Sustiva

Generic Name: efavirenz (e FAV ir enz)

Brand Names: Sustiva

What is efavirenz?

Efavirenz is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Efavirenz is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Efavirenz is not a cure for HIV or AIDS.

Efavirenz may also be used for purposes not listed in this medication guide.

What is the most important information I should know about efavirenz?

Do not use efavirenz if you are pregnant. It could harm the unborn baby. Use two forms of birth control, including a barrier form (such as a condom or diaphragm with spermicide gel) while you are taking efavirenz, and for at least 12 weeks after your treatment ends. Tell your doctor if you become pregnant during treatment.

Efavirenz may cause serious psychiatric symptoms including confusion, severe depression, suicidal thoughts, aggression, extreme fear, hallucinations, or unusual behavior. Contact your doctor at once if you have any of these side effects, even if you have had them before.

Do not take efavirenz with cisapride (Propulsid), pimozide (Orap), midazolam (Versed), triazolam (Halcion), or ergot medicines such as dihydroergotamine (D.H.E. 45), ergonovine (Ergotrate), ergotamine (Ergomar, Cafergot, Wigraine), or methylergonovine (Methergine). These drugs can cause life-threatening side effects if you use them while you are taking efavirenz.

There are many other medicines that can interact with efavirenz, or make it less effective. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Taking this medication will not prevent you from passing HIV to other people. Talk with your doctor about safe methods of preventing HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

What should I discuss with my healthcare provider before taking efavirenz?

You should not use this medication if you are allergic to efavirenz, if you have moderate to severe liver problems, or if you are using any of the following drugs:

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  cisapride (Propulsid);

  
  


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  midazolam (Versed) or triazolam (Halcion);

  
  


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  pimozide (Orap); or

  
  


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  ergot medicine such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine).

  
  

Using any of these medicines while you are taking efavirenz can cause serious medical problems or death.

To make sure you can safely take efavirenz, tell your doctor if you have any of these other conditions:

• liver disease (including hepatitis B or C);


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  high cholesterol or triglycerides; or

  
  


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  if you have ever taken delavirdine (Rescriptor) or nevirapine (Viramune) and they were not effective in treating your condition.

  
  

FDA pregnancy category D. Do not use efavirenz if you are pregnant. It could harm the unborn baby. Use two forms of birth control, including a barrier form (such as a condom or diaphragm with spermicide gel) while you are taking efavirenz, and for at least 12 weeks after your treatment ends. Tell your doctor if you become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of efavirenz on the baby.

Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

How should I take efavirenz?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take efavirenz on an empty stomach at bedtime, unless your doctor tells you otherwise.

Efavirenz can cause side effects such as mood or behavior changes. These symptoms may improve the longer you take the medication. Taking efavirenz at bedtime may also lessen these effects. Contact your doctor if you have more serious symptoms such as severe depression or thoughts of hurting yourself.

Take efavirenz regularly to get the most benefit. Get your prescriptions refilled before you run out of medicine completely.

Do not take efavirenz as your only HIV medication. HIV/AIDS is usually treated with a combination of different drugs. Your disease may become resistant to efavirenz if you do not take it in combination with other HIV medicines your doctor has prescribed. Use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

To be sure efavirenz is helping your condition and not causing harmful effects, your blood and liver function may need to be tested often. Visit your doctor regularly.

This medication can cause you to have a false positive drug-screening test. If you provide a urine sample for drug-screening, tell the laboratory staff that you are taking efavirenz.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose can cause confusion, lack of balance or coordination, severe mood or behavior changes, or thoughts of suicide.

What should I avoid while taking efavirenz?

Efavirenz may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Drinking alcohol can increase certain side effects of efavirenz. Taking this medication will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Efavirenz side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Efavirenz may cause serious psychiatric symptoms including confusion, severe depression, suicidal thoughts, aggression, extreme fear, hallucinations, or unusual behavior. Contact your doctor at once if you have any of these side effects, even if you have had them before.

Call your doctor at once if you have a serious side effect such as:

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  fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

  
  


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  nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  
  


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  fever, chills, body aches, flu symptoms; or

  
  


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  any other signs of new infection.

  
  

Less serious side effects may include:

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  mild nausea, vomiting, or stomach pain, diarrhea or constipation;

  
  


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  cough;

  
  


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  blurred vision;

  
  


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  headache, tired feeling, dizziness, spinning sensation;

  
  


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  trouble concentrating, problems with balance or coordination;

  
  


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  muscle or joint pain;

  
  


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  sleep problems (insomnia), unusual dreams; or

  
  


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  changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect efavirenz?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by efavirenz. Tell your doctor if you regularly use any of these medicines.

There are many other medicines that can interact with efavirenz, or make it less effective. Before taking efavirenz, tell your doctor if you are using any of the following drugs:

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  bupropion (Aplenzin, Budeprion, Wellbutrin, Zyban);

  
  


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  cyclosporine (Gengraf, Neoral, Sandimmune);

  
  


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  itraconazole (Sporanox), posaconazole (Noxafil);

  
  


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  maraviroc (Selzentry);

  
  


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  sirolimus (Rapamune), tacrolimus (Prograf);

  
  


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  St. John's wort;

  
  


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  voriconazole (Vfend);

  
  


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  a blood thinner such as warfarin (Coumadin, Jantoven);

  
  


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  a cholesterol medication such as Lipitor or Zocor;

  
  


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  an antibiotic such as clarithromycin (Biaxin), rifabutin (Mycobutin), or rifampin (Rifadin, Rifater, Rifamate, Rimactane);

  
  


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  heart or blood pressure medications such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), or verapamil (Calan, Covera, Isoptin, Verelan);

  
  


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  other HIV medicines such as atazanavir (Reyataz), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase); or

  
  


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  seizure medications such as phenytoin (Dilantin) or carbamazepine (Tegretol).

  
  

This list is not complete and there are many other drugs that can interact with efavirenz. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

More Sustiva resources

• Sustiva Side Effects (in more detail)
• Sustiva Use in Pregnancy & Breastfeeding
• Drug Images
• Sustiva Drug Interactions
• Sustiva Support Group
• 2 Reviews for Sustiva - Add your own review/rating

• Sustiva Prescribing Information (FDA)


• Sustiva Monograph (AHFS DI)


• Sustiva Advanced Consumer (Micromedex) - Includes Dosage Information


• Sustiva Consumer Overview


• Sustiva MedFacts Consumer Leaflet (Wolters Kluwer)


• Efavirenz Professional Patient Advice (Wolters Kluwer)

Compare Sustiva with other medications

• HIV Infection
• Nonoccupational Exposure
• Occupational Exposure

Where can I get more information?

• Your pharmacist can provide more information about efavirenz.

See also: Sustiva side effects (in more detail)