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Symfi Lo
Symfi Lo is a combination medication containing efavirenz, lamivudine, and tenofovir disoproxil fumarate. It is used in the treatment of HIV-1 infection in adults and pediatric patients weighing at least 35 kg. Symfi Lo combines three antiretroviral drugs into a single tablet, helping to suppress the virus, reduce viral load, and improve immune function. This combination is part of highly active antiretroviral therapy (HAART) for managing HIV infection and delaying the progression to AIDS.
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Frequently Asked Questions
Can I take Symfi Lo with food?
It is recommended to take Symfi Lo on an empty stomach because food increases the absorption of efavirenz, which can lead to more side effects such as dizziness and drowsiness.
What should I do if I miss a dose of Symfi Lo?
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
How long does it take for Symfi Lo to work?
Symfi Lo works to reduce the viral load in HIV patients, and improvements in viral load and immune function may be seen within a few weeks to months. Regular blood tests will monitor your progress.
Can I stop taking Symfi Lo if I feel better?
No, it is important to continue taking Symfi Lo as prescribed, even if you feel better. Stopping the medication can lead to the development of drug resistance and a resurgence of the virus.
Can Symfi Lo cause mood changes?
Yes, efavirenz, one of the components of Symfi Lo, can cause mood changes, including depression, anxiety, and even suicidal thoughts in some patients. Notify your healthcare provider if you experience severe mood changes or suicidal thoughts.
Comprehensive Drug Guide
How Does Symfi Lo Work?
Symfi Lo works by targeting reverse transcriptase, an enzyme crucial to the replication of the HIV virus. Efavirenz (NNRTI) binds directly to reverse transcriptase and disrupts the enzyme's function. Lamivudine and tenofovir (NRTIs) mimic natural nucleosides, becoming incorporated into the viral DNA chain and halting its synthesis. Together, these actions prevent HIV from replicating and spreading, helping to reduce the viral load and improve the body's immune response.
Common Dosages
- Efavirenz 400 mg / Lamivudine 300 mg / Tenofovir disoproxil fumarate 300 mg tablets.
Typical Dosing
- For HIV-1 infection: The recommended dose is one tablet taken orally once daily, preferably on an empty stomach, usually at bedtime to reduce the risk of side effects like dizziness or drowsiness.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and pediatric patients weighing at least 35 kg.
Who Shouldn't Take Symfi Lo?
- Hypersensitivity to efavirenz, lamivudine, tenofovir, or any of the components of Symfi Lo.
- Severe liver disease, including decompensated cirrhosis.
Advice From The Pharmacist
- Take Symfi Lo on an empty stomach, as food can increase efavirenz concentrations and lead to more side effects like dizziness or drowsiness. It's usually taken at bedtime to help minimize these effects.
- Avoid alcohol and recreational drugs, as they can worsen side effects, particularly those related to the central nervous system, such as dizziness, drowsiness, or mood changes.
- Do not stop taking Symfi Lo without consulting your doctor, as stopping the medication could lead to resistance and reduce the effectiveness of the treatment.
- Monitor your kidney and liver function regularly, as tenofovir and efavirenz can impact these organs, particularly in patients with pre-existing conditions.
- Use effective contraception if you are a woman of childbearing potential, as efavirenz can cause birth defects.
Side Effects of Symfi Lo
Common Side Effects
- Dizziness
- Drowsiness
- Nausea
- Headache
- Trouble sleeping (insomnia)
- Mood changes (depression, anxiety)
Uncommon/Severe Side Effects
- Liver damage: Symptoms include jaundice (yellowing of the skin or eyes), dark urine, or abdominal pain.
- Kidney problems: Tenofovir may cause kidney damage, and symptoms include changes in urine output or swelling.
- Bone loss: Long-term use of tenofovir can lead to a decrease in bone mineral density.
- Lactic acidosis: A rare but serious buildup of lactic acid in the blood, which can cause muscle pain, weakness, difficulty breathing, and fatigue.
Risks and Warnings of Symfi Lo
- CNS Side Effects: Efavirenz can cause central nervous system side effects, including dizziness, drowsiness, vivid dreams, and hallucinations. These effects are more common when starting the medication but often decrease over time.
- Liver Toxicity: Symfi Lo can cause hepatotoxicity, especially in patients with underlying liver conditions. Regular monitoring of liver function is recommended.
- Renal Toxicity: Tenofovir can cause kidney damage, especially in patients with pre-existing renal conditions. Regular kidney function tests are necessary during treatment.
- Lactic Acidosis: Symfi Lo may cause a rare but serious condition called lactic acidosis, which can be life-threatening. Symptoms include unusual muscle pain, trouble breathing, stomach pain, and weakness.
Interactions with Symfi Lo
Common Drug Interactions
- CYP3A4 inhibitors/inducers: Efavirenz is metabolized by the liver enzyme CYP3A4. Medications that inhibit or induce CYP3A4 can affect efavirenz levels in the blood. These include medications like ritonavir, ketoconazole, and rifampin.
- Other antiretrovirals: Avoid combining Symfi Lo with other antiretrovirals that contain the same ingredients (efavirenz, lamivudine, or tenofovir) to prevent overdose.
- Herbal supplements: St. John's Wort, a common herbal supplement, can reduce the effectiveness of Symfi Lo by decreasing efavirenz levels in the blood.
Alternatives to Symfi Lo
- Atripla (efavirenz / emtricitabine / tenofovir disoproxil fumarate): A similar single-tablet regimen used to treat HIV-1.
- Biktarvy (bictegravir / emtricitabine / tenofovir alafenamide): Another combination HIV medication, often used for initial HIV therapy.
- Triumeq (dolutegravir / abacavir / lamivudine): Another option for treating HIV, containing an integrase inhibitor and two NRTIs.
- Genvoya (elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide): A single-tablet regimen for HIV treatment with a different combination of drugs.
