What is Sustiva (Efavirenz) prescribed for?

HIV is a virus that lives in human blood, sexual fluids, and breast milk. It weakens your immune system, so it gives your body a hard time to fight off any common germs, viruses, fungi, and any other invaders. It spreads mainly through unprotected sexual contact and sharing needles.

This medication is used along with other HIV medications to help control the HIV virus.  It can help to decrease the amount of HIV within your body so your immune system can function properly. And in turn, this can lower your chances of getting HIV complications such as new infections and cancer. And may overall improve the quality of life. Efavirenz belongs to a class of drugs known as non-nucleoside reverse transcriptase inhibitors (NNRTIs).

Read the Patient Information Leaflet if available from your pharmacist before you start taking efavirenz and each time you get a refill. If you have any questions regarding the information, consult your doctor.

Take this medication by mouth on an empty stomach, without food, usually once daily at bedtime or as directed by your doctor. Taking efavirenz with food increases the blood level of this medication, which may increase your risk of certain side effects.

Swallow this medication whole with water. If you have difficulty swallowing the capsule, it may be opened and the contents mixed gently in a small amount (1 to 2 teaspoons) of soft food such as applesauce, grape jelly, or yogurt. After taking the mixed medication, add 2 more teaspoons of food to the empty mixing container. Swallow the remaining mixture to make sure that you get the entire dose. Swallow within 30 minutes of mixing. Do not eat any food for 2 hours after taking this medication.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use including; prescription drugs, non prescription drugs, and any herbal products.

Before taking this medication, it is best to advise your doctor if you are allergic to Efavirenz; or to any other medications or allergies in general. This product may contain inactive ingredients, which can cause allergic reactions or other problems.

You should also let your doctor know of all of your medical history. Especially if you have ever dealt with any of these experiences in the past; mental/mood conditions (such as depression, thoughts of suicide, psychosis), liver problems (such as hepatitis B or C, cirrhosis), drug/substance/alcohol abuse, seizures, high cholesterol/triglyceride levels.

Efavirenz may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using efavirenz, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics "water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using efavirenz safely.

While minor, some of these side effects may occur. They are as follows; Dizziness, trouble sleeping, drowsiness, unusual dreams, and trouble concentrating may frequently occur. These side effects may begin 1-2 days after starting this medication and usually go away in 2-4 weeks. They are also reduced by taking efavirenz on an empty stomach at bedtime. Avoid alcohol and street drugs while taking efavirenz. They may worsen these side effects. However if any of these persist or worsen, it’s best to speak with your doctor right away.

Tiredness, headache, nausea, vomiting, and diarrhea may also occur.

As your immune system gets stronger, it can begin to fight off infections you already had, possibly causing disease symptoms to come back. You could also have symptoms if your immune system becomes overactive. This reaction may happen at any time (soon after starting HIV treatment or many months later). Get medical help right away if you have any serious symptoms, including: unexplained weight loss, severe tiredness, muscle aches/weakness that doesn't go away, headaches that are severe or don't go away, joint pain, numbness/tingling of the hands/feet/arms/legs, vision changes, signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, non-healing skin sores), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), signs of a certain nerve problem known as Guillain-Barre syndrome (such as trouble breathing/swallowing/moving your eyes, drooping face, paralysis, trouble speaking).

Tell your doctor right away if any of these rare but serious side effects occur: signs of liver problems (such as persistent nausea/vomiting, stomach/abdominal pain, severe tiredness, yellowing eyes/skin, dark urine), mental/mood changes (such as depression, rare thoughts of suicide, nervousness, angry behavior, hallucinations, confusion), loss of coordination.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

What happens if I suddenly stop taking this medication?

There may be a relapse in symptoms as well as side effects. You should speak your doctor before stop taking this medication.

 What is the best dosage to take?

The diagnosis with your doctor will be able to determine the best dosage for your treatment. Work with your doctor closely for dosage and dosing schedules.

 What happens if I miss a dose?

You should take the missed dose as soon you realize you have forgotten. If the forgotten dose is closer to your next scheduled dose, take the next schedule dose to avoid overlapping in dose.

 What is the best way to store this medication?

This medication is stored at room temperature, and should be kept away from children and pets. Do not throw away this medication in the wastebasket. If you are uncertain how to dispose of this medication speak with your pharmacist for help in safely disposing of this medication.