Avifanz
Generic Name
Efavirenz
Manufacturer
Beacon Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| avifanz 600 mg tablet | ৳ 200.00 | ৳ 2,000.00 |
Description
Overview of the medicine
Avifanz 600 mg Tablet contains Efavirenz, an antiretroviral medication used to treat human immunodeficiency virus (HIV) infection. It is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that works by blocking a viral enzyme essential for HIV replication. It is typically used in combination with other antiretroviral drugs.
Uses & Indications
Dosage
Adults
600 mg orally once daily, preferably at bedtime on an empty stomach to reduce CNS side effects. Always used in combination with other antiretroviral agents.
Elderly
No specific dose adjustment recommended, but use with caution due to potential decreased hepatic, renal, or cardiac function.
Renal_impairment
No dose adjustment needed for patients with renal impairment or end-stage renal disease (ESRD).
How to Take
Take orally once daily, preferably at bedtime on an empty stomach. Taking with food, especially high-fat food, can increase efavirenz concentrations and may lead to increased CNS side effects.
Mechanism of Action
Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It non-competitively binds to HIV-1 reverse transcriptase, inhibiting its activity. This prevents the conversion of viral RNA into DNA, thereby halting viral replication.
Pharmacokinetics
Onset
Antiviral effects begin within days to weeks, with sustained viral load reduction over time.
Excretion
Primarily excreted in feces (14-34% as unchanged drug or metabolites); less than 1% excreted in urine as unchanged drug.
Half life
Approximately 52-76 hours (single dose); 40-52 hours (multiple doses).
Absorption
Rapidly absorbed, reaching peak plasma concentrations in approximately 3-5 hours. Food, especially high-fat meals, can increase absorption.
Metabolism
Extensively metabolized in the liver primarily by CYP2B6 and CYP3A4 enzymes to hydroxylated metabolites, which are then glucuronidated.
Side Effects
Contraindications
- Hypersensitivity to efavirenz or any component of the formulation.
- Co-administration with terfenadine, astemizole, cisapride, midazolam, triazolam, pimozide, bepridil, ergot derivatives, or voriconazole (due to potential for serious and/or life-threatening adverse events).
Drug Interactions
Rifampicin
May decrease efavirenz concentrations; dose adjustment for efavirenz might be needed, or an alternative antiretroviral regimen should be considered.
Voriconazole
Efavirenz significantly decreases voriconazole plasma concentrations, leading to loss of efficacy. Co-administration is contraindicated.
Oral Contraceptives
Efavirenz may decrease plasma concentrations of hormonal contraceptives, requiring alternative or additional contraceptive methods.
Statins (e.g., Atorvastatin)
Efavirenz can alter statin concentrations, requiring dose adjustments of the statin.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include increased central nervous system (CNS) side effects such as dizziness, confusion, and difficulty concentrating. There is no specific antidote. Treatment should be supportive, including monitoring vital signs and clinical status.
Pregnancy & Lactation
Pregnancy Category D. Efavirenz should be avoided during the first trimester of pregnancy due to potential for neural tube defects. If used in the second or third trimester, benefits must outweigh risks. Advise HIV-infected women not to breastfeed to avoid transmitting HIV to the infant.
Side Effects
Contraindications
- Hypersensitivity to efavirenz or any component of the formulation.
- Co-administration with terfenadine, astemizole, cisapride, midazolam, triazolam, pimozide, bepridil, ergot derivatives, or voriconazole (due to potential for serious and/or life-threatening adverse events).
Drug Interactions
Rifampicin
May decrease efavirenz concentrations; dose adjustment for efavirenz might be needed, or an alternative antiretroviral regimen should be considered.
Voriconazole
Efavirenz significantly decreases voriconazole plasma concentrations, leading to loss of efficacy. Co-administration is contraindicated.
Oral Contraceptives
Efavirenz may decrease plasma concentrations of hormonal contraceptives, requiring alternative or additional contraceptive methods.
Statins (e.g., Atorvastatin)
Efavirenz can alter statin concentrations, requiring dose adjustments of the statin.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include increased central nervous system (CNS) side effects such as dizziness, confusion, and difficulty concentrating. There is no specific antidote. Treatment should be supportive, including monitoring vital signs and clinical status.
Pregnancy & Lactation
Pregnancy Category D. Efavirenz should be avoided during the first trimester of pregnancy due to potential for neural tube defects. If used in the second or third trimester, benefits must outweigh risks. Advise HIV-infected women not to breastfeed to avoid transmitting HIV to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date, refer to product packaging for specific details.
Availability
Pharmacies, hospitals, specialized HIV treatment centers
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Off-patent (generics available)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials (e.g., ACTG 364, 384, 5095) have established the efficacy and safety of efavirenz in various patient populations, including combination regimens for initial and salvage therapy of HIV-1.
Lab Monitoring
- Liver function tests (ALT, AST, bilirubin) regularly
- Lipid profile (cholesterol, triglycerides) regularly
- Renal function tests
- Viral load (HIV-1 RNA) and CD4+ cell counts to monitor treatment efficacy
Doctor Notes
- Efavirenz-containing regimens are often first-line for HIV-1.
- Monitor for CNS side effects, especially within the first few weeks of therapy.
- Counsel patients on the importance of adherence to prevent resistance.
- Consider alternative regimens for patients with history of psychiatric illness or those planning pregnancy.
Patient Guidelines
- Take Efavirenz exactly as prescribed by your doctor.
- Do not stop taking Efavirenz without consulting your doctor, even if you feel better.
- Use barrier contraception (condoms) to prevent transmission of HIV and pregnancy.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Efavirenz can cause dizziness, drowsiness, and impaired concentration, especially at the start of treatment or after dose changes. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain a healthy diet and regular exercise.
- Avoid alcohol consumption as it can worsen some side effects and liver issues.
- Practice safe sex to prevent HIV transmission.
- Seek counseling or support if experiencing psychological side effects.
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