Efavirenz: Uses, indications and precautions when using

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Efavirenz is used in combination with other HIV medicines to help control HIV infection by reducing the amount of HIV in a person's body so that the immune system can work better. This helps reduce your risk of HIV complications (such as new infections, cancer) and improves your quality of life.

1. How to use Efavirenz

Before you start taking efavirenz and each time you take a supplement, refer to the instructions on the product packaging.
You should take efavirenz on an empty stomach, without food, usually once a day at bedtime or as directed by your doctor. Taking efavirenz with food increases blood levels of the drug, leading to an increased risk of some side effects.
Swallow this medication whole with water. If you have trouble swallowing the capsule, you can open the capsule and mix it with a small amount (1 to 2 teaspoons) of soft food such as apple sauce, grape jelly, or yogurt. After taking the mixed medicine, add 2 teaspoons of food to the capsule. Swallow the remaining mixture to ensure that you receive the entire dose of the medicine. Use within 30 minutes of mixing. Do not eat for 2 hours after taking this medicine. For babies who cannot eat solid foods, the medicine can be mixed with 2 teaspoons of infant formula and given through a straw.
Dosage is determined based on your condition, response to treatment and other medications you may be taking. Make sure your doctor knows about all the products you use (including prescription drugs, over-the-counter medicines, and herbal products). In children, dosage is also determined based on weight.
It is very important that you continue to take this medicine (and other HIV medicines) exactly as prescribed by your doctor. Do not skip any doses, do not increase your dose, take this medicine more often than prescribed, or stop taking it (or other HIV medicines) even for a short time unless directed to do so by your doctor. Skipping or changing the dose of medication without your doctor's approval can cause the viral load to increase, make the infection more difficult to treat (resistant), or worsen side effects.
For best effect, take this medicine at evenly spaced times. To help you remember your dosing schedule, take this medicine at the same time each day.

2. Side effects

Dizziness, trouble sleeping, drowsiness, unusual dreams, and trouble concentrating may frequently occur. These side effects may start 1-2 days after starting this medicine and usually go away after 2-4 weeks. Reduce side effects by taking efavirenz on an empty stomach, before bedtime. Avoid alcohol and street drugs while taking efavirenz because they can make these side effects worse.
Fatigue, headache, nausea, vomiting and diarrhea may also occur after you take efavirenz.
If any of these effects persist or get worse, you should contact your doctor immediately.
As the immune system becomes stronger, it can start fighting the infections you already have, which can cause symptoms to return. You may also have some other signs if your immune system becomes overactive. This reaction can occur at any time (immediately after starting HIV treatment or many months later). Call 911 right away if you have any serious symptoms, including: Unexplained weight loss, severe fatigue, muscle pain/weakness that doesn't go away, severe or persistent headache loss, joint pain, numbness/tingling of hands/feet/arm/leg, vision changes, signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, sores skin does not heal ), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, abnormal growths in the neck/glands thyroid gland called a goiter), a sign of a certain neurological problem known as Guillain-Barre syndrome (such as difficulty breathing/swallowing/eye movement, drooping face, paralysis, difficulty speaking).
Contact your doctor if any of the following rare but serious side effects occur, including: Signs of liver problems (such as persistent nausea/vomiting, stomach/abdominal pain, fatigue) severe fatigue, yellowing eyes/skin, dark urine), mental/mood changes (such as depression, sometimes suicidal thoughts, anxiety, angry behavior, hallucinations, confusion) ), loss of coordination.

While you are taking this medicine there may be changes in the amount of body fat (such as increased fat in the upper back and stomach area, and decreased fat in the arms and legs). The cause and long-term effects of these changes are still unclear. Discuss the risks and benefits of treatment with your doctor, as well as practice exercises to reduce this side effect.
Call 911 or your local medical facility right away if you have any of the following side effects, including: Fast/irregular heartbeat, severe dizziness, fainting.
Efavirenz can often cause a rash, which is usually not serious. In adults, the rash may appear during the first 2 weeks after starting treatment and, if not severe, the condition usually clears up by 4 weeks. In children, a rash may appear during the first 4 weeks after starting treatment. However, you may not be able to tell the difference, aside from a rare rash that could be a sign of a serious reaction. Therefore, seek immediate medical attention if a rash occurs.
It is very unlikely that a serious allergic reaction to this medicine will occur, but tell your doctor right away if you have any of these symptoms: Rash, blisters, peeling skin, fever, itching/swelling (especially in faces/tongue/throat), severe dizziness, trouble breathing.
If you notice any unusual symptoms after taking Efavirenz, immediately contact your doctor.

