Living with HIV in the Philippines: Email 724: Feeling the Side Effects of Efavirenz

Hi. Thank you for all the encouragement and the information that your blog provides, and it has been a great help in my journey since last September when I was confirmed to be HIV+.

I recently had my change of ARV since Nevirapine gave me the expected fever and rashes. Just yesterday I started taking Efavirenz as a new measure.

I took the Efav last night by 10PM and tried to sleep and I noticed that when I was roused from slumber at about 1AM I was really dizzy like I was high on something and I was kept in this state even after I woke up at 8AM to take my Lami/Zido this morning. What's weird is that as I am writing to you now at about 3PM I am still a bit tipsy and rather "floating" or aloof in thoughts...

Is this normal for the first take of Efav? Is there any measure to lessen this experience?

Thank you very much and God keep you.

-Maroon Boy

POZZIEPINOY’S RESPONSE

Hi Maroon Boy.

Thank you for your email. Thank you for the kind words that you wrote about the blog.

Efavirenz has neurologic effects and I do believe that your HIV doctor has discussed this with you. These are the vivid dreams and grogginess that one experiences after taking efavirenz, that is why PLHIV's who are on efavirenz are advised to take it at bedtime so that one won't feel them. Another effect of efavirenz is the warmth and drying of skin which may lead to itchiness.

I, for one, experienced these side effects, but in my case I had them during my first day of taking it. The reason for this was because I followed the instruction in the literature that came with the bottle of efavirenz. It said that to lessen the side effects of efavirenz, take it on an empty stomach. I researched about it and I found out that for one to have an empty stomach, one's last meal should be 3-4 hours prior to taking efavirenz. Efavirenz doesn't react with food, however, with food it becomes absorbed easily in the stomach thus, increasing the probability of the side effects. Without an active digestive process (empty stomach), the efavirenz will be absorbed in the early part of the small intestine which may produce very minimal side effects.

After that, I scheduled my last meal at 6pm and I take my efavirenz at 10pm. Up to now, I don't feel any dizziness or grogginess, now any vivid dreams. I have shared this to a lot of PLHIV's who are taking efavirenz and they have testified that they too didn't experience the side effects with an empty stomach.

You too can try it, then let us know if there are any observable changes.

I hope I was able to answer your concerns. Feel free to email me again if you have other questions.

Stay healthy,

Pozziepinoy