1 What is Sustiva?

Brand: Sustiva

Generic: Efavirenz

Sustiva can be used in combination with other medicines in the management of infections caused by human immunodeficiency virus (HIV). HIV is the virus that causes acquired immune deficiency syndrome (AIDS).

Sustiva is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It works by lowering the amount of HIV in the blood.

Sustiva will not cure or prevent HIV infection or AIDS; however, it helps keep HIV from reproducing and appears to slow down the destruction of the immune system. Use of Sustiva may help delay the development of problems that usually result from AIDS or HIV disease.

However, it will not keep you from spreading HIV to other people. People who receive this medicine may continue to have some of the problems usually related to AIDS or HIV disease. This medicine is available only with your doctor's prescription.

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2 What to Know Before Using

Before using Sustiva, you must know all about the risks and complications associated with it. This is reached when making a decision by both you and your medical doctor.

Also, inform your doctor if you have ever suffered from any of the unusual or allergic reactions after using these medicines or any other medicines. In addition, inform your doctor if you have any types of allergies to foods, dyes, preservatives or animals and their products.

When using the nonprescription products, read the label provided with the package carefully to take note of the ingredients in the food.

When using nonprescription products, read the package and their ingredients carefully. The use of this medicine in children is not well studied.

Similarly, there are no appropriate studies on the relationship of age to the effects of efavirenz in children younger than 3 months of age or those who weigh less than 3.5 kilograms (kg). Moreover, safety and efficacy have not been established.

On the other hand, geriatric appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of efavirenz in the elderly patients.

However, it has been suggested that elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving efavirenz.

There are also no studies on the effect of these medicines on mothers and children that are breastfeeding. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding.

It is important to weigh the potential benefits against the potential risks of using this medicine before this medicine can be prescribed to the breastfeeding mother. Though considered safe, it is possible that drug interactions may also occur.

It is known that certain medicines should be used together. This is even with a possibility of interaction occurring. When it is known, your doctor may also want to change the dose of the medicines and take other necessary precautions as possible. When using this medicines, inform your doctor if you're taking any of the medicines that are listed below.

The following interactions are selected on the basis of their potential significance and are not necessarily all-inclusive.

When using any of this medicine, it is not recommended, your personal doctor may decide not to treat you with this medicines or make some changes in the other medicines that you take to avoid an interaction or the effects that may arise from the interaction.

These medicines include:

  • Carbamazepine
  • Dasabuvir
  • Isavuconazonium Sulfate Paritaprevir Ritonavir
  • St John's Wort
  • Voriconazole

Moreover, use of some other medicines is usually not recommended but may be required in some of the cases. When both of the medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. They include:

  • Amprenavir
  • Apixaban
  • Artemether
  • Avanafil
  • Axitinib
  • Bedaquiline
  • Bexarotene
  • Boceprevir
  • Bosutinib
  • Bupropion
  • Citalopram
  • Clarithromycin
  • Clozapine
  • Cobimetinib
  • Cyclosporine
  • Daclatasvir
  • Darunavir
  • Dexamethasone
  • Dolutegravir
  • Donepezil
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Eliglustat
  • Enzalutamide
  • Erlotinib
  • Etravirine
  • Fosamprenavir
  • Ginkgo Biloba
  • Hydrocodone
  • Idelalisib
  • Ifosfamide
  • Itraconazole
  • Ivabradine
  • Ketoconazole
  • Linagliptin
  • Maraviroc
  • Mifepristone
  • Naloxegol
  • Netupitant
  • Nevirapine
  • Nifedipine
  • Nilotinib
  • Olaparib
  • Palbociclib
  • Panobinostat
  • Piperaquine
  • Ponatinib
  • Posaconazole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rilpivirine
  • Saquinavir
  • Simeprevir
  • Sirolimus
  • Sonidegib
  • Tacrolimus
  • Tolvaptan
  • Ulipristal
  • Vilazodone
  • Warfarin

