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Efavirenz 400mg vs 600mg - as good as, less CNS side effects

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People may be interested in this study report:

Reduced efavirenz dose suppresses HIV as well as standard dose

In brief, 400mg works as well as 600mg but has less side effects.

The study in question, ENCORE1, was a randomised, double-blind, non-inferiority trial of 600+ participants. On an intent-to-treat basis, when combined with Truvada, 400mg and 600mg were as effective as each other after 48 weeks. Side effects were significantly less in the lower dose arm, with 37% on the lower dose vs 47% on standard dose getting CNS side effects.

- matt

I have posted here on the Boards several times about taking low dose Sustiva at 400 mg. I have taken Sustiva at 400 mg since the late 1990s because I could not tolerate the 600 mg when I first started the medication.

My doctor said that he read about a small study at the time in the 1990s that said 400 mg Sustiva was just as effective as 600 mg, so I started.  I have been non detectable for over 11 years with no pronounced and intolerable side effects I often read about here on the Boards. I have also taken low dose Viracept for more than 5 years.

I also think Ann has posted about low dose Sustiva and has a different take.

Thanks that is very cool

I would be interested in Ann's perspective. She seems quite knowledgable.

What might this mean for those of us on Atripla?

I am fine with 2 or 3 pills, as long as they can be taken at the same time each day. Might they retool the levels in Atripla? Or is another combination available to me? Sorry - I am VERY new to all of this...

Efavirenz comes in 200mg capsules, so it is possible to form a 400mg dose and add this to Truvada, which contains the other two drugs present in Atripla. Obviously, for co-payers, this is not good perhaps, since it swaps 1 pill for 3....
I expect someone somewhere will make an all-in-one 400mg of efavirenz-based pill sooner or later.

- matt


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