I have been taking Efavirenz 600 mg at night with Truvada for 3 weeks. I get spaced out after 2 hours and need to go to bed, but I also get next-day trouble concentrating. I've tried taking Efavirenz as early as 7 pm but I end up in bed by 9pm - no social life - and still some problems next morning. Should I break the tab and take 300mg twice daily to stop this acute and prolonged peak effect?
The approach I would take is to split the dose (actually 200 mg in the morning and 400 mg in the evening) and see how it goes. If this does not work, you may have to switch medications. Thankfully, many other choices that do not have this side effect profile are often available...