There is also the possibility of increased risks of certain side effects when using these medicines. However, use of both drugs may be the best treatment for you. But in the event that both of the medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. They include:

  • Atazanavir
  • Atorvastatin
  • Caspofungin
  • Dienogest
  • Diltiazem
  • Estradiol
  • Ethinyl
  • Estradiol
  • Ethynodiol
  • Etonogestrel
  • Indinavir
  • Lopinavir
  • Medroxyprogesterone
  • Mestranol
  • Methadone
  • Norgestimate
  • Ospemifene
  • Pravastatin
  • Proguanil
  • Sertraline
  • Simvastatin
  • Telaprevir and
  • Thiotepa

It is possible that there can be another form of interactions when using some of these medicines around or at the time of eating food or eating certain types of foods. Use of alcohol or tobacco with certain medicines may also cause other forms of interactions to occur. These interactions are selected on the basis of their potential significance and may not be all inclusive.

The presence of other medical problems may affect the use of these medicines. Always inform your doctor on the use of this medicines and whether you have any other medical condition or problems such as alcohol abuse or history of alcohol abuse, depression or mental illness. Use of these medicines may also increase the chance of having psychotic effects.

Hepatitis B or hepatitis C or liver disease also needs to be reported. Use these medicines with cautions. Efavirenz may make this condition worse. Also, if you have suffered from seizures or have a history of seizures, use this medicine with caution. This medicine may also increase a change of convulsions occurring.

3 Proper Usage

Proper usage of Sustiva requires strict adherence to your doctor’s orders. Never take more or less of the medicine and neither should you take the medicine for a longer duration than as advised by your doctor.

Similarly, never change the dose or stop using this medicine without checking with your doctor. In the event that the supply of the medicine is getting low, contact your doctor or pharmacist ahead of time and never allow yourself to run out of this medicine.

The medicine also comes with information and instructions for patients. Always read and follow the instructions carefully before using the medicine.

Also, ask your doctor if you have any other questions, keep using efavirenz for the full time of treatment even when you have signs of improvement and you are feeling better. It is also significant to continue other HIV medicines for HIV infection as instructed by your medical doctor.

Efavirenz will not work when it is taken alone and must be taken with other HIV medicines. It is suggested that the best possible effect of this medicine can be realized when this medicine is present in constant amounts in the blood.

This can be achieved by not missing of the doses, taking the doses evenly spaced out during the day. When using these medicines, try to take the medicine at the same time each day.

Alternatively, seek help from your doctor on the best times when you can take the medicines. It is also advisable to use these medicines on an empty stomach preferably at bedtime. Swallow this medicine with water.

It is also advisable no to break, chew, or crush the tablets. If you or your child cannot swallow capsules or tablets, you may open the capsules and pour the contents into a small amount of soft food such as applesauce, grape jelly or yogurt.

In Young children, it can also be mixed with the infant formula especially for those that are yet to start eating solid foods. It is recommended that it can be given within 30 minutes after it has been mixed.

After the mixture has been given, small amounts of good or formula can be added and stirred gently to mix any capsule contents left in it. It is not advisable to eat anything else for about 2 hours after taking this medicine with food or formula.

Inform your doctor if you take rifampin (Rifadin, Rifamate, Rifater) or voriconazole (Vfend). Your dose may need to be changed and this will be informed by your medical doctor. The dose of this medicine will also be different for different patients. It is necessary to follow the instructions of your medical doctor on the label.

The information provided in this article is only average doses of this medicine. In case your dose is different, never change the dose unless otherwise instructed by your medical doctor. This is because the amount of medicines that is taken is dependent on the strength of the medicine.

It also relies on the number of doses that one takes each day, the time allowed between doses and length of time you take the medicines which vary with the medical problem for which you are using the medicine.

For oral dosage forms (capsules or tablets) in the management of HIV infections, it is recommended that adults use 94600 milligrams (mg) one day when taken with other medicines.

