Sustiva (Efavirenz) + Antibiotics

Interaction between Sustiva and antibiotics exist. The intensity of it varies between antibiotic products. Before co-administering the two meds, it’s necessary to consult with a medical specialist to assess your health and the antibiotics you are using.

Main Information About Sustiva (Efavirenz)

Sustiva is an antiretroviral medicine used as a part of a combination regimen to treat HIV/AIDS. For it to be effective, it must be combined with other antiretrovirals to fully suppress the viral load and boost CD4+ cell count giving an individual a stronger immune system capable of fighting external opportunistic infections.

With the right regimen, Sustiva helps the patients live healthier and longer lives, even though it’s not a complete cure. This drug has Efavirenz as an active medicine. It belongs to the non-nucleoside reverse transcriptase inhibitors (NNRTIs) drug class [1].

How Antibiotics Interact with Sustiva (Efavirenz)?

Sustiva is well tolerated with most of the major antibiotics. Interactions with efavirenz can occur at a lower rate and no dose adjustment is required. However, in some of the antibiotics, dose adjustment may be necessary to get the most out of the combination without affecting any drug efficacy.

The use of antibiotics (especially co-trimoxazole or a combination of azithromycin and atovaquone) alongside life-prolonging ARV meds can lower HIV mortality by a great percentage. ARVs lowers HIV mortality by as much as 90% and the combination of co-trimoxazole reduces it further still [2].

Despite their effectiveness, most antibiotics (including сo-trimoxazole) are associated with liver injury and other hepatotoxicity problems [3]. Negative effects can seriously damage the patient’s health if combined with other medicines that incur the same liver conditions.

Sustiva can cause liver problems [4]. Thus, the use of antibiotics with Sustiva requires a complete patient’s health assessment (including testing blood for the presence of liver problems), as well as close monitoring and dose adjustment, which may be applied whenever needed.


  1. Sustiva® (efavirenz). Sustiva.
  2. Daily co-trimoxazole prophylaxis in severely immunosuppressed HIV-infected adults in Africa started on combination antiretroviral therapy: an observational analysis of the DART cohort. Dr AS Walker, PhD D Ford, PhD Prof CF Gilks, FRCP P Munderi, MBChB F Ssali, MBChB A Reid, MBChB et al. Retrieved March 29, 2010.
  3. Co-trimoxazole-induced hepatic injury–an analysis of cases with hypersensitivity-like reactions. Berg PA, Daniel PT. Infection. 1987;15 Suppl 5:S259-64.
  4. Drug record. Efavirenz. Clinical and research information on drug-induced liver injury.
It may be useful for you