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Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
efavirenz
Names: efavirenz, Sustiva™
Approved dosage: one orange 600mg tablet once a day or three orange 200mg capsules once a day.
Children: approved for use in children aged three years and above, who weigh more than 13kg. Oral solution available.
Tips on taking it: take with or without food. Avoid taking it with a high fat meal which
may increase absorption. If efavirenz causes confusion or dizziness, take before going to bed.
Common side-effects: dizziness, diarrhoea, headache, rash. Psychological effects, most common during the first four weeks of treatment, include feeling 'out of sorts', confusion, vivid dreams, euphoria, suicidal thoughts, psychotic episodes.
Rare side-effects: Stevens-Johnson Syndrome (very rare), alcohol intolerance, fever, asthma, aches and pains, fatigue, dry mouth, raised total cholesterol, pancreatitis, blurred vision.
Resistance to efavirenz: is likely to cause resistance to delavirdine (an NNRTI that is not licensed for use in the UK) and nevirapine.
Key drug interactions: alters blood levels of protease inhibitors. May interfere with oral contraceptives. Do not take efavirenz with hard gel saquinavir, St John’s wort, clarithromycin, terfenadine, astemizole, cisapride, triazolam, rifampicin and midazolam. Drug levels may be affected if taken with Viagra™, Cialis™, Levitra™, Zyban™ or rifabutin.
Brain: efavirenz crosses the blood-brain barrier and has some action against HIV in the brain and the central nervous system.
Pregnancy: efavirenz is not recommended during pregnancy or in people planning pregnancy.
nevirapine
Names: nevirapine, Viramune™
Approved dosage: one white 200mg tablet once a day for the first two weeks and then one 200mg tablet twice a day thereafter. Men should not start treatment with nevirapine if their CD4 cell count is above 400, women should not start treatment with nevirapine if their CD4 cell count is above 250 as this increases the risk of potentially dangerous side-effects.
Experimental dosage: two white 200mg tablets once a day. This is not normally recommended within the first two months of taking nevirapine.
Children: syrup available.
Tips on taking it: take with or without food.
Common side-effects: rash, fatigue, liver problems, muscle pain, depression.
Rare side-effect: Stevens-Johnson Syndrome.
Resistance to nevirapine: is likely to cause resistance to delavirdine (an NNRTI that is not licensed in the UK) and efavirenz.
Key drug interactions: drug levels may be affected if nevirapine is taken with a number of drugs including atazanavir, indinavir, lopinavir/ritonavir, ketoconazole, Cialis™, Viagra™, LevitraTM. Nevirapine may reduce the effectiveness of oral contraceptives. Drugs that may worsen side-effects are clarithromycin, erythromycin and amoxicillin. Do not take
with St John’s wort.
Brain: nevirapine may have some effect against HIV in the brain.
Names: efavirenz, Sustiva™
Approved dosage: one orange 600mg tablet once a day or three orange 200mg capsules once a day.
Children: approved for use in children aged three years and above, who weigh more than 13kg. Oral solution available.
Tips on taking it: take with or without food. Avoid taking it with a high fat meal which
may increase absorption. If efavirenz causes confusion or dizziness, take before going to bed.
Common side-effects: dizziness, diarrhoea, headache, rash. Psychological effects, most common during the first four weeks of treatment, include feeling 'out of sorts', confusion, vivid dreams, euphoria, suicidal thoughts, psychotic episodes.
Rare side-effects: Stevens-Johnson Syndrome (very rare), alcohol intolerance, fever, asthma, aches and pains, fatigue, dry mouth, raised total cholesterol, pancreatitis, blurred vision.
Resistance to efavirenz: is likely to cause resistance to delavirdine (an NNRTI that is not licensed for use in the UK) and nevirapine.
Key drug interactions: alters blood levels of protease inhibitors. May interfere with oral contraceptives. Do not take efavirenz with hard gel saquinavir, St John’s wort, clarithromycin, terfenadine, astemizole, cisapride, triazolam, rifampicin and midazolam. Drug levels may be affected if taken with Viagra™, Cialis™, Levitra™, Zyban™ or rifabutin.
Brain: efavirenz crosses the blood-brain barrier and has some action against HIV in the brain and the central nervous system.
Pregnancy: efavirenz is not recommended during pregnancy or in people planning pregnancy.
nevirapine
Names: nevirapine, Viramune™
Approved dosage: one white 200mg tablet once a day for the first two weeks and then one 200mg tablet twice a day thereafter. Men should not start treatment with nevirapine if their CD4 cell count is above 400, women should not start treatment with nevirapine if their CD4 cell count is above 250 as this increases the risk of potentially dangerous side-effects.
Experimental dosage: two white 200mg tablets once a day. This is not normally recommended within the first two months of taking nevirapine.
Children: syrup available.
Tips on taking it: take with or without food.
Common side-effects: rash, fatigue, liver problems, muscle pain, depression.
Rare side-effect: Stevens-Johnson Syndrome.
Resistance to nevirapine: is likely to cause resistance to delavirdine (an NNRTI that is not licensed in the UK) and efavirenz.
Key drug interactions: drug levels may be affected if nevirapine is taken with a number of drugs including atazanavir, indinavir, lopinavir/ritonavir, ketoconazole, Cialis™, Viagra™, LevitraTM. Nevirapine may reduce the effectiveness of oral contraceptives. Drugs that may worsen side-effects are clarithromycin, erythromycin and amoxicillin. Do not take
with St John’s wort.
Brain: nevirapine may have some effect against HIV in the brain.