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Efavirenz-lamiVUDine-Tenofovir
Efavirenz-lamivudine-tenofovir is a combination medication used for the treatment of HIV-1 infection. This combination includes three antiretroviral drugs: efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI); lamivudine, a nucleoside reverse transcriptase inhibitor (NRTI); and tenofovir disoproxil fumarate, another NRTI. Together, they work to reduce the amount of HIV in the blood, helping to improve the immune system and reduce the risk of complications related to HIV infection. This medication is usually prescribed as part of a highly active antiretroviral therapy (HAART) regimen.
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Frequently Asked Questions
Can I take efavirenz-lamivudine-tenofovir if I am pregnant?
Efavirenz is not recommended during pregnancy, especially in the first trimester, due to the potential risk of birth defects. Discuss alternative treatments with your healthcare provider if you are pregnant or planning to become pregnant.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and take your next dose at the regular time. Do not double up on doses.
Can efavirenz-lamivudine-tenofovir cure HIV?
This medication does not cure HIV but helps manage the virus by reducing its replication and slowing the progression of the disease. It is important to continue taking the medication as prescribed even if you feel well.
Are there any foods I should avoid while taking this medication?
It is recommended to take efavirenz-lamivudine-tenofovir on an empty stomach to minimize the risk of side effects like dizziness. Avoid high-fat meals, as they can increase the absorption of efavirenz and heighten its side effects.
How will this medication affect my mental health?
Efavirenz can cause side effects such as vivid dreams, insomnia, depression, and other psychiatric symptoms in some patients. If you experience mood changes or thoughts of self-harm, contact your healthcare provider immediately.
Comprehensive Drug Guide
How Does Efavirenz-lamiVUDine-Tenofovir Work?
- Efavirenz binds directly to reverse transcriptase, inhibiting its function.
- Lamivudine and tenofovir mimic the natural building blocks of DNA, but when incorporated into the viral DNA, they stop the replication process. Together, they prevent the virus from multiplying, which helps reduce the viral load in the body.
Common Dosages
Efavirenz-lamivudine-tenofovir is typically available in fixed-dose combination tablets containing:
- Efavirenz 600 mg
- Lamivudine 300 mg
- Tenofovir disoproxil fumarate 300 mg
Typical Dosing
- The usual adult and adolescent dose is one tablet once daily, taken on an empty stomach, usually at bedtime. This helps to reduce side effects like dizziness and drowsiness caused by efavirenz.
- The medication should be taken at the same time every day to maintain effective drug levels in the body.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and adolescents (aged 12 years and older) who weigh at least 40 kg (88 lbs).
- It is commonly used as part of a complete antiretroviral therapy regimen for HIV infection.
Who Shouldn't Take Efavirenz-lamiVUDine-Tenofovir?
- Known hypersensitivity to efavirenz, lamivudine, tenofovir, or any component of the medication
- Severe liver disease or impaired liver function
- Concurrent use of certain medications, such as voriconazole, due to drug interactions
Advice From The Pharmacist
- Take the medication on an empty stomach, preferably at bedtime to minimize side effects like dizziness and nausea.
- Consistently follow the prescribed dosing schedule to avoid drug resistance.
- Regular monitoring of liver function and kidney function is important while taking this medication.
- Women who are pregnant or planning to become pregnant should discuss the risks with their healthcare provider, as efavirenz has been associated with birth defects.
Side Effects of Efavirenz-lamiVUDine-Tenofovir
Common Side Effects
- Dizziness or drowsiness (particularly with efavirenz)
- Nausea
- Diarrhea
- Headache
- Insomnia or vivid dreams
Uncommon/Severe Side Effects
- Lactic acidosis: A rare but serious build-up of lactic acid in the blood, which can be life-threatening
- Liver toxicity
- Kidney problems
- Depression or psychiatric symptoms (including suicidal thoughts)
- Bone density loss (associated with tenofovir)
Risks and Warnings of Efavirenz-lamiVUDine-Tenofovir
- Lactic Acidosis and Severe Hepatomegaly: NRTIs like lamivudine and tenofovir have been associated with lactic acidosis and liver enlargement. Patients with pre-existing liver conditions should be closely monitored.
- Psychiatric Symptoms: Efavirenz has been associated with psychiatric symptoms such as depression, anxiety, and hallucinations. Patients with a history of mental health issues should use this medication with caution.
- Renal Impairment: Tenofovir may cause kidney damage, especially in patients with pre-existing kidney issues or those taking other nephrotoxic medications.
- Bone Health: Long-term use of tenofovir may result in decreased bone mineral density, increasing the risk of fractures. Bone health should be monitored in patients taking this drug.
Interactions with Efavirenz-lamiVUDine-Tenofovir
Common Drug Interactions
- CYP3A4 Substrates: Efavirenz is a potent inducer of CYP3A4, which may reduce the effectiveness of drugs metabolized by this enzyme, including oral contraceptives, warfarin, and certain antifungal medications.
- Other Antiretroviral Drugs: Concurrent use with certain other antiretrovirals may increase the risk of side effects or reduce the effectiveness of the treatment.
- Rifampin: This medication, used to treat tuberculosis, can reduce efavirenz levels, requiring a dosage adjustment.
Alternatives to Efavirenz-lamiVUDine-Tenofovir
- Atripla (Efavirenz/Emtricitabine/Tenofovir): A similar combination medication for the treatment of HIV-1.
- Triumeq (Dolutegravir/Abacavir/Lamivudine): An alternative for HIV treatment that does not contain efavirenz.
- Biktarvy (Bictegravir/Emtricitabine/Tenofovir): A newer fixed-dose combination therapy for HIV with fewer neuropsychiatric side effects.
- Genvoya (Elvitegravir/Cobicistat/Emtricitabine/Tenofovir): Another combination HIV medication with a lower risk of bone and kidney problems compared to tenofovir disoproxil fumarate.
