Efavir

🧠 Introduction to Efavir

Efavir by Cipla contains Efavirenz, a non-nucleoside reverse transcriptase inhibitor (NNRTI) for HIV-1 treatment. Key features:

• 🧠 High CNS penetration → Effective in viral load suppression

• 🌙 Must be taken at bedtime (reduces neuropsychiatric impact)

• ⚠️ Black-box warning for severe psychiatric reactions

• 🚫 Contraindicated in pregnancy (Category D teratogen)

Cipla’s 30-tablet bottle provides a full month’s supply for combination ART. Used with NRTIs like Tenofovir+Emtricitabine, it forms the backbone of regimens like Viraday.

💊 Dosage & Indications

⚠️ Side Effects, Storage & Warnings

• ❗ Common Side Effects:

  • Dizziness (52%)

  • Vivid dreams (48%)

  • Rash (30%)

• 🚫 Serious Effects:

  • Severe depression/suicidal ideation

  • Stevens-Johnson syndrome

  • False-positive cannabinoid tests

• ❄️ Storage: 15–30°C; keep bottle tightly closed (desiccant included).

• ⚠️ Critical Warnings:

  • Contraindicated with elbasvir/grazoprevir

  • Pregnancy test before initiation (women)

  • Neuropsychiatric evaluation baseline & monthly

🌍 Global Availability & Shipping

🔗 Related Indian Alternatives (Different in Same Category)

📚 External Medical References

1. WHO: HIV NNRTI Guidelines 2023

2. FDA: Sustiva Black Box Warning

3. DHHS: Efavirenz Neuropsychiatric Management

🩺 Expert Commentary

Dr. Arjun Nair, HIV Specialist:
“Efavir remains cost-effective but requires careful patient selection. I avoid it in pilots, drivers, or those with depression history. For such cases, [dolutranz] (Dolutegravir-based) is preferable. Cipla’s amber bottle protects against light degradation – never transfer tablets to pill organizers.”

📌 Disclaimer

This information is not medical advice. Use under physician supervision. Cipla’s Efavir carries black-box warnings for severe psychiatric adverse reactions and fetal harm.

💡 Clinical Protocol:

• Neuropsychiatric Management:

  Symptom	Action
  Mild dizziness	Reassurance + take 2h before bedtime
  Insomnia	Temporary melatonin 3mg
  Suicidal thoughts	IMMEDIATE DISCONTINUATION

• Bottle Specifications:

  • Amber HDPE bottle with UV filter

  • Tablet ID:

    • 200mg: “EFV200”

    • 600mg: “EFV600”

  • Silica gel canister (do not eat)

• Drug Interactions:

  Concomitant Drug	Risk	Action
  Rifampicin	↓ Efavirenz levels 25%	Increase to 800mg/day
  Voriconazole	↑ Efavirenz toxicity	Contraindicated
  Ethinyl Estradiol	↓ Contraceptive effectiveness	Use barrier methods

• Pregnancy Protocol:

  • Confirm negative pregnancy test before initiation

  • Two forms of contraception during therapy

  • Switch to alternative if pregnancy occurs