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Efavirenz

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Efavirenz is the preferred NNRTI recommended for first-line therapy in Australia.

While highly effective at controlling HIV, efavirenz is probably best known for it's psychotropic side-effect profile. When starting on efavirenz, people often feel strange or ill and experience vivid dreams. This is why it is not recommended for anyone with an existing psychiatic condition.

Generic name: efavirenz (EFV)
Pronunciation:uh-FAV-ur-inz
Brand name:Stocrin
Also known as:Sustiva
DMP-266
Drug class:non-nucleoside
Pregnancy safe?Not suitable for use in pregnancy. If you are pregnant or may become pregnant, you should not take this treatment.
Availability in Australia:
  • Available on the Pharmaceutical Benefits Scheme (PBS) through S100 prescribers.
  • This drug may be available through clinical trials in Australia.
  • You may be able to import this drug from overseas for your personal use.
Presentation:600mg tablet; 200mg capsule; oral suspension 30mg per ml
What the treatment guidelines say:Australian treatment guidelines list efavirenz as the preferred treatment option for people who have not taken treatment before, except for women in the first trimester of pregnancy, women who may become pregnant or some people with pre-existing mental illness. Efavirenz-containing treatment regimens are also an option for people who have taken treatment before and who need to change treatments, provided that they have not experienced treatment failure while taking efavirenz, nevirapine or delavirdine.
Links:

Like most anti-HIV drugs, efavirenz must be taken in combination with other drugs to be completely effective. Commonly, efavirenz is combined with two nucleoside (NRTI) drugs, although other combinations are sometimes used. Your doctor will advise you on the right combination of drugs to suit your circumstances.

Dosage

The normal adult dose is one 600mg tablet per day, usually at bedtime. Different doses are available for children.

Regardless of what you read on this website or elsewhere, you should always take your medications according to your doctor's instructions. If you're unsure, speak to your doctor or pharmacist.

With or without food?

Efavirenz may be taken with or without food, but side effects may be increased if taken with or immediately after a meal.

Side effects

All drugs can produce side effects in some people. These may be mild, moderate or severe, so you should be aware of potential side effects before starting any drug, and speak to your doctor if you experience side effects that concern you.

  • Common side effects may include dizziness, drowsiness or insomnia, vivid dreams, confusion, abnormal thinking, impaired concentration.
  • Less common side effects may include aggravation of underlying psychiatric illness, depression, mania, rash.
  • Rare side effects may include headache, lipodystrophy, fever, dry mouth, alcohol intolerance, aches, pains and fatigue, fluid retention.
  • It's unlikely you will experience all of these side effects, and you may not experience any side effects at all. Before starting any new drug, ask your doctor about side effects you might experience and discuss strategies for dealing with side effects if they do occur. If you experience any significant side effect you should continue taking your medicine and see your doctor as soon as possible.

Interactions with other drugs

Efavirenz can interact with other drugs or supplements that you are taking. These interactions can change the amount of each drug in your bloodstream and cause an under- or overdose. New interactions are being identified all the time. Drugs to watch out for include other ARVs, drugs to treat tuberculosis , for erectile dysfunction (such as Viagra), for heart rhythm (antiarrhythmics), or angina and for migraine headaches. Interactions are also possible with several antihistamines (allergy medications), sedatives, drugs to lower cholesterol or blood pressure, and anti-fungal drugs. Efavirenz decreases blood levels of methadone. Efavirenz can lower concentrations of buprenorphine. The herb St. John's Wort lowers the blood levels of some nonnucleoside reverse transcriptase inhibitors. Do not take it with efavirenz. The herbal remedy Ginkgo biloba should not be taken with efavirenz. http://www.aidsmap.org/en/news/A6F3B12F-7937-4F9B-BC73-11DA35FB7574.asp
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Consumer Medical Information for efavirenz (Stocrin)54.13 KBmkcstocr10508.pdfPDF
Managing Side Effects: Efavirenz (Positive Life NSW fact sheet)582.65 KB1_Efavirenz.pdfPDF

Rilpivirine as good as efavirenz

Positive Living article • David Menadue • 24 November 2011

Dr Mark Bloch from Holdsworth House in Sydney presented the 48-week results of the combined ECHO and THRIVE studies which determined that the new NNRTI rilpivirine (RPV) is as effective as efavirenz (EFV) for first-line treatment.

