Used For:

• HIV treatment

Contraindications:

• Allergy to efavirenz, lamivudine, or tenofovirSevere liver disease (hepatitis, cirrhosis)Severe renal impairment (Creatinine clearance < 50 mL/min)Pregnancy (1st trimester) – efavirenz may cause fetal riskExisting psychiatric disorders (EFV may worsen depression, psychosis)Active suicidal thoughtsConcomitant use of strong CYP-inducing drugs (rifampicin may reduce EFV levels—medical supervision needed)

Side Effects:

• Common (usually mild and temporary):Dizziness, drowsiness, strange dreams (efavirenz)HeadacheNausea, vomiting, diarrheaRash or pruritusFatigueSerious (need immediate medical help):Severe psychiatric symptoms → depression, anxiety, hallucinationsLiver toxicity → jaundice, abdominal pain, dark urineKidney problems (due to tenofovir)Lactic acidosis (rare but serious)Severe skin reactions (Stevens–Johnson syndrome)Bone mineral density loss (tenofovir long-term)

Precautions:

• Take on an empty stomach, preferably at bedtime, to reduce dizziness & vivid dreams.Avoid missing doses, as it can lead to drug resistance.Regular monitoring required:Liver function tests (LFTs)Kidney function (creatinine, eGFR)Viral load & CD4 countUse cautiously in patients with:Mental health disordersHepatitis B or C coinfection (withdrawal may cause HBV flare)Pregnancy: Alternatives preferred; if used, under strict medical supervision.Do NOT stop the medicine abruptly → risk of viral rebound.

Dietary Restrictions:

• Avoid alcohol → increases liver toxicity risk.Avoid high-fat meals before dose → increases efavirenz side effects.Maintain healthy hydration.Avoid recreational drugs → dangerous interactions with EFV.Limit grapefruit (may alter efavirenz metabolism).Maintain a balanced diet rich in calcium & vitamin D → counter bone loss from tenofovir.