Efavirenz Stella 600mg medicine after HIV exposure (3 blisters x 10 tablets)

rash

Light to the medium has been reported in clinical studies with Efavirenz. The appropriate antihistamine or corticosteroid drug can improve the tolerance and resolve the rash. The severe rash accompanied by blistering, peeling or ulcers was reported with a rate of less than 1% of patients treated with Efavirenz.

Diverse ratio of roses or Stevens - Johnson syndrome is about 0.1%. Efavirenz must be discontinued in patients with severe rash accompanied by blistering, peeling mucosa or fever.

Mental symptoms

Mental side effects have been reported in patients treated with Efavirenz. The risk of serious mental side effects occurs in patients with a history of mental disorders. Especially severe depression is more common in patients with a history of depression. There have been reports on severe depression, death due to suicide, hallucinations and mental disorders.

Patients should be warned that if there are symptoms such as severe depression, mental disorders or suicide intent, immediately contact the doctor to assess the possibility of symptoms whether or not to use Efavirenz, and if any, to determine whether the drug is continued to use is greater than the benefit or not.

neurological symptoms

Dizziness, insomnia, drowsiness, sleep quality and often have abnormal dreams. Neurological symptoms usually start in one to two days of treatment and usually in the first treatment, which is solved after 2-4 weeks of treatment.

epilepsy

Conference has been observed in patients using Efavirenz. Patients used in combination with anti -convulsions are often metabolized through the liver such as phenytoin, carbamazepine and phenobarbital, may require periodic concentration in plasma concentrations.

liver disease

There are several reports on liver failure reports in patients who have not had previous liver disease or known risk factors. Also consider monitoring liver enzymes for both patients without liver disease before or risk factors.

Food influence

Use Efavirenz with increased absorption and can lead to increased frequency of side effects.

recommend that Efavirenz should be hungry, preferably before going to bed.

immune activation syndrome

In HIV -infected patients with severe immunodeficiency at the time of combination of antiviral drugs (Cart), an inflammatory reaction to opportunistic or asymptomatic or remaining pathogens may arise and cause serious or serious clinical conditions. These reactions are usually observed for a few weeks or the first few months of Cart therapy.

The related inflammatory reactions are cytomegalovirus retinopathy, systemic or localized Mycobacteria infection and localized pneumonia and pneumocystis jiroveci (formerly known as Pneumocystis Carinii). Any symptoms of inflammation should be evaluated and treated when needed. Autoimmune disorders (such as Grave's disease) have also been reported in the immunosuppressant disease, however, the time of development changes more and these reactions may appear after months after the beginning of treatment.

fat and metabolic disorders

Combination therapy of antacids of Retrovirus may be related to the re -distribution of body fat in HIV -infected patients. It is not clear the long -term consequences of this impact. The mechanism of this impact is not fully known. There has been the theory of the relationship between the accumulation of organ fat, protease inhibitors, fat atrophy and nucleoside drugs inhibit the reverse copy enzyme.

Higher risk of fat dysplasia if accompanied by individual factors such as older and drug -related factors such as long -term treatment for Retrovirus and related metabolic disorders. Clinical examination should include evaluation of physical signs of fat re -distribution. Should consider lipd lipd and blood sugar when hungry. Lipid disorders should be properly treated.

bone necrosis

Special subjects

Liver disease

Efavirenz is contraindicated for patients with severe liver failure and is not recommended for patients with medium liver failure due to lack of data to determine whether to adjust the dose. Due to the widely metabolic mechanism through Efavirenz's cytochrome P450 intermediaries and limited clinical experience in patients with chronic liver disease, cautious when taking Efavirenz for patients with mild liver failure. Patients should be carefully monitored the side effects related to the dose, especially the symptoms on the nervous system. Testing should be done to evaluate liver disease in these patients in periods periodically.

If there is evidence of the worsening of liver disease or the persistent increase of transaminase in serum from 5 times or more than the upper limit of the normal concentration range, it is recommended to consider the benefits of continuing treatment with Efavirenz and potential risks due to liver toxicity in the liver. In these patients, disruption or stop treatment. In patients treated with toxic drugs on the liver, the monitoring of liver enzymes is also recommended. In the case of simultaneous use of antiviral hepatitis B or C antiviral therapy, it is necessary to consult the relevant information of these drugs.

kidney failure

Efavirenz pharmacokinetics has not been studied for patients with renal impairment, however, only less than 1% of Efavirenz dose is excreted in the form of unchanged urine, so the effect of kidney failure on Efavirenz elimination is very small. There is no experience in taking drugs in patients with severe renal impairment and should closely monitor safety in these patients.

Older people

Do not have enough older patients who are assessed in clinical studies to determine whether or not the difference is compared to young patients.

Children

The rash was reported on 26 children out of 57 (46%) treated with Efavirenz for 48 weeks and 3 children had a heavy rash. Preventive treatment should be considered for anti -histamine suitable for children before starting treatment with Efavirenz.

lactose

This drug contains lactose. Patients with rare genetic diseases are galactose intolerance, lactase deficiency, or glucose - galactose should not be used.

The ability to drive and operate machinery

Efavirenz can cause dizziness, concentration or drowsiness. Patients should avoid dangerous jobs such as driving and operating machinery if they experience these symptoms.

Pregnancy

There are 07 recovery reports on neuromable duct defects, including meningeal hernia, all mothers using Efavirenz treatment regimen (excluding combined tablets with a dose of Efavirenz) in the first 3 months of pregnancy. There are two more cases (1 case of rescue and 1 rescue shift) including events of neural tube defects that have been reported to the fixed -dose combination pills containing Efavirenz, Emtricitabin, and Tenofovir Disoproxil Fumarat.

The cause of the cause - the results between these events and the use of Efavirenz have not been established. Because the neural tube defects appear within the first 4 weeks in the fetal development process (the time when the neural tubes are closed), this risk is only related to women who use Efavirenz during the first 3 months of pregnancy.

Salvation reports on 904 pregnant women were treated with an efavirenz regimen in the first 3 months of pregnancy, resulting in 766 cases of living. A child is reported to have neuromuscular defects, and frequency and other types of defects at birth are similar to the group observed on children who are exposed to the Efavirenz -free treatment regimen, as well as the negative verification team with HIV. The rate of neural tube defects in the general population from 0.5 - 1 shift on 1,000 cases.

Details have been observed in the fetus of monkeys treated with Efavirenz.

Breastfeeding period

According to current recommendations, HIV -infected women should not breastfeed to avoid infection from mother to child. Mouse studies have shown that Efavirenz excreted milk. Mothers should stop breastfeeding.

Drug interaction