Q and A

Question

How long do efavirenz side effects last?

I just started with efavirenz and Truvada 10 days ago. I’m not sleeping properly and feel dizzy all the time.

Is this normal, and when will it get better?

Answer

Hi

The type of side effects you report are pretty common when starting efavirenz.

For most people the dizzyness starts to get easier to tolerate within the first week or two, but it sounds like you may be having a particularly difficult time.

One thing to check is that you are not taking your meds after dinner. Meals that contain a lot of fat increase efavirenz levels by about 60%. Efavirenz should not be take until at least two houf after food that contains a lot of fat. Taking efavirenz before bedtime means you are hopefully sleeping during the side effects.

It is up to you how long you want to give this before trying another drug. Although your clinic might suggest giving it more time, some people change within a week if they are badly affected.

You don’t need to prove anything to anyone by staying on a drug that doesn’t work for you. There are lots of other options and switching is easy.

There is more information on efavirenz at this link.

This answer was updated in January 2016 from a question first posted on 11 June 2011.

129 comments

  1. Simon Collins

    Hi Ncebakazi, have you just started these meds?

    Trenvir is a generic version of Atripla which includes a drug called efavirenz. This often causes people to feel strange with difficult sleep and mood changes. The side effects usually become easier after a week or two.

    If they are too difficult though please talk to your doctor. You could switch to a newer HIV combination called TLD where this is much less of a problem.

    More info on every drug is at this link:
    https://i-base.info/guides/category/arvs

  2. Ncebakazi

    Hi I have. A question.. I’m taking Trenvir and the side effect is my body is feeling strange and my head is rotating. Is it normal?

  3. Roy Trevelion

    Hi Rohzalia,

    Dumiva is a generic version of Kivexa. It is normally well tolerated.

    But sometimes Dumiva can cause a serious reaction. Symptoms of the reaction include fever, rash, headache, sore throat, diarrhoea, abdominal pain, tiredness, nausea, vomiting, flu-like aches etc that get progressively worse each day.

    Please contact your doctor urgently if you think you’re having this reaction. You can ask to switch to other meds that are better for you.

    Dumiva is just part of HIV treatment. What other meds are you taking? Please let us know. And if you have access to your CD4 count and viral load results, please let us know these too.

  4. Rohzalia

    For how long is Dumiva side effects last.

  5. Roy Trevelion

    Hi Davie,

    Unfortunately we are not doctors at i-Base. So it’s a good idea to talk to your doctor about these symptoms. Please check that this is not a reaction to your HIV meds in PEP. You can also ask if there are other reasons for your symptoms.

  6. davie

    I started taking pep for a week now but I take it one pill in the morning but am experiencing high fever in the afternoon and night,I also have pain in the bones,when will this last or am I experiencing first symptoms of HIV,Pls help

  7. Lisa Thorley

    Hi Elizabeth,

    The skin darkening could be due to low levels of vitamin D. However, it could also be due to a host of other reasons. The darkening is unlikely to be related to your medication.

  8. Elizabeth

    hi;I’ve started trivenz 3 weeks ago ; my problem is i now see the change in my face ; my complexion it become darker especially under my eyes

  9. Roy Trevelion

    Hi Paul,

    Atripla is one of the most widely use single-pill combinations. It is based on efavirenz, and side effects can include feeling dizzy. This is best managed by taking Atripla before bedtime.

    But as Simon says on this Q&A, in the UK, someone working with frequent shift changes would use a different HIV combination.

    So one thing is to please speak to your doctor to see if there is a choice. Explain how difficult this is to work shifts and say you need a different medicine.

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