My Online Wellness - Health Library

Reverse Transcriptase Inhibitors

The human immunodeficiency virus (HIV) contains genetic information in the form of RNA. When HIV infects a human T cell, it must convert this RNA to DNA. It does so by using an enzyme called reverse transcriptase. Reverse transcriptase inhibitors interfere with this process.

There are two major categories of reverse transcriptase inhibitors: nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) .

Reverse transcriptase inhibitors include:

  • Combivir (lamivudine and zidovudine)
  • Emtriva (emtricitabine)
  • Epivir (lamivudine)
  • Epzicom (abacavir and lamivudine)
  • Hivid (zalcitabine)
  • Rescriptor (delaviridine)
  • Retrovir (AZT, zidovudine)
  • Trizivir (abacavir-lamivudine-zidovudine)
  • Truvada (emtricitabine-tenofovir)
  • Videx (didanosine)
  • Viramune (nevirapine)
  • Viread (tenofovir)
  • Zerit (stavudine)
  • Ziagen (abacavir)

Possible Benefits and Risks

The reverse transcriptase inhibitors lamivudine and zidovudine can cause damage to the mitochondria, the energy-producing subunits of cells. This may lead to symptoms such as lactic acidosis (a dangerous metabolic derangement), peripheral neuropathy (injury to nerves in the extremities), and lipodystrophy (cosmetically undesirable rearrangement of fat in the body). The supplement CoQ 10 has been tried for minimizing these side effects. In one double-blind, placebo-controlled study, use of CoQ 10 improved general sense of well-being in people with HIV infection using reverse transcriptase inhibitors; however, for reasons that are unclear, it actually worsened symptoms of peripheral neuropathy.1 For this reason, people with HIV who have peripheral neuropathy symptoms should use CoQ 10 only with caution.

Dangerous Interaction

Use of the herb St. John’s wort can lower blood levels of numerous medications, including protease inhibitors used for HIV. Case reports indicate St. John’s wort also lowers blood levels of the non-nucleoside reverse transcriptase inhibitor nevirapine.2 The bottom line: If you have HIV, do not take St. John's wort! Furthermore, if you have been stabilized on HIV medications while taking St. John's wort, if you stop taking the herb your blood levels of the drugs could rise, potentially leading to increased side effects.

References[ + ]

1. Christensen ER, Stegger M, Jensen-Fangel S, et al. Mitochondrial DNA levels in fat and blood cells from patients with lipodystrophy or peripheral neuropathy and the effect of 90 days of high-dose coenzyme Q treatment: a randomized, double-blind, placebo-controlled pilot study. Clinical Infectious Diseases. 2004;39:1371–1379.

2. de Maat MM, Hoetelmans RM, Mathot RA, et al. Drug interaction between St. John’s wort and nevirapine [letter]. AIDS. 2001;15:420–421.

Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebscohost.com. Our Health Library Support team will respond to your email request within 2 business days.

Everyday Health

Diabetes Center

Like most people, you’re busy—trying to accomplish a lot in a small amount of time. But when you have diabetes, you have to keep track of your blood glucose levels, give yourself medication, eat right, and exercise. Visit our Diabetes Center to learn more about managing your Diabetes
...click here

Cold and Flu Center

Before you attempt to treat your condition, step back, consider your symptoms, and figure out if you have a cold, a flu, or both. ... click here