3. Precautionary measures

Before taking efavirenz, tell your doctor if you are allergic to it; or any other allergic reaction. Efavirenz may contain inactive ingredients, which can cause allergic reactions or other problems.
Before using this medication, share your medical history, especially if you have: Mental/mood condition (such as depression, suicidal thoughts, disorder). mental illness), liver problems (such as hepatitis B or C, cirrhosis), drugs/substances/alcohol abuse, seizures, high cholesterol/triglyceride levels.
Efavirenz may cause a condition that affects heart rhythm (QT prolongation). Some cases of QT prolongation, resulting in severe tachycardia/irregularity (rarely fatal) and other symptoms (such as dizziness, fainting) require immediate medical attention. ie.
If you have certain medical conditions or are taking other medications that increase your risk of QT prolongation, it may cause QT prolongation. Before using efavirenz, tell your doctor about all medications you are taking and have one of the following conditions: Heart problems (heart failure, bradycardia, QT prolongation in the EKG), history family history of certain heart problems (QT prolongation in electrocardiogram, sudden cardiac death).
Low levels of potassium or magnesium in the blood can also increase the risk of QT prolongation. If you take certain medications (such as diuretics) or have problems such as sweating, diarrhea, or vomiting, this risk may be increased. Talk to your doctor about the safe use of efavirenz.
Using Efavirenz may make you dizzy, drowsy, or have trouble concentrating. This condition will get worse if you use marijuana and alcohol. Do not drink alcoholic beverages while taking this medicine.
Rash may become increasingly severe in children taking efavirenz. Your doctor may prescribe an antihistamine for your child before starting efavirenz.
Side effects that occur in the elderly may become more sensitive, especially QT prolongation.
During pregnancy, use Efavirenz only when absolutely necessary. Treatment can reduce your child's risk of HIV infection, and efavirenz can be part of that treatment. Women of childbearing age should consult about reliable forms of birth control while using this medicine and for 12 weeks after stopping treatment. If you become pregnant, talk to your doctor right away about the risks and benefits of using Efavirenz.
This medicine may pass into milk. Because breast milk can transmit HIV, it should not be breastfed.

4. Interaction

The interaction between efavirenz and certain medications can affect how the drug works as well as the risk of side effects. Tell your doctor about any medications you are taking.
Start, change, or stop taking efavirenz only with your doctor's approval.
Some products may interact with efavirenz, including: A certain combination product used to treat chronic hepatitis C (ombitasvir/ paritaprevir/ ritonavir/ dasabuvir), orlistat.
Without a specific prescription from your doctor, do not share Efavirenz with other people.
Other medicines may affect the removal of efavirenz from your body, which may affect how efavirenz works. Examples include certain drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin), rifamycins (such as rifampin).
Efavirenz may speed up the removal of many other medicines from your body, which may affect how they work. Examples of affected drugs include: Atovaquone/proguanil, azole antifungals (such as itraconazole, ketoconazole), bedaquiline, cobicistat, elbasvir, grazoprevir, ethdone, rifabutin, sertraline, certain cholesterol-lowering statins (such as atorvastatin) , pravastatin, simvastatin), some protease inhibitors (boceprevir, simeprevir), warfarin.
Certain other drugs to treat HIV infection (such as elvitegravir, other NNRTIs including etravirine/nevirapine/rilpivirine) may also interact with efavirenz. If you are taking atazanavir together with this medicine, you may also need to take another medicine (ritonavir).
Taking Efavirenz may decrease the effectiveness of hormonal birth control such as the pill, patch, or ring. Talk to your doctor about additional or alternative reliable forms of birth control, and use an effective method of birth control (condoms or polyurethane condoms) to reduce the risk of HIV transmission. others. Tell your doctor if you have any new or sudden bleeding, as these may be signs that hormonal birth control is not working as well.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana, antihistamines (such as certirizine, diphenhydramine), sleeping pills (such as diazepam, zolpidem), muscle relaxers, and pain relievers opioid pain relievers (such as codeine).
Check the labels on all medicines you are taking (such as allergy, cough and cold products) as they may contain ingredients that cause drowsiness.
If you take Efavirenz and experience severe symptoms such as fainting or difficulty breathing, call 911.
Medical tests (such as liver tests, viral load, cell count T cells, cholesterol and triglyceride levels) should be taken before you start taking this medicine and while you are taking it. Women of childbearing age should also have a pregnancy test before starting Efavirenz.
Store Efavirenz at room temperature, away from light and moisture. Do not store this medicine in the bathroom.

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Reference source: webmd.com