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What Causes Dizziness, Weakness And Lethargy Along With Nausea While On Triumeq?
Question: Lately I have been having problems with pounding heartbeat, dizziness, and weakness, lethargy.
I'm thinking might be breakthrough anxiety attacks, but I'm also worried that my new HIV medication is keeping me in a state of mild metabolic acidosis. I tend to get nauseous sometime after I take it, my body feels very cold, and weakness happens. I switched from Atripla to Triumeq in October. I have also reduced my lamictal from 175/200mgs to 150mgs.
I just had blood and urine work that showed nothing unusual outside elevated creatinine and prostate levels. Could acidosis be transitory? Might I be barking up the wrong tree?
I'm thinking might be breakthrough anxiety attacks, but I'm also worried that my new HIV medication is keeping me in a state of mild metabolic acidosis. I tend to get nauseous sometime after I take it, my body feels very cold, and weakness happens. I switched from Atripla to Triumeq in October. I have also reduced my lamictal from 175/200mgs to 150mgs.
I just had blood and urine work that showed nothing unusual outside elevated creatinine and prostate levels. Could acidosis be transitory? Might I be barking up the wrong tree?
Brief Answer:
most of them are common side effects
Detailed Answer:
Hello,
dizziness, weakness, lethargy, nausea are all side effects (and fairly common ones) of Triumeq. It's not unusual for a patient to feel this way. The metabolic acidosis scenario will have to be proved before attributing symptoms to it. The drug may indeed cause lactic acid elevation (and thus metabolic acidosis). Arterial blood gases and lactic acid measurement should suffice to confirm or exclude it.
Regarding creatinine, it may rise when using the drug. This elevation does not usually mean that the kidney function is impaired. It's a pathophysiologic side effect due to impaired creatinine excretion. The creatinine levels should stabilize 4 weeks after initiating it, so if they did then it's probably this side effect.
Since creatinine is an important indicator of renal functionality you'd better check that no metabolic disorders are present (like metabolic acidosis, potassium/phosphorus/calcium/sodium disorders, etc).
Regarding the pounding heart, perhaps this is due to anxiety. The drug is not supposed to directly cause any such symptom...
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
most of them are common side effects
Detailed Answer:
Hello,
dizziness, weakness, lethargy, nausea are all side effects (and fairly common ones) of Triumeq. It's not unusual for a patient to feel this way. The metabolic acidosis scenario will have to be proved before attributing symptoms to it. The drug may indeed cause lactic acid elevation (and thus metabolic acidosis). Arterial blood gases and lactic acid measurement should suffice to confirm or exclude it.
Regarding creatinine, it may rise when using the drug. This elevation does not usually mean that the kidney function is impaired. It's a pathophysiologic side effect due to impaired creatinine excretion. The creatinine levels should stabilize 4 weeks after initiating it, so if they did then it's probably this side effect.
Since creatinine is an important indicator of renal functionality you'd better check that no metabolic disorders are present (like metabolic acidosis, potassium/phosphorus/calcium/sodium disorders, etc).
Regarding the pounding heart, perhaps this is due to anxiety. The drug is not supposed to directly cause any such symptom...
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks doctor. I've been on Triumeq since mid-october, so that's more than 3 months.
Vitamin D was low, cortisol was high. No ketones apparent in blood. Not seeing a specific lactic acid test
Vitamin D was low, cortisol was high. No ketones apparent in blood. Not seeing a specific lactic acid test
Brief Answer:
arterial blood gases should give that information
Detailed Answer:
You're welcome!
Testing your arterial blood gases should provide that information (both for acidosis and for lactic acid elevation). One important clinical aspect of acidosis is the patient's effort to compensate with deep breaths. Patients with severe acidosis breath like if they've just ran 100 meters with full speed!
Kind Regards!
arterial blood gases should give that information
Detailed Answer:
You're welcome!
Testing your arterial blood gases should provide that information (both for acidosis and for lactic acid elevation). One important clinical aspect of acidosis is the patient's effort to compensate with deep breaths. Patients with severe acidosis breath like if they've just ran 100 meters with full speed!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Continuing on this thread, I notice since I've been on Triumeq (I also switched my Lamictal brand around the same time) I start getting pounding heartbeat after one drink. This is in addition (and usually worse than) the episodic heart pounding.
There is a lot of atrial fibrilation in my family.
If the heartbeat were anxiety related, I would think a drink would reduce, not exacerbate this? And I'm not talking about a lot of drinking either.
I also take 10-15mgs celexa and prilosec (20mgs?). Not sure if that is pertinent but I think it is below warnings about Q-interval problems.
There is a lot of atrial fibrilation in my family.
If the heartbeat were anxiety related, I would think a drink would reduce, not exacerbate this? And I'm not talking about a lot of drinking either.
I also take 10-15mgs celexa and prilosec (20mgs?). Not sure if that is pertinent but I think it is below warnings about Q-interval problems.
Brief Answer:
a Holter might help
Detailed Answer:
Hi,
triumeq is not supposed to cause increased rate of atrial fibrillation (AF). It may cause more myocardial infarctions.
The only certain way to find out what's wrong is to get an ECG right when you have the symptoms. Since this is not always feasible, the next best thing is to do a Holter, that is a 24 hour recording of your ECG. If AF ensues it will be recorded. Alcohol may cause AF but not with just a drink or two...
I don't know any important interaction between alcohol and triumec either...
Finally, prilosec and celexa may indeed interact but you're taking a very low dose of celexa which is not supposed to cause serious problems. Despite that, you can check whether a serious interaction has occurred by doing an ECG. Thus the QT-interval can be easily assessed.
Kind Regards!
a Holter might help
Detailed Answer:
Hi,
triumeq is not supposed to cause increased rate of atrial fibrillation (AF). It may cause more myocardial infarctions.
The only certain way to find out what's wrong is to get an ECG right when you have the symptoms. Since this is not always feasible, the next best thing is to do a Holter, that is a 24 hour recording of your ECG. If AF ensues it will be recorded. Alcohol may cause AF but not with just a drink or two...
I don't know any important interaction between alcohol and triumec either...
Finally, prilosec and celexa may indeed interact but you're taking a very low dose of celexa which is not supposed to cause serious problems. Despite that, you can check whether a serious interaction has occurred by doing an ECG. Thus the QT-interval can be easily assessed.
Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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