Everyone in the studies received a nucleoside backbone to their treatment – in ECHO it was Truvada, in THRIVE it was tenfovir/3TC or abacavir/3TC. read more »

The ongoing effects of efavirenz

Positive Living article • Adrian Ogier • 1 September 2011

Neuropsychiatric side effects are a common problem for people on efavirenz (EFV), but a study reported last year reveals just how common they are, and how long they last.

The SENSE trial was designed to evaluate whether 12 weeks of treatment with once-daily etravirine (ETR) plus 2NRTIs would lead to fewer neuropsychiatric adverse events than treatment with efavirenz plus 2NRTIs. read more »

Drugs linked to heart risks, minimal

Positive Living article • Adrian Ogier • 26 May 2011

A Canadian study has associated abacavir, efavirenz, lopinavir and ritonavir with an increased risk of heart attackA life-threatening emergency in which the blood supply to the heart is suddenly cut off, causing the heart muscle (myocardium) to die from lack of oxygen.. The research also showed that patients with HIV had twice the risk of heart attack compared to matched HIV
negative controls. read more »

Efavirenz dose reduction possible

Positive Living article • www.aidsmap.org • 26 November 2009
symptoms, illnesses and opportunistic infections

People who experience ongoing central nervous system (CNS) side effects from the treatment efavirenz will be pleased to know that they may soon be able to take a lower dose of the drug. read more »

Stepped dosing lessens efavirenz side-effects

Positive Living article • 20 August 2009

Efavirenz is currently one of the preferred options for people starting treatment. Used in combination with other antiretroviralsA 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. read more »

Lower dosing trial funded

Positive Living article • Adrian Ogier • 5 June 2009

The Bill and Melinda Gates Foundation has granted AUD $12.4 million to the University of NSW to study whether lower doses of some commonly used antiretroviralA medication or other substance which is active against retroviruses such as HIV. drugs are as effective as currently prescribed doses. read more »

CROI 2007: A great leap forward

Positive Living article • Paul Kidd • 22 March 2007

A major scientific conference on HIV has wound up with promising news on treatments which could signal a significant improvement in HIV treatment for the first time in some years. read more »

Non-nukes

Positive Living article • Paul Kidd • 10 July 2006

Non-nucleosides are a powerful option for treating HIV, but cross-resistanceHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistantHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant.. can mean you only get one bite of the cherry. This is the final instalment in a three-part series looking at key drug classesA group of anti-HIV drugs with the same target of action. Anti-HIV drug classes include nucleoside analogue reverse transcriptase inhibitors, protease inhibitorsA type of anti-HIV drug that works by preventing the production of an enzyme, protease, that HIV needs to replicate. and non-nucleoside analogue reverse transcriptase inhibitors, as well as several others. Combining drugs from three or more classes is the basis of Highly Active AntiretroviralA medication or other substance which is active against retroviruses such as HIV. Therapy (HAARTHighly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together.).read more »

You can get there from here

Positive Living article • Sam Pesci • 24 March 2005

Getting started on treatments is never easy. And sometimes, as SAM PESCI found, it takes a concerted effort to fit treatments into your life. read more »

The power of one

Positive Living article • Paul Kidd • 15 December 2003

We all want simpler treatment regimens with fewer side effects and no meal restrictions, right? Well how does once-a-day treatment sound? As PAUL KIDD reports, it may be closer than you think. read more »

The table below shows all the clinical trials in the database with the keyword efavirenz.

Short titleStatus
Lersivirine long term safety study Not yet started
UK-453, 061 Concluded
ENCORE-1 Enrolling
ALTAIR (Truvada for treatment-naive) Reported
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This Treatments database entry was first published on 27 March 2009 — more than two years ago.

While the content of this treatments database entry was checked for accuracy at the time of publication, NAPWA recommends checking to determine whether the information is the most up-to-date available, especially when making decisions which may affect your health.

This article may contain medical information. NAPWA makes every reasonable effort to ensure the information on this website is accurate, reliable and up-to-date, including obtaining technical reviews by medically-qualified reviewers, however the authors of information on this website are not qualified to give medical advice, except where explicitly stated.

The content of this website is intended to support, not replace, the relationship between people living with HIV/AIDS and their medical advisers, and is not intended as a substitute for medical advice.

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