Efavirenz is associated with a variety of side effects, ranging from common to serious. Common side effects often develop early in therapy and may lessen with time. However, some effects can persist or be severe and require medical attention.
- Common side effects may include:
- Rash and itching
- Dizziness, drowsiness, and trouble concentrating
- Headache and tired feeling
- Unusual or vivid dreams, trouble sleeping (insomnia), nightmares
- Nausea, vomiting, abdominal pain, and diarrhea
- Sleep disturbances and abnormal thinking
- Anxiety and mild depression
- Increased sweating
- Changes in the shape or location of body fat
[1][2][3][4][5][6]
- Nervous system and psychiatric side effects are notable for efavirenz:
- Confusion, impaired concentration, and agitation
- Strange, vivid, or abnormal dreams
- Hallucinations, delusions, mania, and euphoria
- Anxiety, paranoia, and feelings of being ‘out-of-sorts’
- Severe depression or suicidal thoughts (in rare cases)
- Speech, balance, or muscle movement problems
- These symptoms often occur in the first two to four weeks but may persist in some individuals.[2][4][5]
- Serious side effects (seek immediate medical attention):
- Signs of allergic reaction: hives, swelling of face or throat, difficulty breathing
- Severe skin reactions: fever, sore throat, burning eyes, red or purple skin rash with blistering and peeling
- Seizures or convulsions
- Mental changes: suicidal thoughts, severe depression, paranoia, aggression
- Liver problems: nausea, stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), clay-colored stools
- Heart rhythm problems: QT prolongation or torsade de pointes, presenting as fainting or abnormal heartbeat
- New or worsening infections
[1][3][5][6]
- Other possible effects:
- Raised triglyceride and liver enzyme levels
- Muscle cramps or pain
- Impotence or menstrual changes
- Loss of memory, ataxia (loss of full control of bodily movements), tremor, vertigo, tinnitus
- Swelling in the neck or throat (enlarged thyroid)
- Immune reconstitution syndrome (an inflammatory response following treatment initiation)
[2][4][6]
Most neurological and psychiatric side effects of efavirenz appear within the first month of therapy and often improve with continued treatment, though a subset of patients may experience persistent symptoms.[2][4]
Rarely, patients discontinue efavirenz due to side effects; studies show that only around 1–3% stop treatment for this reason.[2]
References
- [1] Efavirenz Uses, Side Effects & Warnings – Drugs.com
- [2] Efavirenz – Aidsmap
- [3] Efavirenz Side Effects: Common, Severe, Long Term – Drugs.com
- [4] Efavirenz / Emtricitabine / Tenofovir Disoproxil Side Effects
- [5] Efavirenz (Sustiva): Uses, Side Effects, Interactions – WebMD
- [6] Side Effects of Sustiva (efavirenz): Interactions & Warnings – MedicineNet
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