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Alternative to Sustiva
Feb 20, 2009

I am currently taking Sustiva and Kivexa, and have been for a year now. I had a terrible start with sustiva due to fogginess etc, which subsided after a month or so, but it still really disrupts my sleep. I am really craving some high quality sleep! I avoid high fat meals and always take it at 2230 in the evenings (usually about 4hrs after dinner), but I still often feel like i'm sleeping with one eye open! I am wondering if there is an alternative to Sustiva that I could try? If that alternative has worse side effects (constant nausea etc) is it possible to switch back to the Sustiva or is it too late?

My CD4 is around 500 and my VL undetectable. I have a doctors appointment in a few weeks and would like to go armed with some questions about alternatives that you may suggest.

Many thanks

Response from Dr. Henry

Depending on where you are located there are varying alternative to efavirenz that could be considered in the setting of viral suppression , persistence efavirenz central nervous side effects , and no history of drug resistance. Possible alternative include nevirapine, raltegravir, boosted protease ihhibitors, atazanavir unboosted, or maraviroc in some cases. KH

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