Sustiva (efavirenz): what you need to know right now

Sustiva (generic name efavirenz) is an antiretroviral drug used to treat HIV. If you or someone you care for is starting Sustiva, the basics you need are simple: how to take it, what side effects to watch for, and when to call the clinic. This short guide gives practical, no-nonsense tips so you can use Sustiva safely and get the most benefit from treatment.

How to take Sustiva

Sustiva is usually taken once daily. Many people take it at bedtime on an empty stomach to lower the chance of dizziness, vivid dreams, or other brain-related side effects. Follow your prescriber's dose exactly — don’t split pills or change the time without checking first. If you miss a dose and remember within a few hours, take it; otherwise skip and resume the usual schedule. Never double up doses.

Consistency matters. Missing doses or stopping Sustiva can let the virus reproduce and may cause drug resistance. Set a phone alarm, use a pillbox, or tie taking your medicine to a daily habit like brushing your teeth.

Common side effects and safety tips

The most common side effects are vivid dreams, dizziness, trouble sleeping, and mild rash. These often start in the first few weeks and fade for many people. Serious rash, mood changes, or thoughts of harming yourself are less common but need prompt medical attention. Tell your doctor right away if you notice a severe rash, intense mood swings, or suicidal thoughts.

Sustiva can affect the liver and some lab values. Your clinician will usually check liver tests, especially if you have hepatitis or drink alcohol regularly. Also mention all other medicines, supplements, and herbal products you take — St. John's wort, some seizure drugs, and certain heart or tuberculosis medicines can change how Sustiva works or make side effects worse.

Pregnancy and planning pregnancy: talk with your provider. Efavirenz has had safety concerns in pregnancy in the past, so your care team will discuss the best options if you are pregnant or trying to conceive.

Alcohol and recreational drugs can increase dizziness and other side effects. Avoid driving or using heavy machinery until you know how Sustiva affects you.

Monitoring: expect routine blood work and viral load checks while on Sustiva. These tests confirm the medicine is working and help spot problems early. If your viral load doesn’t drop as expected, your doctor may adjust your regimen.

Questions to ask your provider: Are there safer alternatives for me? What side effects should I expect and for how long? What interactions should I avoid? How often will you check my blood tests? Having clear answers makes it easier to stick with treatment.

Sustiva is one tool that can keep HIV under control when used correctly. Stay consistent, watch for side effects, and keep open communication with your healthcare team — that’s the best path to staying healthy while on Sustiva.