What are the alternatives to efavirenz?
I need to change Sustiva because of anxiety, but to what best combo if this is urgent?
I have been on efavirenz/tenofovir/lamuvidine for almost two years.
I began to have more anxiety even to the extent that I could not drive again the same I used to drive before. I still take my anxiety meds (lexapro, tranxene, haldol).
Now I’m feeling depressed everyday even too much to exercise. I don’t know whether to blame the Sustiva or HIV itself, so I want to throw this problem to this forum to help me decide what to do if to change my Sustiva or what else to do.
Mainly I need combo that can be taken once at bed time that can go with Truvada with not more three pills a night.
You are describing common side effects associated with efavirenz (trade name Sustiva). It is important that your doctor know how this is significantly affecting you daily quality of life.
Even if you have underlying anxiety, it is important to change the efavirenz to see whether using an alternative drug helps reduce this problem.
Switching treatment should be easy and most people who are having problems report significant changes after they switch.
Easy alternatives to efavirenz (Sustiva) include:
- An interase inhibitor (either doluteravir or raltegravir).
- A boosted PI (usually atazanavir/r or darunavir/r).
- Another NNRTI (etravirine or rilpivirine). Outside the UK this could include nevirapine.
Your doctor might suggest other option depending on your previous treatment history.
These drugs only involve a couple of additional pills each day, and most are still once-daily combinations.
Your overall quality of life is probably more important than the number of pills you need to take.
Please print out this question and answer and take it to your doctor so that you have support in changing to an alternative combination.
This answer was updated in January 2016 from a question first posted on 26 September 2012.