Basic Sustiva Information

• International Nonproprietary Name (INN): Efavirenz
• Brand names available in Australia: Sustiva (discontinued brand in U.S.); Stocrin (Australia)
• ATC Code: J05AG03
• Forms & dosages: Tablets (600 mg), Capsules (50 mg, 100 mg, 200 mg)
• Manufacturers in Australia: Various generic suppliers including Mylan, Cipla, and more
• Registration status in Australia: Registered and prescribed for HIV treatment
• OTC / Rx classification: Prescription-only (Rx)

Morning Vs Evening Dosing (Australian Daily Routines)

Determining when to take Sustiva (efavirenz) could significantly influence daily energy levels and overall success of treatment. Many Australians find that morning dosing fits better with their routine. For those who experience drowsiness as a side effect, taking Sustiva at night may be more suitable. According to TGA recommendations, keeping a consistent dosing time is crucial for maintaining steady blood levels of efavirenz. This regularity helps ensure that the medication effectively controls HIV viral loads. A quick shift in dosing time can sometimes lead to fluctuations in therapeutic levels, so consistency is key.

Standard Practices for Dosing

• Consider personal energy patterns when deciding on morning or evening dosing.
• Stick to the same time every day for optimal results.
• Consult with healthcare providers to adjust based on personal schedules.

Taking With Or Without Meals

Food intake can have a profound impact on the absorption of Sustiva. Taking efavirenz on an empty stomach may enhance its absorption, making it more effective. However, for those who experience gastrointestinal upset, taking the medication with a light meal may help ease these side effects. Here are some practical tips for meal timing related to your Sustiva doses:

• Take Sustiva at least 1 hour before eating or 2 hours after eating for optimal absorption.
• If gastrointestinal upset is an issue, consider a light meal that is low in fat to accompany the dose.
• Avoid high-fat meals, as they can significantly reduce the medication's effectiveness.
• Plan your meals and doses to maintain a structured daily schedule.

Safety Priorities

Understanding who should avoid efavirenz is crucial for ensuring patient safety. Authorities like the TGA provide guidance on which demographics are at increased risk when using this medication. It’s essential to know these vital safety precautions to prevent serious health complications and ensure effective treatment.

Who should avoid it (TGA safety notices)

Certain populations are recommended to avoid using efavirenz due to its potential adverse effects. These include:

• Individuals with hypersensitivity to efavirenz or its excipients.
• People with a history of psychiatric disorders, such as severe depression or psychosis.
• Patients taking medications that interact significantly with efavirenz, such as elbasvir/grazoprevir (Zepatier), which can lead to harmful side effects.
• Those with severe hepatic impairment, as efavirenz is metabolised in the liver.
• Pregnant women, particularly in the first trimester, due to risk of fetal harm.

Monitoring is crucial for these groups to prevent potentially severe side effects associated with efavirenz.

Activities to limit (driving, machinery, workplace safety)

Efavirenz can lead to side effects such as dizziness, impaired concentration, and vivid dreams. These effects can significantly impact daily activities like driving or operating heavy machinery. Hence, engaging in tasks that require high levels of focus and coordination should be approached with caution.

To manage these risks at work and home:

• Regularly assess mental clarity and physical coordination before undertaking complex tasks.
• Consider discussing job roles with supervisors; adjustments or support may be necessary.
• If dizziness occurs, plan to remain seated until the sensation fades away.
• Develop a routine sleep schedule to help mitigate insomnia risks.

Implementing these practical safety measures can help individuals navigate daily life more comfortably while on efavirenz treatment. Knowledge of its effects can foster a safer environment both at home and in the workplace.

Dosage & Adjustments

General regimen (PBS-listed guidelines)

When managing HIV treatment, accurate dosing of efavirenz, marketed as Sustiva, is essential for effectiveness and patient safety. The standard dosage for adults and children is detailed below.

The standard forms available in the market include:

• Tablets: 600 mg (adult dose)
• Capsules: 50 mg, 100 mg, 200 mg (for paediatric dosing)

Special cases (elderly, Indigenous health, comorbidities)

Adjustments in dosing are sometimes necessary, particularly for special demographics. Elderly patients may experience heightened sensitivity to efavirenz due to age-related factors.

Key points for consideration include:

• Children: Should receive weight-based dosing with careful monitoring.
• Elderly patients: No fixed adjustments; however, increased monitoring for CNS effects is advised.
• Liver and kidney impairment: Specific caution is warranted. For those with moderate to severe liver dysfunction, a dosage adjustment or alternative treatment may be necessary. Generally, no adjustments are required for kidney issues, as renal clearance is minimal.

Indigenous health considerations should encompass cultural sensitivities and potential genetic factors that could affect drug metabolism, requiring individual assessment and potential dose adjustments.

Lastly, comorbidities, such as psychiatric disorders or severe hepatic impairment, necessitate cautious monitoring and possibly avoided medication use. Patients with a history of seizures or those currently experiencing psychiatric conditions should be closely observed while on Sustiva.

Delivery Options for Sustiva