HIV Management

Sustiva

Efavirenz

Sustiva is generic efavirenz in 200mg and 600mg tablets, a once-daily HIV medicine taken as part of combination treatment to keep the virus under control.

All strengths and pack prices
Sustiva: price of every strength and pack size
Strength Pack Price
200mg 30 tablets $151.20
200mg 60 tablets $253.80
200mg 90 tablets $357.30
200mg 120 tablets $464.40
600mg 30 tablets $340.20
600mg 60 tablets $616.80
600mg 90 tablets $765.00
600mg 120 tablets $968.40
600mg 180 tablets $1,377.00
Category
HIV Management
Active ingredient
Efavirenz
Route
Oral
Form
Capsule, Tablet
Strengths
200/600mg

You will receive a quality generic equivalent, depending on stock.

Shipped in a discreet, unmarked envelope.

Details

Conditions
HIV treatment
Therapeutic Class
NNRTI
Pharmacological Class
Antiviral
Minor Side Effects
Dizziness, Vivid dreams
Moderate Side Effects
Skin rash, Insomnia
Dosage Forms
Capsule, Tablet
Administration Route
Oral
Originator
Bristol-Myers Squibb
Onset Time
Individual response varies
Duration
24 hours
Storage Instructions
Store at room temperature.
Drug Interactions
St. John's wort, Midazolam
Age Restrictions
Weight-based dosing.

What you will receive

Sustiva is the originator brand name, made by Bristol-Myers Squibb. We use it to identify the medicine; the pack you receive is a generic equivalent, not the original Sustiva.

  • The same active ingredient (Efavirenz) at the same strength.
  • The exact brand supplied depends on what is in stock when your order ships.

FAQ

Which Sustiva strengths and pack sizes can I order?

Sustiva tablets come in 200mg and 600mg. The 200mg strength comes in packs of 30, 60, 90 or 120 tablets, and 600mg in packs of 30, 60, 90, 120 or 180. It is generic efavirenz, not the original Sustiva.

How is a longer course of Sustiva delivered to Hong Kong?

Your generic efavirenz order ships by tracked courier in 5 to 9 business days, or by standard airmail in 14 to 21 business days, untracked. Very large orders over 120 units may be split into several parcels. Support answers 24/7 in English and Cantonese by live chat.

Can I take Sustiva with food?

Food does not stop efavirenz working, but a heavy, greasy meal taken near dose time raises the amount that gets into the blood, and with it the dizziness and dreams. That is why the tablet is usually swallowed at bedtime, well after the evening meal.

Can I drink alcohol while taking Sustiva?

Efavirenz and alcohol both bring on dizziness and drowsiness, so mixing the two can leave you more unsteady than either would alone. Many people keep to one drink or avoid alcohol while the first few weeks settle; the effect is strongest in that early stretch.

Can I take St John's wort with Sustiva?

St John's wort reduces the amount of efavirenz in the blood, and levels that fall too low give HIV the chance to multiply and to become resistant to the treatment. Herbal products sold for low mood or poor sleep are worth checking for it before you add one to your routine.

Does Sustiva cause vivid dreams?

Yes, for many people. Vivid dreams and nightmares are among the best-known effects of efavirenz. They are strongest in the first weeks, and a bedtime tablet means they play out during sleep. By the second month most people say they have faded or become easier to live with.

How long does Sustiva take to work?

Viral load starts falling within days of the first tablet, but the full effect of the combination builds over weeks and is followed with blood tests. Efavirenz does not remove HIV from the body, so treatment continues long term.

About Sustiva

What Sustiva tablets are for

The tablets on this page are generic efavirenz, sold under the Sustiva name. Efavirenz is never used alone: it joins other HIV-1 antivirals in a combination that pushes the viral load down far enough for the immune system to rebuild, and it is given to adults, teenagers and children. The 200mg tablet comes in packs of 30, 60, 90 or 120, the 600mg in packs of 30, 60, 90, 120 or 180. Most adults need one 600mg tablet a day, while the 200mg strength lets a daily amount be built up in steps.

How efavirenz works

HIV has to convert its RNA into DNA before it can copy itself, and the viral enzyme reverse transcriptase does that job. Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI): it attaches to the enzyme at a site away from the working part and jams it, so no new viral DNA gets made. Human cells have no such enzyme, which is why the drug can target the virus alone. The other antivirals in a regimen hit different steps, so a virus that slips past one still meets the rest.

Bedtime dosing and the first weeks

Most people swallow the daily tablet at bedtime on an empty stomach. A fatty meal raises the amount absorbed, and with it the light-headed, dream-filled feeling efavirenz is known for, so sleeping through those hours is the easier way to start.

Dizziness, drowsiness, muddled thinking, vivid dreams and nightmares are the usual early complaints, showing up in the first days and easing over some weeks. Alcohol makes the wooziness worse. A mild rash often appears and then fades. Keep the tablets somewhere dry, out of children's reach.

Some effects need attention quickly: a rash that blisters, peels or arrives with fever; yellowed eyes or skin, dark urine or pain on the right below the ribs, which can point to liver trouble; and low mood that deepens, agitation or thoughts of self-harm. All have been reported with efavirenz.

Mixing with other medicines

Efavirenz makes the liver clear many other drugs faster, and a few drugs push efavirenz levels down in turn, rifampicin (the tuberculosis antibiotic) among them. Some antifungals, epilepsy medicines and other HIV drugs also interact, which is why the whole regimen is built around it rather than adding drugs one at a time. Efavirenz also speeds up the clearance of hormonal contraceptives (pill, patch, ring and implant, though not the injection or coils).

Sources

  1. Efavirenz 600mg film-coated tablets - Summary of Product Characteristics (SmPC) - (emc) — UK Electronic Medicines Compendium (EMC)