Stepped dosing lessens efavirenz side-effects

Efavirenz is currently one of the preferred options for people starting treatment. Used in combination with other antiretrovirals [1]A medication or other substance which is active against retroviruses such as HIV., it is a highly efficient therapy, however, it is also common for people to experience ‘trippy’ side effects on the drug, particularly within the first few weeks.

About half those who start on efavirenz report feeling dizzy or depressed and many have trouble sleeping. Sometimes these effects are so bad they have to abandon the treatment altogether.

A small, randomised trial [2]A clinical trial in which participants are randomly (i.e., by chance) assigned to one of two or more treatment arms of a clinical trial. in Spain has found that introducing efavirenz gradually over a couple of weeks both lessens the chance of developing these side effects as well as their severity. The trial compared those who started on the full 600mg dose with people who stepped up to the dose by taking 200mg for the first week then 400mg for the second.

The trial may have been small but its outcomes are heartening and will hopefully help improve the ‘efavirenz experience’ for many in the future.