Drug Name
Sustiva (Efavirenz)

Drug Uses
This medication is used to treat HIV infection in combination with other anti-HIV medications. If sustiva is the only drug you take to treat HIV infection, it may stop working. Consult your doctor or pharmacist for more details.

How to use
Take this drug by mouth, generally once daily as directed. Take on an empty stomach with a glass of water. Taking sustiva with food, especially a high-fat meal can lead to increased blood levels of the drug and increase your risk of having side effects. Best taken at bedtime during the first month of use. Using this drug regularly at bedtime may decrease certain side effects. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day. Do not take more or less of this drug than prescribed, or stop taking it unless directed to do so by your doctor. Read the patient information leaflet provided by your pharmacist.

Drug Class and Mechanism
Sustiva is an oral medication that is used for the treatment of infections with the human immunodeficiency virus (HIV). It is similar to nevirapine (Viramune) and delavirdine (Rescriptor). Sustiva is in a class of drugs called reverse transcriptase inhibitors which also includes zalcitabine (Hivid), zidovudine (Retrovir), didanosine (Videx), and lamivudine (Epivir). During infection with HIV, the HIV virus multiplies within the body's cells. The newly-formed viruses then are released from the cells and spread throughout the body where they infect other cells. In this manner, the infection continually spreads to new, uninfected cells that the body is continually producing, and HIV infection is perpetuated. When producing new viruses, the HIV virus must manufacture new DNA for each virus. Reverse transcriptase is the enzyme that the virus uses to form this new DNA. Sustiva directly inhibits the activity of reverse transcriptase and blocks the production of DNA and new viruses. Unlike zidovudine, efavirenz does not need to be converted to an active form. Sustiva does not kill existing HIV virus and it is not a cure for HIV.

Missed Dose
If you miss a dose, use it as soon as you remember. If it is within 2 hours of the next dose, skip the missed dose and resume your usual dosing schedule. It is important not to miss doses of this drug.

Storage
Store at room temperature (77 degrees F/25 degrees C). Storage for brief periods at 59-86 degrees F (15-30 degrees C) is permitted.

Warnings/Precautions
Tell your doctor your medical history, including: allergies, mental disorders, liver disease (such as hepatitis). Limit alcohol intake, as it may intensify drug side effects. Caution when performing tasks requiring alertness (e.g., driving), since this drug may cause dizziness, drowsiness or unsteadiness. Women in the childbearing years should have a pregnancy test before using this drug. Pregnancy should be avoided while using this drug. Barrier-type (latex condom) birth control should always be used along with other methods of birth control (such as birth control pills). If already pregnant, use this drug only when clearly needed. Discuss the risks and benefits with your doctor. It is not known whether this drug is excreted into breast milk. Avoid breast-feeding because breast milk can transmit HIV. Consult your doctor or pharmacist for any questions. Caution is advised when using this drug in children, as this group may be more likely to develop rash.

Possible Side Effects
Dizziness, drowsiness or trouble sleeping may occur. If these effects persist or worsen, notify your doctor promptly. Report promptly: skin rash. Unlikely but report promptly: mood/mental changes (e.g., depression, and in rare cases, thoughts of suicide), dark urine, stomach pain, yellowing eyes or skin, fever. Very unlikely but report promptly: seizures. Some side effects (such as dizziness, drowsiness, certain mental changes) may decrease as your body adjusts to the drug. Changes in body fat may occur while you are taking this medication (e.g., increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of therapy with your doctor, as well as the possible role of exercise to reduce this side effect. If you notice other effects not listed above, contact your doctor or pharmacist.

More Information
This product is not a cure for HIV infection but has shown positive results. The long-term effects are unknown at this time. Keep all doctor appointments and scheduled laboratory tests (e.g., liver function) as your condition will be checked closely. Be aware that this product does not reduce the risk of passing the virus to others through sexual contact or blood contamination. This is a potent product which should not be shared. Do not allow anyone else to use your medication.