Pharm

Efavirenz

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Efavirenz, Sustiva, EFV

  • See Also
  1. Anti-Retroviral Therapy
  2. Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)
  • Class
  1. Anti-retroviral agent
  2. Non-Nucleoside Reverse Transcriptase Inhibitor
    1. First generation agent
  • Indications
  • HIV and AIDS
  1. Most commonly used NNRTI in 2011 and available in combination (Atripla)
  • Dosing
  1. Adult
    1. Efavirenz 600 mg qhs
  2. Child
    1. Weight 10-14 kg: 200 mg qhs
    2. Weight 15-19 kg: 250 mg qhs
    3. Weight 20-24 kg: 300 mg qhs
    4. Weight 25-32 kg: 350 mg qhs
    5. Weight 32-40 kg: 400 mg qhs
  • Adverse Effects
  1. General: CNS effects
    1. Onset 1-3 hours after dose
    2. Symptoms abate over 1-2 weeks
  2. CNS adverse effects (affects 50% at 1 month, 23% at 3 months, baseline at 6 months)
    1. Dizziness
    2. Headache
    3. Insomnia
    4. Difficulty concentrating
    5. Vivid dreams
    6. Nightmares
    7. Hallucinations
  • Pregnancy
  1. Potentially Teratogenic
  • Drug Interactions
  1. Take on empty Stomache at bedtime
  2. Induces CYP3A4 enzyme
  3. Decreases serum levels of some Protease Inhibitors
    1. Avoid concurrent use of Saquinavir
    2. Raise dose of Indinavir to 1000 mg PO q8h
  4. Decreases some Macrolide levels
    1. Decreases Clarithromycin level
    2. Azithromycin not effected
  • Labs
  1. Causes False Positive drug screen for Cannabinoids, Benzodiazepines
  • Reference
  1. (1998) Med Lett Drugs Ther 40(1041):115 [PubMed]
  2. (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]