EFAVIRENZ = EFV = EFZ oral

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    Last updated: November 2022

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antiretroviral, HIV-1 non nucleoside reverse transcriptase inhibitor

    Indications

    • HIV-1 infection, in combination with other antiretrovirals

    Forms and strengths

    • 200 mg breakable tablet, 200 mg capsule and 600 mg tablet

    Dosage

    The daily dose is administered once daily at bedtime, on an empty stomach.

    • Child 3 years and over and adult:

     

    Weight Daily dose Tablets or capsules
    10 to < 14 kg 200 mg

    1 tab 200 mg

    or 1 cap 200 mg
    14 to < 25 kg 300 mg 1 tab 200 mg + ½ tab 200 mg
    25 to < 35 kg 400 mg

    2 tab 200 mg

    or 2 cap 200 mg
    ≥ 35 kg

    400 mg

    or 600 mg

    2 tab 200 mg

    or 2 cap 200 mg

    or 1 tab 600 mg

     

    Duration

    • Depending on the efficacy and tolerance of efavirenz.

    Contra-indications, adverse effects, precautions

    • Do not administer to children under 3 years and to patients with severe hepatic impairment. 
    • Do not combine with amodiaquine (risk of hepatotoxicity).
    • Administer with caution to patients with psychiatric disorders (or history of) or epilepsy.
    • Administer with caution and monitor combination with:
      • central nervous system depressants (opioids, benzodiazepines, phenobarbital, etc.), carbamazepine, phenytoin, oral anticoagulants;
      • QT prolonging drugs (amiodarone, co-artemether, mefloquine, quinine, haloperidol, etc.). 
    • May cause:
      • neuropsychiatric disorders: dizziness, headache, insomnia, drowsiness, abnormal dreaming, anxiety, aggressive behaviour, impaired concentration, seizures, depression, suicidal ideation;
      • hepatotoxicity and gastrointestinal disturbances;
      • skin reactions, possibly severe (Stevens-Johnson syndrome).
    • Efavirenz reduces the efficacy of implants and oral contraceptives: use injectable medroxyprogesterone or an intrauterine device.
    • Pregnancy: no contra-indication

    Remarks

    • Capsules can be opened and their content mixed into a spoon with a small amount of food.
    • Also comes in fixed-dose combinations (tenofovir/emtricitabine /efavirenz or tenofovir/lamivudine/efavirenz). Preferably use these formulations when available.

    Storage

     
    –  
     
    –  Below 25 °C​
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