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Atripla (Generic Efavirenz)

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Why is this medication prescribed?

Human immunodeficiency virus (HIV) infection is treated with efavirenz in combination with other drugs. A group of drugs known as non-nucleoside reverse transcriptase inhibitors includes efavirenz (NNRTIs). It functions by lowering the level of HIV in the blood. Despite the fact that efavirenz does not treat HIV, it may lower your risk of getting AIDS and other HIV-related conditions such serious infections or cancer. The risk of transmitting (spreading) the HIV virus to others may be reduced by taking these medications, engaging in safer sexual behaviour, and changing other aspects of one’s lifestyle.

How should this medicine be used?

Efavirenz is available as a tablet and a capsule for oral use. It is often taken once daily, first thing in the morning, with lots of water (at least 1 hour before or 2 hours after a meal). Efavirenz should be taken every day at about the same time. Some side effects of efavirenz may become less irritating if taken before night. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Efavirenz should be taken as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

Do not split, chew, or crush the tablets or capsules; instead, swallow them whole.

You can still take efavirenz if you can’t swallow it whole by combining the contents of the capsule with soft food and then eating it. Open the capsule and sprinkle the contents onto 1-2 teaspoons of soft food in a small container to prepare each dose. You can utilise soft meals like yoghurt, grape jelly, or applesauce. Be careful not to spread the capsule’s contents out or spill it when misting. Combine the soft food with the medicine. The mixture shouldn’t be lumpy but should have a gritty appearance. The combination of soft food and medicine must be consumed within 30 minutes of combining. To ensure that you have consumed the entire amount of medication, add an additional 2 tablespoons of soft food to the empty container, stir, and then eat. For the next two hours, don’t eat anything.

If efavirenz is being administered to a child who is not yet able to eat solid meals, the contents of the capsule can be combined in a small container with 2 teaspoons of infant formula at room temperature. Be careful not to spill the contents of the capsule or scatter it across the air as you empty it. The mixture shouldn’t be lumpy but should have a gritty appearance. Within 30 minutes of mixing, the baby should be syringe-fed the mixture. To be sure you have given the baby the entire amount of medication, add 2 more tablespoons of newborn formula to the empty container, swirl, and syringe feed. The baby should not be given the medication in a bottle. For the following two hours, do not feed the infant.

Although it doesn’t treat HIV infection, efavirenz manages it. Despite feeling fine, keep taking efavirenz. Without first consulting your doctor, do not discontinue taking efavirenz. Ask your doctor or pharmacist for more efavirenz when you start to run low on it. Missing doses or stopping efavirenz use could make treating your illness more challenging.

Other uses for this medicine

Healthcare workers or other individuals who were unintentionally exposed to HIV may also benefit from the combination of efavirenz and other drugs to help avoid infection. Discuss the potential dangers of using this medicine for your illness with your doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

What special precautions should I follow?

