him to shoot up?
If you had a clue, which you don't Jamie, you'd know about tincture of opium. It's probably on your ADAP formulary for extreme diarrhea in connection with HIV infection and/or HAART complications.
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my name is not jamie, mi amor. Nor do I have ADAP. Not being an American Citizen I would not be eligible for it. :-) Good day. You my take my bait, but I'm not taking yours.
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yeah, yeah, yeah...and "no speaka da ingles".
we got it.
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why don't you take your tranny panties to another thread? It's okay for you to insult my race, but not okay for me to say something that I don't even know what it means?
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http://forums.poz.com/index.php?topic=13529.msg167864#msg167864
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why don't you take your tranny panties to another thread? It's okay for you to insult my race, but not okay for me to say something that I don't even know what it means?
i'm not unsulting any race...just not buying this BS story that you don't understand english - and understand it well.
meh. whatever. this mystery's solved, and it's getting boring now. about off to bed.
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why don't you take your tranny panties to another thread? It's okay for you to insult my race, but not okay for me to say something that I don't even know what it means?
If you're going to try to speak about something when you don't even know what it means, you should probably just keep silent.
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(I am somewhat concerned due to some yellowness in my eyes, but I'm pretty sure that's from a night of excesses and having a cold.)
It's an effect of the Reyetaz. Entirely harmless. I went yellow for a few days on Reyetaz. I looked like a 6'4" gay banana.
MtD
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Try a couple of cups of Kashi go Lean, high fiber,high protein version. (red/white box - and no I don't work for Kashi) I eat it for breakfast with milk and snack on it dry throughout the day. This along with half an imodium tablet keeps things reasonably well controlled with my Kaletra/Truvada regimen. Plus 13g protein per cup!! Also, I eat a very low fat diet. But be warned, they should have called it "Twigs and Bark" it's not exactly Captain Crunch. :)
Also, I noticed a post about Metamucil. Great stuff, but only take it two hours before or two hours after meds. The psyllium husks will absorb the meds and then out they go.
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Try a couple of cups of Kashi go Lean, high fiber,high protein version. (red/white box - and no I don't work for Kashi) I eat it for breakfast with milk and snack on it dry throughout the day. This along with half an imodium tablet keeps things reasonably well controlled with my Kaletra/Truvada regimen. Plus 13g protein per cup!! Also, I eat a very low fat diet. But be warned, they should have called it "Twigs and Bark" it's not exactly Captain Crunch. :)
Also, I noticed a post about Metamucil. Great stuff, but only take it two hours before or two hours after meds. The psyllium husks will absorb the meds and then out they go.
A doc on The Body addressed fiber supplements and meds and said it was ok. If only I could find the link.
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I so can tell you about med diaherrea, as I had this issue for just about all of 03 and 04. Over-the-counter drugs can't match Cholestyramine Powder that can be taken withour adverse problems with all hiv meds.
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It's enough to give you the shits. ::)
This is pretty cool resource - http://positivelife.org.au/files/17_Diarrhoea.pdf
A friend uses loperimide and finds that if he takes it half an hour before his other meds it works better.
Kaletra is probably the culprit, seems to be one of the PI's more associated with diarrhoea. I know someone who recently switched to a non PI combo - his diarrhoea resolved within hours. (And so did his quiet sex life).
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When I was having problems with diarrhea one of the things my doctor recommend was Calcium supplements (since I'm not a big fan of milk ... unless its chocolate).
AA
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I hate to repeat, but I will.
Believe it or not, it seems like the increase in fruits and veggies actually have a reverse affect on me. I live in constant diarrhea, however I notice firmer stools when I have gotten carried away with the fruits and veggies. You are just then left with the gas!
My Dr. also suggests Calcium or even eating Tums/Rolaids. To be honest (and a bit vulgar) I have been on Kaletra for 6 years, so 6 non stop years of diarrhea, I sort of enjoy the clean up....(being a hairy person, To much info....too late)
;)
Craig
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I hate to repeat, but I will.
Believe it or not, it seems like the increase in fruits and veggies actually have a reverse affect on me. I live in constant diarrhea, however I notice firmer stools when I have gotten carried away with the fruits and veggies. You are just then left with the gas!
My Dr. also suggests Calcium or even eating Tums/Rolaids. To be honest (and a bit vulgar) I have been on Kaletra for 6 years, so 6 non stop years of diarrhea, I sort of enjoy the clean up....(being a hairy person, To much info....too late)
;)
Craig
Craig, just keep on eating those veggies and fruits. Its safer ...
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Add in some yogurt or kefir to your diet or take acidophilus pills. It works like a charm. You can find the acidophilus refrigerated in your health store.
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Have tried yogurt and the yogurt drinks. Immodium and the generics, etc. etc. it's all a veritable stew.
I just get used to the "box of chocolates" pooping, although it is a pain always knowing there's a Saturday 3 PM one, LOL! And it's seldom pretty.
Just happy to be nearly undetectable after a year starting at VL of 1.82 Million and CD-4 of 186, the 'reverse seroconversion' items, staph, MRSA, etc.
Hopefully the next year will be better one and get better adjusted to the pooping. Oh, the whole wheat breads appear favorable.