Efavirenz
(EFV)

Drug type:

• Family of NNRTI (Non-nucleoside reverse transcriptase inhibitor antiretroviral agent)

Important prescribing information

• Rash is the most common side effect, occurring in 5-25% of patients. Rash is usually mild to moderate, but will require discontinuation in 2% of patients. Life-threatening cutaneous reactions have been reported.
• Central nervous system side effects occur in up to 50% of patients, and can include vivid dreams, dizziness and insomnia; the medication is best taken before going to sleep. These adverse effects often resolve alter the first month and are severe enough to require discontinuation in only 2-5% of patients.
• Hepatotoxicity is less frequent and less severe than in nevirapine, but elevation of liver function tests > 5x upper limits of normal has been reported in 2-8%.

Contraindications:

• Pregnancy or potential/intended future pregnancy
• Severe renal insufficiency
• Severe hepatic insufficiency
• History of previous intolerance

Usual dose:

• Three 200-mg pills once daily or one 600-mg pill
  once daily.
• May be taken with or without food, but do not take
  with high-fat meals.
• Best taken prior to sleep.

Information for patients:

• Patients should be aware that the medication may
  cause vivid dreams, dizziness and insomnia and
  that these side effects often pass after three to four
  weeks.