Antiretroviral drugs: what they do and how to use them

If you or someone you care about is starting antiretroviral therapy (ART), questions pop up fast: how do these drugs work, what side effects should you expect, and how strict do you need to be with doses? This page gives practical, no-nonsense answers you can use right away.

How antiretrovirals work

Antiretroviral drugs stop HIV from copying itself and damaging your immune system. They don’t cure HIV, but they keep viral levels low so you stay healthy and can’t pass the virus to others if your viral load stays undetectable. Common drug classes include:

- NRTIs (nucleoside reverse transcriptase inhibitors) — block an enzyme HIV needs to copy its RNA.
- NNRTIs (non-nucleoside reverse transcriptase inhibitors) — another way to block that same enzyme.
- PIs (protease inhibitors) — stop a later step in the virus life cycle.
- INSTIs (integrase strand transfer inhibitors) — prevent HIV from inserting its genes into your cells.
- Entry inhibitors — keep the virus from getting into cells.

Doctors usually prescribe a combination of drugs from different classes. That combo lowers the chance the virus will become resistant.

Practical tips for everyday use

Sticking to your schedule matters. Missing doses makes resistance more likely and reduces how well the treatment works. Try these simple habits:

- Pick a fixed day and time and tie pills to a daily habit (like brushing your teeth).
- Use a pillbox or an app that reminds you.
- If you miss one dose, check with your clinic or pharmacist — don’t guess.
- Carry a small note with your medication names and dosing in case of emergency or travel delays.

Watch for common side effects: nausea, fatigue, headaches, or sleep changes. Many side effects ease after the first few weeks. If something is severe—like jaundice, chest pain, breathing trouble, or fainting—seek care immediately.

Drug interactions matter. Antiretrovirals can change how other medicines work and vice versa. Tell every clinician and pharmacist about your ART. That includes OTC medicines, supplements, and herbal products like St. John’s wort, which can interfere with certain antiretrovirals.

Monitoring is part of care. Labs check viral load and CD4 counts, plus liver and kidney tests. Keep those appointments—labs tell your doctor if the regimen is working or needs changing.

Travel and storage: keep meds in original packaging if possible, follow temperature instructions, and carry a doctor’s note when flying. If you run out, contact your clinic or a trusted pharmacy before you miss doses.

Resistance can develop if the virus is exposed to low drug levels. If treatment stops working, your clinic may switch your regimen based on resistance tests.

Questions? Talk to your healthcare team. If you want straightforward articles and patient tips, our site covers treatments, side effects, and how to live well on medication. Stay informed, stay consistent, and treat your clinic team as partners—you don’t have to do this alone.