Sustiva (generic name efavirenz) is an HIV medicine most people take once a day. The exact dose and timing matter — small changes can affect side effects and how well the drug works. Read this to get practical, easy-to-use information about dosing, common problems, what to watch for, and when to call your provider.
For adults the standard dose of Sustiva is 600 mg once daily. Most doctors tell patients to take it at bedtime on an empty stomach. Why bedtime and empty stomach? Food (especially high-fat meals) increases efavirenz absorption and can make side effects like dizziness and vivid dreams worse. Taking it at night helps many people sleep through early side effects.
Some clinics now use a lower 400 mg daily dose in selected patients. The ENCORE1 study found 400 mg kept virus levels under control for many people and caused fewer side effects. Whether 400 mg is right for you depends on your treatment plan, resistance testing, and other drugs you take — talk with your prescriber before switching.
Children get efavirenz as a weight-based dose. Exact mg/kg rules vary by age and formulation, so follow the pediatric dosing provided by the doctor or the drug label. If a liquid or smaller tablet is needed, the pharmacy can help with proper measuring.
Common short-term side effects include dizziness, trouble sleeping, vivid dreams, and mild nausea. These often improve after a few weeks. More serious problems to watch for are severe rash, new or worse depression or suicidal thoughts, and signs of liver trouble (yellowing skin/eyes, dark urine, severe stomach pain). Call your provider right away if those appear.
Efavirenz interacts with many drugs because it affects liver enzymes. Examples: hormonal birth control may be less effective, methadone levels can fall, some statins and warfarin need dose checks, and herbal St. John's wort should be avoided. Always tell every provider and your pharmacist you take efavirenz so they can check for interactions.
If you miss a dose, take it as soon as you remember unless it's almost time for the next dose — then skip the missed one. Don’t double up doses. Stopping efavirenz suddenly can cause resistance, so don’t stop without advice from your clinic.
Practical tips: take it at night on an empty stomach, avoid alcohol for the first few weeks if you feel dizzy, don't drive until you know how it affects you, store at room temperature away from moisture, and keep follow-up labs (viral load, liver tests) as ordered.
Questions? Your HIV clinic or pharmacist should answer dosing, side effect, and interaction questions. If you see severe rash, mood changes, or signs of liver injury, get medical help right away.
Sustiva (efavirenz) is a common HIV medication. Learn about uses, side effects, dosage information, tips for taking, and important facts in this detailed article.
Continue reading...