However, in children that are 3 months of age or older by weight 3.5 to 5 kilograms of body weight: 100 mg once a day, taken with other medicines for 5 to 7.5 kilograms of body weight: 150 mg once a day, taken with other medicines.

7.5 to 15 kilograms of body weight: 200 mg once a day, taken with other medicines. 15 to 20 kilograms of body weight: 250 mg once a day, taken with other medicines. 20 to 25 kilograms of body weight: 300 mg once a day, taken with other medicines.

25 to 32.5 kilograms of body weight: 350 mg once a day, taken with other medicines. 32.5 to 40 kilograms of body weight: 400 mg once a day, taken with other medicines. 40 kilograms of body weight or over: 600 mg once a day, taken with other medicines.

Children of up to 3 months of age, use, and dose of the medicine must be determined by your medical doctor. In the event of missed doses, take the medicine as soon as possible. However, when it is almost time for your next dose, it is advisable to skip the missed dose and go back to your regular dosing schedule.

It is not recommended to double doses. The medicine also needs to be stored in a closed container and at room temperature, away from children, direct light and any source of heat. Keep this medicine from freezing.

Do not store outdated medicines or medicines that are no longer needed. As a healthcare professional, it is advisable to dispose of any of the medicines that are not in use.

4 Precautions to Take

Before using Sustiva, there are some precautions you must take. Regular medical checkups for progress are important both for you and your child so as to ensure that the medicine is working properly as required. Blood tests may also be needed and also to check for unwanted effects.

Using this medicine when pregnant can harm your unborn baby. It is recommended to use an effective form of birth control so as to reduce the chance of getting pregnant.

It is also advisable not to become pregnant when using this medicine and for 12 weeks after stopping it. When you think you have become pregnant when using this medicine, inform your medical doctor immediately.

This medicine may decrease the effects of some birth control including pills, injections, or implants. It is recommended to use additional of birth control besides the use of your pill, injections or contraceptive foams or jelly to avoid getting pregnant.

It is also not advisable for you or your child to use this medicine when you are using Atripla. Atripla has an additional efavirenz.

This medicine may cause a change in moods or behaviors such as feeling sad or hopeless or getting upset easily. You could feel nervous or hostile. Some people become violent and want to hurt themselves or others. Call your doctor right away if you or your children have any strange feelings, thoughts, or behaviors.

This medicine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising. It is important to know how you react to this medicine before you can drive, use machines, or do anything else that can be dangerous.

Always check with your doctor before using efavirenz with alcohol or other medicines that affect the functioning of your brain. Seek advice from your doctor before using efavirenz with alcohol or any other of the medicines affecting the functioning of the CNS.

The use of alcohol or other medicines may affect the CNS and efavirenz may make the situation worse and increase the side effects of the medicine characterized by dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping.

Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

Inform your doctor immediately when you or your child had any form of skin rash. In case they also have blisters in the rashes, then call your doctor immediately.

Side effects may also be presented in the form of fever, sores in the mouth, red, irritated eyes, swelling of the face, muscles or joint pain, muscles weakness. Liver problems may also occur while you are using this medicine.

Moreover, also check with your doctor when you have more than any of the following symptoms: Abdominal or stomach pain or tenderness, clay-colored stools, dark urine, a fever, a headache, itching, loss of appetite, nausea and vomiting, skin rash, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.

Use of this medicine may increase the level of body cholesterol and fats in your blood. As a result, your doctor may give you medicines that will be able to reduce the levels of cholesterol and fats in your blood. In the case of any concerns, it is important to talk to your doctor.

It is suggested that the immune system may be boosted immediately after you start using HIV medicines. Inform your doctor of any noticeable changes in your blood and overall health.

The immune system may also start to find other infections hidden in your bodies such as pneumonia, herpes, or tuberculosis. Autoimmune disorders (eg, Graves' disease, polymyositis, and Guillain-Barr syndrome) may also occur. You may grow big after using this medicine as a result of an increase in the body fat.

