Q and A


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?



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.


  1. Paul

    Can I still work nights if taking Atripla medication or will I need to change medication as I take these of a night time

  2. Roy Trevelion

    Hi Ziohoh,

    Do you have access to your CD4 count and viral load results? This can help tell you how well Trivenz is working against HIV.

    When starting HIV treatment (ART) many people have mild side effects, but they often go away in a week or two.

    Can you talk to your doctor about your symptoms to find out what’s causing them? If they are caused by Trivenz you can ask if there are other HIV meds that would be better for you.

  3. Ziohoh

    Hi,i started taking Trivenz on the 7th of this month but up until now I still feel nauseous and weak ,how long will this last ,I can’t take this feeling anymore

  4. Roy Trevelion

    Hi Stanley K,

    The kind of treatment for HIV (ART) is the same. However, the drugs that are used can vary from country to country. The same drugs can be cheaper if they are generic rather than branded drugs.

    These cost differences mean that low and middle income countries can benefit from cheaper generics. But generics are just as safe and effective as the branded versions.

  5. Stanley k

    I am from Kenya and i would like to know if the kind of treatment in USA and UK is the same as in Kenya. Thanks

  6. Roy Trevelion

    Hi Busiwe,

    Are you taking efavirenz as part of your meds? Feeling dizzy and not sleeping well are reported side effects of efavirenz. You can ask the clinic if you can switch to different meds. You can tell them it’s making it difficult to work properly.

  7. Busiwe

    It’s all most a year now I’m drinking this drugs it’s killing me slowly an my highblood it’s going up they can’t even controlled it I complain at the clinic but they still offer me it I feel dizzy nosea I can’t even work at work I’m always tired

  8. Roy Trevelion

    Hi Micolash,

    Here’s a similar question about Atripla. Is this the combination you’re taking: efavirenz, tenofovir and emtricitabine (FTC)?

    You’re probably not in trouble at all. But you can ask at the clinic to check your viral load to make sure it’s still undetectable.

  9. Micolash

    Hye. I stopped taking Tenovir and Efavirenz for 4 days for a very good reason. Am i in trouble?

  10. Roy Trevelion

    Hi Dave,
    The recommendation in the UK, and in many countries, is to start HIV treatment at any CD4 count. Was your test HIV negative? Often people are asked to take another HIV test in 3 months – but that’s to confirm the result. If you tested HIV positive your doctor can test to see what meds are best for you.


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