EFAVIRENZ = EFV = EFZ oral

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:

WeightDoseTablets or capsules
10 to < 14 kg200 mg1 tab 200 mg or 1 cap 200 mg
14 to < 25 kg300 mg1 tab 200 mg + ½ tab 200 mg
25 to < 40 kg400 mg2 tab 200 mg or 2 cap 200 mg
≥ 40 kg400 mg or 600 mg2 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 -  -