Tell your doctor if you have or notice any changes in the shape of your body including the fat around the neck or upper back around your chest or stomach area. You may also lose fat from your legs, arms, and face.

This medicine does not decrease the risk of transmitting the HIV infections to others through sexual contact or contaminated blood. Learn and practice safe sex even when your partner is also HIV positive.

Avoid sharing any of the needles. Inform your doctor that you are using these medicines before you can use or perform any of the medical tests. The results of the tests may also be affected by the use of the medicines.

Never take the medicine unless it has been discussed with your doctor. This includes both uses of prescription or non-prescription over the counter medicines, herbal or vitamins supplements.

5 Potential Side Effects

It is known that not all side effects may occur while using Sustiva, however, when it occurs, you will need medical attention.

Check with the medical doctor immediately of any of the following side effects occurs:

The more common side effects includes:

  • depression
  • skin rash or itching

Less common side effects include:

  • Blood in the urine
  • Difficult or painful urination pain in the lower back or side

There are also rare side effects such as:

  • Abdominal or stomach pain blistering changes in vision
  • Clumsiness or unsteadiness
  • Confusion convulsions (seizures)
  • Cough
  • Dark urine
  • Delusions
  • Double vision
  • Fainting fast or pounding
  • Heartbeat
  • Fever or chills
  • A headache (severe and throbbing) hives
  • Inappropriate behavior
  • Loss of appetite
  • Mood or mental changes (severe) muscle cramps or pain
  • Nausea or vomiting
  • Nerve
  • Pain
  • Open sores pain
  • Tenderness
  • Bluish color
  • or Swelling of the leg or foot rapid weight gain seeing
  • Hearing, or feeling things that are not their sense of constant movement of self or surroundings sores
  • Ulcers, or white spots in the mouth or on the lips
  • Speech disorder
  • Swelling or tenderness in the upper abdominal or stomach area
  • Swelling of the hands, arms, feet, or legs
  • Thoughts of suicide or attempts at suicide
  • Tightness in the chest
  • Tingling
  • Burning
  • Numbness or pain in the hands, arms, feet, or legs tingling, burning
  • or Prickling sensations
  • Tremor
  • Troubled breathing
  • Unusual tiredness
  • Weight loss
  • Yellow eyes or skin

There other incidences that are not known such as:

  • Actions that are out of control attack
  • Assault, or force continuing vomiting delusions of persecution
  • Mistrust
  • Suspiciousness, or combativeness difficult or labored breathing early appearance of redness or swelling of the skin
  • General feeling of tiredness or weakness
  • Irritability
  • Late appearance of rash with or without weeping blisters that become crusted, especially in sun-exposed areas of the skin
  • May extend to unexposed areas light-colored stools
  • Nervousness
  • Talking
  • Feeling, and acting with excitement

There are some side effects which may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Always check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

The more common side effects include:

  • Diarrhea
  • Dizziness
  • Drowsiness
  • A headache increased sweating poor concentration trouble sleeping

The less common or rare side effects include:

  • Abnormally decreased sensitivity
  • Particularly to touch agitation or anxiety belching change in sense of taste or smell dry mouth excessive gas false sense of well-being flaking and falling off of the skin flushing
  • General feeling of discomfort
  • Heartburn indigestion joint pain
  • Lack of feeling or emotion
  • Loss of hair
  • Loss of memory
  • Loss of sense of reality
  • Mood changes
  • Pain
  • Painful, red, hot, or irritated hair follicles ringing in the ears stomach
  • Discomfort unusual dreams weakness Incidence not known
  • Difficulty having a bowel movement (stool)
  • Discoloration of the fingernails or toenails
  • Dizziness or lightheadedness
  • Feeling of constant movement of self or surroundings
  • Increased amount of fat in the upper back and neck or around the chest and stomach area
  • Lose fat from the legs, arms, and face sensation of spinning
  • Swelling of the breasts or breast soreness in both females and males

Some of the other side effects that may not be listed here may occur in some of the patients. If there are any other side effects, other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.