Efavirenz Dosage
Medically reviewed by Drugs.com. Last updated on Apr 4, 2025.
Applies to the following strengths: 50 mg; 100 mg; 200 mg; 600 mg
Usual Adult Dose for:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for HIV Infection
600 mg orally once a day
Comments:
- This drug should be used with a protease inhibitor and/or NRTIs.
Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection
Usual Adult Dose for Nonoccupational Exposure
US CDC Recommendations: 600 mg orally once a day
Duration of therapy: 28 days
Comments:
- Only with expert consultation, as part of an alternative antiretroviral regimen for use as HIV nonoccupational postexposure prophylaxis (nPEP)
- This drug is contraindicated as nPEP in pregnant patients; it should be avoided in nPEP regimens during the first trimester and should not be used for patients of childbearing potential who might become pregnant during antiretroviral prophylaxis.
- Prophylaxis should be started as soon as possible, within 72 hours of exposure.
- Current guidelines should be consulted for additional information.
Usual Adult Dose for Occupational Exposure
US Public Health Service Working Group Recommendations: 600 mg orally once a day
Duration of therapy: 28 days, if tolerated
Comments:
- Only with expert consultation, as part of an alternative antiretroviral regimen for use as HIV postexposure prophylaxis
- Prophylaxis should be started as soon as possible, preferably within hours after exposure.
- The optimal duration of prophylaxis is unknown and may differ based on institution protocol.
- Current guidelines should be consulted for additional information.
Usual Pediatric Dose for HIV Infection
3 months and older:
- Weight 3.5 to less than 5 kg: 100 mg orally once a day
- Weight 5 to less than 7.5 kg: 150 mg orally once a day
- Weight 7.5 to less than 15 kg: 200 mg orally once a day
- Weight 15 to less than 20 kg: 250 mg orally once a day
- Weight 20 to less than 25 kg: 300 mg orally once a day
- Weight 25 to less than 32.5 kg: 350 mg orally once a day
- Weight 32.5 to less than 40 kg: 400 mg orally once a day
- Weight at least 40 kg: 600 mg orally once a day
Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Mild liver dysfunction: No adjustment recommended; caution recommended.
Moderate or severe liver dysfunction (Child-Pugh B or C): Not recommended
If hepatotoxicity develops during therapy:
- Persistent elevations of serum transaminases to greater than 5 times the upper limit of normal: Consider discontinuation of this drug.
- Elevation of serum transaminases accompanied by clinical signs/symptoms of hepatitis or hepatic decompensation: Discontinue this drug.
Comments:
- Careful monitoring is recommended for patients with mild liver dysfunction; this drug should be administered with caution to such patients.
Dose Adjustments
Adult patients:
- If coadministered with voriconazole (maintenance dose increased to 400 mg orally every 12 hours): Decrease the efavirenz dose to 300 mg orally once a day using the capsule formulation; the manufacturer product information should be consulted.
- If coadministered with rifampin in patients weighing at least 50 kg: Increase the efavirenz dose to 800 mg orally once a day.
Precautions
CONTRAINDICATIONS:
- History of clinically significant hypersensitivity (e.g., Stevens-Johnson syndrome, erythema multiforme, toxic skin eruptions) to the active component or any of the ingredients
- Coadministration with elbasvir and grazoprevir
Safety and efficacy have not been established in pediatric patients weighing less than 3.5 kg or younger than 3 months; this drug is not recommended for use in these patients.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Comments:
- This drug is highly protein-bound; significant removal via dialysis is unlikely.
Other Comments
Administration advice:
- Monitor hepatic function before and during therapy.
- Administer on an empty stomach, preferably at bedtime; administration with food increases drug levels and may increase frequency of adverse reactions.
- Administration at bedtime may improve tolerability of nervous system symptoms.
- Swallow tablets intact with liquid; do not crush or break the tablets.
- Capsules can be swallowed intact with liquid or administered using the capsule sprinkle method.
- For patients unable to swallow capsules or tablets: The capsule contents may be administered with a small amount (1 to 2 teaspoons) of food; use of infant formula for mixing should only be considered for young infants who cannot reliably consume solid foods.
- After administration of the drug mixture, add an additional small amount (about 2 teaspoons) of food or formula to the empty mixing container, stir to disperse any remaining drug residue, and administer to the patient.
- Administer the drug mixture within 30 minutes of mixing.
- Do not consume any additional food for 2 hours after administration of this drug.
- Consult the manufacturer product information for further instructions on the capsule sprinkle method of administration.
- If a dose is missed, take it as soon as remembered; if it is almost time for the next dose, skip the missed dose and take the next dose at the regularly scheduled time. Do not take 2 doses at the same time.
Storage requirements:
- Store at 25C (77F); excursions permitted to 15C to 30C (59F to 86F).
Reconstitution/preparation techniques (for the capsule sprinkle method of administration):
- Open the capsule carefully to avoid spillage or dispersion of the capsule contents into the air; hold the capsule horizontally over a small container and carefully twist to open.
- For patients able to tolerate solid foods: In the small container, gently mix the entire capsule contents with a small amount (1 to 2 teaspoons) of an age-appropriate soft food (e.g., applesauce, grape jelly, yogurt).
- For young infants receiving the capsule sprinkle-infant formula mixture: In the small container, gently mix the entire capsule contents into 2 teaspoons of reconstituted room temperature infant formula by carefully stirring with a small spoon, then draw up the mixture into a 10 mL oral dosing syringe for administration.
- The manufacturer product information should be consulted.
General:
- This drug should always be used in combination with other antiretroviral agents; it should not be used as a single agent to treat HIV-1.
- This drug should not be added on as a sole agent to a failing regimen.
Monitoring:
- General: Pregnancy testing (before starting this drug)
- Hepatic: Liver enzymes (before and during therapy); hepatic function (before and during therapy)
- Metabolic: Triglycerides and cholesterol (before and periodically during therapy)
Patient advice:
- Read the US FDA-approved patient labeling (Patient Information and Instructions for Use).
- This drug may impair mental abilities needed to perform potentially hazardous tasks (e.g., driving, operating machinery); CNS effects may be additive if used with alcohol or psychoactive drugs. Avoid hazardous tasks if CNS symptoms (e.g., dizziness, impaired concentration, drowsiness) occur.
- Seek immediate medical evaluation if severe psychiatric adverse events occur.
- Contact physician promptly if rash occurs.
- Watch for early warning signs of liver inflammation or failure (e.g., fatigue, weakness, lack of appetite, nausea/vomiting) as well as later signs (e.g., jaundice, confusion, abdominal swelling, discolored feces); consult your health care professional without delay if such symptoms occur.
- Patients of childbearing potential:
- Use effective contraception (as well as a barrier method) during therapy and for 12 weeks after the last dose.
- Contact your health care provider if you plan to become pregnant, become pregnant, or if pregnancy is suspected during therapy.
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