Sustiva® (Efavirenz, Stocrin)
Who should take this?
Sustiva can be taken by both adults and children who are three months old or older. It may cause problems for people with liver disease, a history of mental illness or depression or who have high cholesterol or triglycerides. People who have these issues may need to be monitored more often while taking Sustiva. In some cases, a doctor may need to adjust the dosage prescribed.
Women who are or who plan to become pregnant should discuss this with their doctors before taking Sustiva. It is not known yet how Sustiva will affect an unborn baby.
In some cases, Sustiva is taken by people who have been exposed to HIV in the work place. An example is a healthcare provider who accidentally gets stuck by a needle and is exposed to HIV-infected blood.
How is it taken? / Dosage
Sustiva comes in capsules or tablets and is taken by mouth. It can be taken with or without food. It should not be taken with a meal that has a lot of fat. Taking Sustiva before bed may reduce some of the side effects.
People who like to eat grapefruit or drink grapefruit juice should discuss this with their doctors. Grapefruit can sometimes affect how drugs are absorbed by the body.
It is important not to miss a dose. If this happens, take the missed dose right away. If it is close to the time to take the next dose, skip the missed dose and continue with the regular schedule. Taking Sustiva exactly as the doctor directs is important in preventing HIV from becoming resistant to the drug.
Side Effects
While Sustiva has many benefits, it also can cause side effects. Some side effects can be serious. If any of the following occur in a person taking Sustiva, a doctor should be contacted:
- Abnormal thinking
- Aggressive behavior
- Confusion
- Depression
- Hallucinations
- Manic reactions
- Memory loss
- Paranoid thinking
- Thoughts of suicide
Some side effects may get better or go away in time. If they linger or are bothersome, individuals taking Sustiva should talk to a doctor. These include:
- Changes in certain blood tests
- Changes in body fat. Fat may build up on the breasts and upper back and go away from arms and legs. This is called lipodystrophy.
- Diarrhea
- Difficulty concentrating
- Dizziness
- Headache
- Nausea
- Sleep problems or abnormal dreams
Sustiva may make a person taking it drowsy or dizzy. It is wise to avoid driving or operating machinery until its effects on an individual are known. Drinking alcohol while taking Sustiva may increase some side effects.
Some people may be allergic to Sustiva. Anyone taking Sustiva who experiences difficulty breathing, swelling of the face, lips, tongue or throat needs emergency medical help right away. A doctor should be contacted if a rash occurs after taking Sustiva.
People who take Sustiva should let their doctor or dentist know that before they have surgery, including dental surgery.
Drug Interactions
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Resistance
HIV can adapt and change (mutate). When this happens drugs that once were effective against HIV no longer are. The virus has found a way to grow even when the drug is taken properly. A sign of resistance is an HIV viral load that doesn’t drop.
Drug resistance is a particular worry with nonnucleoside reverse transcriptase inhibitors (NNRTIs). A single change (mutation) in the reverse transcriptase gene can produce a virus that rests all NNRTIs.
The best way to prevent possible drug resistance is to take all medications exactly as prescribed by the doctor. This makes them most effective against HIV infection.
