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Sustiva (Generic)

Sustiva (Efavirenz) is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It works by blocking the growth of HIV.

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Uses

Efavirenz (eh-FAV-er-enz) is used to treat HIV infection in combination with other medicines. If Efavirenz is taken alone to treat HIV, it may stop working.

How to take

Take Efavirenz by mouth on an empty stomach at least one hour before or two hours after eating. Taking Efavirenz with food, especially with a high-fat meal, may lead to increased blood levels of Efavirenz. This may increase your risk for side effects. Take this medicine with a full glass of water. Take Efavirenz at the same time(s) every day, preferably at bedtime unless otherwise directed by your doctor. Continue to use Efavirenz even if you feel well. Do not miss any doses.

Side effects

Check with your doctor if any of these most common side effects persist or become bothersome: Abnormal dreams, changes in body fat, diarrhea, dizziness, drowsiness, headache, trouble concentrating, trouble sleeping. Seek medical attention right away if any of these severe side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior, change in personality, behavior, mood, or emotions; dark urine or pale stools; delusions, hallucinations, memory loss, mouth sores, paranoia, rash with or without fever; severe depression, suicidal thoughts or behaviors; unusual fatigue, vision changes, yellowing of the skin or eyes. This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. Symptoms of overdose may include muscle twitching. If you suspect an overdose of Efavirenz, seek medical attention immediately.

Precaution

Do NOT use Efavirenz if you are allergic to any ingredient in Efavirenz. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: if you are pregnant, planning to become pregnant, breast-feeding, or of childbearing age; if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; if you have allergies to medicines, foods, or other substances; if you have liver or kidney problems. Efavirenz may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Efavirenz with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Efavirenz; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness. Do not take more of Efavirenz than prescribed by your doctor. Taking more medicine than prescribed may not provide additional benefits and may increase the risks of side effects. Efavirenz is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor. Efavirenz does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors. Efavirenz will not prevent you from getting sexually transmitted infections (STIs). Always use a condom during sexual intercourse. If your health changes, check with your doctor. Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Efavirenz. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor. Efavirenz may interfere with certain lab tests, including cannabinoids false-positive result. Be sure your doctor and lab personnel know you are taking Efavirenz. Hormonal birth control (eg, birth control pills) may not work as well while you are using Efavirenz. To prevent pregnancy, use an extra form of birth control (eg, condoms). Lab tests, including liver function, may be performed while you use Efavirenz. These tests may be used to monitor your condition or check for side effects. Talk to your doctor about whether you should have a pregnancy test before you begin taking Efavirenz. Efavirenz may cause harm to the fetus. Do not become pregnant while you are using it. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Efavirenz while you are pregnant. It is not known if Efavirenz is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Efavirenz to the baby.

Drug interactions

Tell your health care provider if you are taking any other medicines, especially any of the following: Astemizole bepridil, cisapride, pimozide, or terfenadine because serious heart problems (eg, irregular heartbeat) may occur; Midazolam or triazolam because serious side effects such as prolonged sedation or breathing problems may occur; Ergot medicines (eg, ergotamine, methylergonovine) because serious blood flow problems may occur; St. John's wort because it may decrease Efavirenz's effectiveness; Protease inhibitors (eg, amprenavir, ritonavir) or warfarin because their effectiveness may be decreased or the risk of their side effects may be increased by Efavirenz; Azole antifungals (eg itraconazole), calcium channel blockers (eg, diltiazem, nifedipine), carbamazepine, certain hormonal contraceptives (eg, birth control pills), HMG Co-A reductase inhibitors (eg, atorvastatin), macrolide antibiotics (eg, clarithromycin) methadone, phenobarbital, phenytoin, rifabutin, rifampin, sertraline, or voriconazole because their effectiveness may be decreased by Efavirenz. This may not be a complete list of all interactions that may occur. Ask your health care provider if Efavirenz may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Missed dose

If you miss a dose of Efavirenz, take it as soon as possible. If it is within two hours of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take two doses at once.

Storage

Store Efavirenz at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Efavirenz out of the reach of children and away from pets.