Generic Name: efavirenz

Pronunciation: sus-TEE-vah

Abbreviation: EFV

Other Market Name: Stocrin

Drug Class: Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Pharmaceutical Company: Bristol-Myers Squibb

Approval Status: Approved

Generic Version Available: No

Experimental Code: N/A


Drug Recommendation

A component of alternative treatment regimens for antiretroviral-naive people living with HIV, as indicated by the U.S. Department of Health and Human Services (DHHS) Panel on Antiretroviral Guidelines for Adults and Adolescents. Visit https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/0 for the full DHHS guidelines.


General Info

Sustiva is an HIV medication. It is in a category of HIV medicines called non-nucleoside reverse transcriptase inhibitors. Sustiva was approved by the U.S. Food and Drug Administration for use by people living with HIV in 1998.

Sustiva is available as a single drug or in the fixed-dose combination drug, Atripla.

Sustiva must be used in combination with other HIV drugs.


Dosage

Adult Dose: One 600mg tablet once a day, or three 200mg capsules once a day

Pediatric Dose: Age 3 months to 18 years: dosing based on weight.

Dosing Info: Take on an empty stomach. Dose should be taken at bedtime to minimize dizziness, drowsiness and impaired concentration.


Side Effects

Many patients have dizziness, headache, trouble sleeping, drowsiness, trouble concentrating, and/or unusual dreams after starting treatment with Sustiva. These feeling may be less noticeable if you take Sustiva at bedtime on an empty stomach. They also tend to go away after you've taken the medicine for a few weeks. Tell your doctor promptly if any of these side effects continue or if they bother you.

A small number of patients have had severe depression, strange thoughts, or angry behavior while taking Sustiva. Some patients have had thoughts of suicide and a few patients have actually committed suicide. These problems tend to occur more often in patients with a history of mental illness. You should contact your doctor immediately if you think you are having these symptoms, so your doctor can decide whether you should continue to take Sustiva.

Rash is another common side effect of Sustiva. These rashes usually go away without any change in treatment. In a small number of patients, rash may be serious. If you develop rash, call your doctor as soon as possible.


Drug Interactions

The following medications should not be taken while you are being treated with Sustiva:
Antibiotics: Priftin (rifapentine)
Antifungals: Standard doses of Vfend (voriconazole)
Antihistamines: Hismanal (astemizole) or Seldane (terfenadine)
Antipsychotics: Orap (pimozide)
Acid reflux/heartburn medications: Propulsid (cisapride)
Heart medications: Vascor (bepridil)
Sedatives: Versed (midazolam) and Halcion (triazolam)
Antimigraine medications: Wigraine and Cafergot (ergot medications)
Antivirals: Hepsera (adefovir)

Sustiva should not be used at the same time as Vfend (a voriconazole), a medication used for certain fungal infections. Sustiva can significantly decrease the effectiveness of Vfend; Vfend can significantly increase the risk of Sustiva side effects.

Other medications that may be best avoided while being treated with Sustiva: Fortovase, Invirase (saquinavir), Biaxin (clarithromycin), Noxafil (posaconazole), and Sporanox (itraconazole), along with the hepatitis C medications Victrelis (boceprevir) and Olysio (simeprevir).

Dose modifications may be required for the following medications, if combined with Sustiva: calcium channel blockers such as Cardizem or Tiazac (diltiazem), Covera HS or Isoptin (verapamil) and others; Crixivan (indinavir), Selzentry (maraviroc); the immunosuppressant medicines cyclosporine (Gengraf, Neoral, Sandimmune, and others), Prograf (tacrolimus), or Rapamune (sirolimus); Methadone; Mycobutin (rifabutin); Rifampin; cholesterol-lowering medicines such as Lipitor (atorvastatin), Pravachol (pravastatin), and Zocor (simvastatin); or the anti-depressant medications bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban) or Zoloft (sertraline).

Other durg interactions are possible. Consult the Sustiva package insert for more details: http://packageinserts.bms.com/pi/pi_sustiva.pdf


Other Info

Before taking this medication, tell your doctor if you have kidney disease, liver disease (including hepatitis B), or a history of depression/suicidal thoughts. In addition, tell your doctor if you are pregnant or planning to become pregnant, if you are breastfeeding, and all your medical conditions, including all prescription and over-the-counter medications and supplements you are taking.


For More Info: http://packageinserts.bms.com/pi/pi_sustiva.pdf

Co-Pay Program Info: https://www.poz.com/basics/hiv-basics/drug-assistance-programs

Patient Assistance Program Info: https://www.poz.com/basics/hiv-basics/drug-assistance-programs

Last Revised: July 15, 2016