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Precautions and Warnings With Efavirenz

Understanding precautions and warnings with efavirenz can help minimize risks. Before starting the drug, tell your healthcare provider if you have high cholesterol or triglycerides, liver disease, or any allergies. Precautions and warnings with efavirenz also apply to people who are allergic to any components of the medicine or who are taking certain drugs that may interact with it.

Efavirenz: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking efavirenz (Sustiva®) if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Efavirenz

Warnings and precautions to be aware of prior to taking efavirenz include the following:
 
  • Efavirenz can interact with several different medications. Many of these interactions are quite dangerous. Make sure that all of your healthcare providers know that you are taking efavirenz, and make sure to check with your healthcare providers before starting or stopping any new medications (see Drug Interactions With Efavirenz).
     
  • Efavirenz can cause psychiatric problems, including anxiety, depression, aggressiveness, and suicidal thoughts or behavior. Tell your healthcare provider immediately if you are experiencing any psychiatric-related side effects of efavirenz.
     
  • The medication can cause dizziness, drowsiness, and problems concentrating. Make sure you know how efavirenz affects you before driving, operating heavy machinery, or consuming alcoholic beverages.
     
  • Efavirenz often causes harmless skin rashes. However, if you have a rash with blisters, loss of skin, a fever, or mouth sores, be sure to tell your healthcare provider immediately, as this may be a sign of a life-threatening reaction to the medication.
     
  • If you have liver disease (especially hepatitis), high liver enzymes, or are taking other drugs that can damage the liver, your healthcare provider should monitor your liver function using regular blood tests to make sure that efavirenz is not causing further liver damage. Also, you may need a lower efavirenz dosage, since the liver helps to remove the drug from the blood.
     
  • Efavirenz may increase your risk for seizures. Make sure your healthcare provider knows if you have epilepsy or a history of seizures.
     
  • The medication may increase your triglyceride or cholesterol level. Your healthcare provider should monitor your cholesterol and triglycerides while you are taking efavirenz.
     
  • Efavirenz can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
     
  • There have been a few reports of efavirenz causing false-positive drug tests for marijuana.
     
  • Efavirenz is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, whether or not you are taking medications.
     
  • As with all HIV medications, it is important that you take efavirenz exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
     
  • Efavirenz is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy, although the full risks are not known (see Sustiva and Pregnancy).

Women able to have children must have a pregnancy test before starting efavirenz and must use a barrier contraceptive (such as condoms), even if other forms of birth control, such as birth control pills, are used. Women must continue to use birth control for 12 weeks after stopping efavirenz, because the medication remains in the blood for quite a while after the medication is stopped. 

  • It is not known whether efavirenz passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Sustiva and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.
     

Efavirenz for HIV/AIDS

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