Question
What are the alternatives to efavirenz?
5 January 2016. Related: All topics, Changing treatment, Side effects.
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.
Answer
Hi
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.
Information on efavirenz side effects, including how to 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.
Am running out of my tablets so long found that where l am they don’t have atroiza but l found out that they have medication which contains 400mg efarvirenz is it okay to take them
Hi Tony,
Please talk to your doctor about this. You aren’t supposed to have seizures when on meds.
i have bin taking adco efravirenz 2 years and im having seizures frequently what can i do should stop taking my meds at all?
Hi Reuben,
This is something that should be discussed with a doctor. It could be related to the ARVs, however it could also be a number of other things.
Hi I have discovered that am loosing memories (having problems to remember..)since I started taking ARVS. .efavirenz actually. 9yrs now since I started.
For example. .if I keep something far ..or if someone ask me a question. It takes time to have a quick answer(s)Am 44yrs and I do mechanical works which gives me a slow phases than before.
Why its like this and how can I improve from such slowlineless to atleast quality and quick thinking capacity?
Yes, gynaecomastia are fatty breast lumps in men, and this has been mainly linked to efavirenz. Switching treatment is a first option for this.
As it says above in this question, easy alternatives to efavirenz include:
An integrase inhibitor
A boosted PI
Another NNRTI
You can ask your doctor about changing treatment if this is affecting your quality of life. If you change your combination, you have to change it to one that is just as effective against HIV. You can ask about any different side effects of the new drugs to make sure that switching improves your quality of life.
You can find out more about HIV drugs and fat accumulation here:
http://i-base.info/guides/side/fat-accumulation
Hello,
I’m taking efavirenz. I have been researching lately on one of the side effects that I suspect could be the result of using the drug; the condition referred to as gynaecomastia if I’m correct with the term. This is the condition where a male tends to develop a lot of fat tissue around the breast. What alternative drugs can one change to in order to counteract this condition?
I have been on Kaletra and Truvada for 2years now and it has worked just fine for me. I take them once a day. I take four Kaletra tablets and one Truvada tablet all at once. I know Kaletra is specified for twice a day but my doctor said it was fine taking all the same time because i hate taking medications. My CD4 count has been stable for years and my viral load undetectable. The only effect i get is runny stomach (diarrhoea) which i am cool with because it helps maintain my flat tummy :-). I take it at 6pm and having the runny tummy two hours later and go to bed feeling good :-). I also reacted to Sustiva and had to switch to Kaletra and Truvada. Good luck with your medications…
Some researchers are looking at reduced doses of some drugs (including Sustiva). However, this is mainly to reduce costs in resource limited countries. Although the dose may be safe, there is little research to support this. It also may not have any effect on side effects.
Anyone with Sustiva side effects that are causing this level of difficulty should just switch to an alternative drug.
Is it possible to take Sustiva at a dose of 400mg rather than 600mg with Truvada once a day to reduce the CNS side effects of Sustiva. I mean the anxiety disorder?