Before taking efavirenz,

  • If you have any allergies to efavirenz, any other medications, or any of the substances in efavirenz capsules or tablets, let your doctor and pharmacist know right away. For a list of the ingredients, ask your doctor or pharmacist.
  • You should be aware that efavirenz can be purchased with another drug under the brand name Atripla. In order to avoid receiving the same drug again, let your doctor know if you are taking this medication.
  • If you are taking grazoprevir and elbasvir, let your doctor know (Zepatier). If you are taking this medicine, your doctor most likely will advise you to avoid using efavirenz.
  • Inform your doctor and pharmacist about any additional prescription and over-the-counter drugs, vitamins, and dietary supplements you are currently taking or intend to take. Mention any of the following medications: bupropion (Wellbutrin, Zyban, and others, in Contrave); carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Teril); clarithromycin (Biaxin, in Prevpac); cyclosporine (Gengraf, Neoral, Sandimmune); atazanavir (Reyataz); atorvastatin (Lipitor, in Cadue (Rescriptor), felodipine, fosamprenavir (Lexiva), itraconazole (Sporanox), indinavir (Crixivan), levonorgestrel (Mirena, Plan B one step, skyla, in Climera Pro, Seasonale, among others), lopinavir, and others. Diltiazem, ethinyl estradiol, and norgestimate, as well as other medications (in Kaletra), maraviroc (Selzentry), drugs for seizures, drugs for anxiety, drugs for mental illness, drugs for seizures plus methadone (Dolophine, Methadose), nevirapine (Viramune), nifedipine (Adalat, Afeditab, Procardia XL), norelgestromin (in Xulane), drugs for seizures plus phenobarbital, drugs for mental illness including phenytoin (Dilantin (Mycobutin), sertraline (Zoloft), simeprevir (Olysio), simvastatin (Zocor, in Vytorin), sirolimus (Rapamune), sleeping pills, tacrolimus (Envarsus XR, Prograf), tranquillizers, verapamil (Calan, Covera, Verelan, in Tarka), voriconazole (Vfend), and warfarin are some examples of medications that can cause bleeding (Coumadin, Jantoven). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all of the medications you are taking, including any that do not appear on this list, as many other drugs may interact with efavirenz or raise your chance of developing an irregular heartbeat.
  • Please let your doctor know if you are taking any herbal supplements, especially St. John’s wort.
  • Inform your doctor if you experience or have ever experienced prolonged QT interval (a rare cardiac condition that can lead to fainting or an irregular heartbeat), irregular heartbeat, other heart conditions, heavy alcohol use, drug use, or overuse of prescription medications. Additionally, let your doctor know whether you now or previously had seizures, hepatitis (a viral infection of the liver), or any other liver condition.
  • If you are pregnant or want to become pregnant, let your doctor know. Throughout your therapy and for 12 weeks following your last dose, you shouldn’t get pregnant. Before starting this medicine, you must have a negative pregnancy test. You must also use reliable birth control while undergoing therapy if you are capable of getting pregnant. You shouldn’t use hormonal contraceptives (birth control pills, patches, rings, implants, or injections) as your sole form of birth control while taking efavirenz because it may reduce their effectiveness. Along with any other method of birth control you choose, you must utilise a barrier method of contraception (device that prevents sperm from entering the uterus, such as a condom or a diaphragm). Ask your doctor to assist you in selecting a birth control technique that will be effective for you. Call your doctor if you become pregnant while taking efavirenz.
  • If you are taking efavirenz or have HIV, you shouldn’t breastfeed.
  • You should be aware that efavirenz may cause you to feel sleepy, lightheaded, or unable to focus. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
  • Inquire with your doctor about whether drinking alcohol is safe while taking efavirenz. The negative effects of efavirenz can be made worse by alcohol.
  • You should be aware that while you use medications to treat your HIV infection, your immune system could become stronger and start to fight other infections you previously have in your body or trigger the development of other illnesses. You might start to exhibit signs of certain illnesses as a result of this. During your efavirenz medication, be sure to let your doctor know if you experience any new or worsening symptoms.
  • You should be aware that your body fat may rise or shift to several regions, including your breasts, upper back, neck (the “buffalo hump”), and the area surrounding your abdomen. Your face, legs, and arms may show a reduction of body fat.
  • You should be aware that efavirenz may impact your mental health, behaviour, or thinking. If you experience any of the following side effects while taking efavirenz: depression, suicidal thoughts, plans, attempts, irrational anger or aggressive behaviour, hallucinations (hearing voices or seeing things that are not there), loss of reality, or other strange thoughts, call your doctor right away. Make sure your family is aware of any potentially critical symptoms so they can contact your doctor on your behalf if you are unable to get help on your own.
  • You should be aware that months or years after you initially take efavirenz, it may still result in very catastrophic nervous system issues, such as encephalopathy (a serious and sometimes deadly brain illness). It’s crucial that you and your doctor are aware that efavirenz could be the reason behind your nervous system issues, even though they might not manifest until after you’ve been taking the medication for a while. At any point while taking efavirenz, if you develop balance or coordination issues, confusion, memory issues, or any other issues brought on by aberrant brain function, call your doctor straight once. You might be advised by your doctor to stop taking efavirenz.

What special dietary instructions should I follow?

If you plan to consume grapefruits or grapefruit juice while taking this medication, consult your doctor.

What should I do if I forget a dose?

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

There may be adverse consequences from efavirenz. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Indigestion
  • Headache
  • Confusion
  • Forgetfulness
  • feeling uneasy, jittery, or agitated
  • Unusual level of happiness
  • Having trouble falling or staying asleep
  • Strange dreams
  • Pain

Some adverse effects can be very harmful. Call your doctor right away if you have any of the following signs or those listed in the SPECIAL PRECAUTIONS section:

  • Fever
  • Rash
  • Itching
  • Skin that is flaking, blistering, or peeling
  • Oral sores
  • Red eye
  • Your facial swelling
  • Fainting
  • Abnormal heartbeat
  • Extreme fatigue
  • Not enough energy
  • Reduced appetite
  • Upper right stomach region discomfort
  • Uncommon bruising or bleeding
  • The skin or eyes turning yellow
  • Flu-like signs
  • Seizures

Other negative effects of efavirenz are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Store it away from excessive heat and moisture at room temperature (not in the bathroom).

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medicines website at for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

  • Physical movements that are out of your control
  • Dizziness
  • Headache
  • Difficulty paying attention
  • Nervousness
  • Confusion
  • Forgetfulness
  • Having trouble falling or staying asleep
  • Strange dreams
  • Drowsiness
  • Hallucinations (seeing things or hearing sounds and voices that do not exist)
  • Unusual level of happiness
  • Strange ideas

What other information should I know?

Keep all of your appointments with your physician and the lab. To determine how well your body is responding to efavirenz, your doctor may request specific lab tests.

Inform the lab staff and your doctor that you are taking efavirenz prior to any laboratory test.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Sustiva®
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