EFAVIR
EFAVIRENZ · by A. J. MIRZA
Composition
Tab 200 mg/600 mg: Efavirenz 200 mg/600 mg. Cap 50 mg/100 mg/200 mg: Efavirenz 50 mg/100 mg/200 mg.
Indications & Dosage
HIV infection in combination with other antiretroviral drugs: Adult: 600 mg cap/tab once daily, in combination with protease inhibitor &. /or nucleoside analogue reverse transcriptase inhibitors (NRTIs). Children below 17 yr40 kg: 600 mg once daily; less than 40 kg: 400 mg once daily; 25 - 32.5 kg: 350 mg once daily, 20 - 25 kg: 300 mg once daily; 15 - 20 kg: 250 mg once daily; 13 - 15 kg: 200 mg once daily. Children 3 yr see literature.
Precautions
Caution use in patient with liver disease, history of seizures, known or suspected history of hepatitis B or C infections & in patients with other medications associated with liver toxicity. May impair ability to drive or operate machinery. Pregnancy should be avoided in, women receiving efavirenz, children less than 3 years or less than 13 kg body weight. Use of efavirenzas a single agent to treat HIV or added on as a sole agent to a failing regimen is not recommended. If any antiretroviral medication in a combination regimen is interrupted because of suspected intolerance, serious consideration should be given to simultaneous discontinuation of all antiretroviral medications. Prophylaxis with appropriate antihistamines prior to initiating therapy in children may be considered. Monitor psychiatric adverse experiences, nervous system symptoms & cholesterol.
Interactions
Amprenavir, indinavir, ritonavir;rifamycin, clarithromycin, oral contraceptives, anticonvulsants, methadone, St. Johns Wort, sertraline, cetirizine. lorazepam. Other compounds that are substrates of CYP3A4 may have decreased plasma concentration when co-administered with efavirenz. Should not be administered concurrently with terfenadine, astemizole, cisapride, midazolam, triazolam, or ergot derivatives
Pregnancy
Avoid, use only when no safer alternative exists for a serious problem.
Lactation
Contraindicated
Side Effects
Abdominal pain, abnormal dreams, anxiety, depression, diarrhoea, dizziness, fatigue, headache, impaired concentration, nausea, pruritus, rash, sleep disturbances, Stevens-Johnson syndrome, vomiting, osteonecrosis, raised serum cholesterol, amnesia, ataxia, blurred vision, convulsions, flushing, gynaecomastia, hepatitis, hypersensitivity, mania, pancreatitis, psychosis, suicidal ideation, tinnitus, tremor, vertigo. Rare: Hepatic failure, photosensitivity, suicide