Overview
What is Efavirenz?
Efavirenz (EFV) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used in combination with other antiretrovirals to treat HIV-1. It is typically taken once daily at bedtime due to neuropsychiatric side effects that diminish during sleep.
Mechanism
How Does It Work?
1
NNRTI binding
Efavirenz binds directly to HIV reverse transcriptase at a site adjacent to the active site, causing a conformational change.
2
Enzyme inhibition
The conformational change inhibits RNA-dependent and DNA-dependent DNA polymerase activity, blocking viral DNA synthesis.
3
Viral suppression
Without reverse transcriptase, HIV cannot convert its RNA genome to DNA, halting replication inside CD4+ T cells.
Dosage
How to Use
Timing
Once daily, preferably at bedtime
How to Take
Swallow capsule or tablet whole. Take on an empty stomach — a high-fat meal increases exposure and side effects.
With Food
Take on an empty stomach or with a light meal. Avoid high-fat meals.
Alcohol
Avoid alcohol — worsens CNS side effects
Missed Dose
Take as soon as remembered. If within 4 hours of next dose, skip. Never double dose.
Safety
Side Effects & Precautions
Common Side Effects
- Dizziness
- Vivid dreams / nightmares
- Difficulty concentrating
- Rash (usually mild)
- Nausea
Serious Side Effects — seek help immediately
- Severe rash (Stevens-Johnson syndrome — rare)
- Serious psychiatric symptoms (depression, suicidal ideation)
- Liver toxicity (monitor LFTs)
- Immune Reconstitution Inflammatory Syndrome (IRIS)
Who Should Not Take This
- Concurrent use of voriconazole (standard doses)
- Severe hepatic impairment
- First trimester of pregnancy (avoid if possible — teratogenic risk)
Value
Generic vs Brand
Generic (OnlineMeds)
Sustiva / Stocrin
Price per unit
$55.00
$500–$800/month
Active ingredient
Identical
Identical
Storage
Storage & Handling
Light
Keep in original packaging
Children
Keep out of reach of children.
Why OnlineMeds
Why Buy From Us
Manufacturer Direct
Sourced directly from licensed pharmaceutical manufacturers.
Quality Verified
Every batch tested for purity and bioequivalence.
Global Delivery
Discreet shipping to UK, US, AU, EU and beyond.
Licensed Pharmacy
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FAQ
Frequently Asked Questions
Is Efavirenz the same as Sustiva?
Efavirenz is the active ingredient in Sustiva. A generic Efavirenz medicine contains the same active ingredient at the same strength and is taken the same way — the main difference is cost. Always use it as prescribed by a licensed medical professional.
Why do I need to take Avonza Tablet at bedtime?
Efavirenz causes dizziness and vivid dreams in many patients, especially during the first few weeks. Taking it at bedtime means you sleep through most side effects. They typically lessen after 2–4 weeks.
Can Efavirenz cause mood changes?
Yes. Efavirenz is known to cause neuropsychiatric effects including depression, anxiety, and rarely suicidal thoughts. Report any persistent mood changes to your doctor immediately.
Is Avonza Tablet safe to take during pregnancy?
Efavirenz should be avoided in the first trimester if possible due to evidence of neural tube defects in animal studies. Discuss alternatives with your HIV specialist if you are pregnant or planning a pregnancy.
How long before Efavirenz controls my viral load?
Most patients achieve significant viral suppression within 12–24 weeks. Consistent daily dosing without missed doses is essential for long-term virological success.
Drug Interactions
| Drug / Substance | Effect | Action |
| Voriconazole |
EFV dramatically reduces voriconazole levels; EFV levels increase |
Contraindicated at standard doses |
| Rifampicin |
Reduces EFV plasma levels by ~26% |
Increase EFV dose to 800mg if ≥50kg |
| Hormonal contraceptives |
EFV may reduce contraceptive efficacy |
Use barrier contraception in addition |
Approved Indications
-
HIV-1 infection in adults and children ≥3 months FDA / EMA
References
-
Bristol-Myers Squibb. Sustiva (efavirenz) prescribing information. ↗
Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any medication. Used as prescribed by a licensed medical professional.