Sustiva

Generic Name: efavirenz (e FAV ir enz)

What is Sustiva?

Sustiva (efavirenz) is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Sustiva is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Efavirenz is not a cure for HIV or AIDS.

Sustiva may also be used for other purposes not listed in this medication guide.

Important information about Sustiva

Sustiva may cause serious psychiatric symptoms including confusion, severe depression, suicidal thoughts, aggression, extreme fear, hallucinations, or unusual behavior. Contact your doctor at once if you have any of these side effects, even if you have had them before.

Do not use Sustiva without telling your doctor if you are pregnant. It could harm the unborn baby. Use two forms of birth control, including a barrier form (such as a condom or diaphragm with spermicide gel) while you are taking Sustiva, and for at least 12 weeks after your treatment ends. Tell your doctor if you become pregnant during treatment.

Do not take Sustiva with cisapride (Propulsid), pimozide (Orap), midazolam (Versed), triazolam (Halcion), or ergot medicines such as dihydroergotamine (D.H.E. 45), ergonovine (Ergotrate), ergotamine (Ergomar, Cafergot, Wigraine), or methylergonovine (Methergine).

These drugs can cause life-threatening side effects if you use them while you are taking Sustiva.

There are many other medicines that can interact with Sustiva, or make it less effective. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Taking Sustiva will not prevent you from passing HIV to other people. Talk with your doctor about safe methods of preventing HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Before taking Sustiva

Do not use Sustiva if you are allergic to efavirenz, or if you are using any of the following drugs:

cisapride (Propulsid);

midazolam (Versed) or triazolam (Halcion);

pimozide (Orap); or

ergot medicine such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine).

Using any of these medicines while you are taking Sustiva can cause serious medical problems or death.

If you have certain conditions, you may need a dose adjustment or special tests to safely take Sustiva. Before you take Sustiva, tell your doctor if you have:

high cholesterol or triglycerides; or

if you have ever taken delavirdine (Rescriptor) or nevirapine (Viramune) and they were not effective in treating your condition.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Do not use Sustiva without your doctor’s consent if you are pregnant. Use two forms of birth control, including a barrier form (such as a condom or diaphragm with spermicide gel) while you are taking Sustiva, and for at least 12 weeks after your treatment ends. Tell your doctor if you become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using Sustiva. The purpose of this registry is to track the outcome of the pregnancy and delivery to evaluate whether Sustiva had any effect on the baby.

You should not breast-feed while you are using Sustiva. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

How should I take Sustiva?

Take Sustiva exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take Sustiva on an empty stomach at bedtime, unless your doctor tells you otherwise.

Sustiva can cause side effects such as mood or behavior changes. These symptoms may improve the longer you take the medication. Taking Sustiva at bedtime may also lessen these effects. Contact your doctor if you have more serious symptoms such as severe depression or thoughts of hurting yourself.

Take Sustiva regularly to get the most benefit. Get your prescriptions refilled before you run out of medicine completely.

Do not take Sustiva as your only HIV medication. HIV/AIDS is usually treated with a combination of different drugs. Your disease may become resistant to Sustiva if you do not take it in combination with other HIV medicines your doctor has prescribed. Use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

To be sure Sustiva is helping your condition and not causing harmful effects, your blood and liver function may need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

This medication can cause you to have a false positive drug-screening test. If you provide a urine sample for drug-screening, tell the laboratory staff that you are taking Sustiva.

Store Sustiva at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose can cause confusion, lack of balance or coordination, severe mood or behavior changes, or thoughts of suicide.

What should I avoid while taking Sustiva?

Sustiva can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of Sustiva. Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Sustiva. Tell your doctor if you regularly use any of these medicines. Avoid having unprotected sex or sharing needles, razors, or toothbrushes. Taking this medication will not prevent you from passing HIV to other people. Talk with your doctor about safe methods of preventing HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Sustiva side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Sustiva may cause serious psychiatric symptoms including confusion, severe depression, suicidal thoughts, aggression, extreme fear, hallucinations, or unusual behavior. Contact your doctor at once if you have any of these side effects, even if you have had them before.

Call your doctor at once if you have any of these serious side effects:

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

fever, chills, body aches, flu symptoms; or

any other signs of new infection.

Less serious Sustiva side effects may include:

mild nausea, vomiting, or stomach pain, diarrhea or constipation;

cough;

blurred vision;

headache, dizziness, tired feeling;

trouble concentrating, problems with balance or coordination;

muscle or joint pain;

sleep problems (insomnia), unusual dreams; or

changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Sustiva?

There are many other medicines that can interact with Sustiva, or make it less effective. Before taking Sustiva, tell your doctor if you are using any of the following drugs:

itraconazole (Sporanox);

St. John’s wort;

voriconazole (Vfend);

a blood thinner such as warfarin (Coumadin);

a cholesterol medication such as Lipitor or Zocor;

an antibiotic such as clarithromycin (Biaxin), rifabutin (Mycobutin), or rifampin (Rifadin, Rifater, Rifamate, Rimactane);

heart or blood pressure medications such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), or verapamil (Calan, Covera, Isoptin, Verelan);

other HIV medicines such as indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nevirapine (Viramune), ritonavir (Norvir), or saquinavir (Invirase); or

seizure medications such as phenytoin (Dilantin) or carbamazepine (Tegretol).

This list is not complete and there are other drugs that can interact with Sustiva. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.