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Sustiva and Fat Content in Meals
Apr 12, 2002

Hello there:

I have been on Sustiva & Combivir for a year-and-a-half now and am doing well on it with no side effects. The only real anoyance I have is in restricting my fat intake with Sustiva. I try to keep the grams of fat in my evening meal (which is when I take Sustiva) below 30g., but definitely notice if I eat more (a bit dizzy, and night sweats) - so... 1. Is it only Sustiva that has this reaction and 2. What is the time window of fat intake to affect the Sustiva? Would it be affected if I had a very high fat meal at noon, even if I took the Sustiva at 8p.m.?

Many thanks for your advice. This site is a true God-send for many of us and your heroic efforts at disseminating information are more appreciated than I can say.

Response from Ms. Fields-Gardner

Of the drug regimens you mention, efavirenz (Sustiva) is the only one that carries a clear warning about high fat meals. The reason for this warning is that a high fat meal eaten around the time you take efavirenz causes the drug to be better absorbed and increases the potential for side effects.

While a lunch more than 2 hours earlier should not affect the absorption of an evening dose of efavirenz, there is another reason to consider a lower fat diet: elevated blood lipids (triglycerides and cholesterol). If this is one of the problems you face, talk with your dietitian before dumping your lower fat diet. If you take lipid-lowering medication, you should know that they should generally be used to enhance and not replace a lower fat diet.

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