EFAVIRENZ = EFV = EFZ oral

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    Last updated: September 2021

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antiretroviral, HIV-1 non nucleoside reverse transcriptase inhibitor

    Indications

    • HIV-1 infection, in combination with other antiretroviral drugs

    Forms and strengths

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

    Dosage

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

    • Child 3 years and over and adult:

     

    Weight 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 < 40 kg 400 mg 2 tab 200 mg or 2 cap 200 mg
    ≥ 40 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.
    • Avoid combination with amodiaquine and drugs that prolong QT interval: amiodarone, bedaquiline, chloroquine, clarithromycin, co-artemether, fluconazole, haloperidol, hydroxyzine, mefloquine, moxifloxacin, ondansetron, pentamidine, quinine, etc.
    • Administer with caution to patients with psychiatric disorders (or history of) or epilepsy.
    • Monitor combination with central nervous system depressants (opioids, benzodiazepines, phenobarbital, etc.), carbamazepine, phenytoin, oral anticoagulants.
    • 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 effectiveness of implants and oral contraceptives: use an intrauterine device (copper or levonorgestrel) or a progestogen-only injectable (medroxyprogesterone).
    • 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