The human immunodeficiency virus (HIV) affects the immune system and gradually weakens it leading to the fatal disease known as AIDS (acquired immune deficiency syndrome). This is the point where Sustiva is prescribed to treat HIV type 1.
Sustiva (efavirenz) is in the category of HIV medicines called non-nucleoside reverse transcriptase inhibitors (NNRTIs) and prevents the virus from entering the nucleus of healthy T-cells. In this way, cells will not produce a new virus anymore and will decrease existing amounts of virus present in the body. The drug must be used in combination with other medicines to treat the virus. Sustiva is typically usually with anti-retroviral agents as part of an expanded post exposure prophylaxis regimen to prevent HIV transmission.
To simplify the drug regimen for many patients, Sustiva was combined with another popular HIV medication, Truvada, under the brand name Atripla.
A very important fact about Sustiva is that it is not a cure; it only slows the progress of HIV. Patients may still get infections associated with the virus. The drug does not stop the spread of HIV through blood or sexual contact.
Every patient should take efavirenz exactly as prescribed by the doctor. A usual adult dose is 600 mg per day (preferably given at bedtime) or 800 mg per day if is given with rifampicin as part of treatment of co-infection with tuberculosis. If a dose is missed you should take it as soon as you remember but do not double it. It is recommended to take Sustiva on an empty stomach at the same hour every day if possible.
Sustiva may interact with other drugs metabolized in the liver and lowers the blood levels of most protease inhibitors. Also some natural remedies like St John's Wort and garlic may decrease efavirenz blood levels.
Some adverse effects of Sustiva may include:
- trouble sleeping, trouble concentrating, dizziness, abnormal dreaming or thinking
- it can cause birth defects
- the use of it can produce a false positive test in the urine test for marijuana
- angry behavior, severe depression, change in personality or mood
- diarrhea, vomiting, upset stomach
- memory loss, delusions, paranoia, hallucinations
- changes in body fat, vision changes
- yellowing of the eyes or skin
Sustiva should be used with extreme caution in children younger than 3 years old because its safety have not yet been confirmed in these cases. The medicine may harm the fetus but it is not known if the drug is found in breast milk. It is very important to mention that mothers infected with HIV should not breast-feed anyway.
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