Abstract
No abstract available.
Highlights
Efavirenz has been linked to early transient as well as late neuropsychiatric effects, which include increased risk of suicidal ideation,[2] encephalopathy,[3] catatonia,[4] psychosis and ataxia.[5,6] All of these have been directly linked to EFV toxicity
Clinicians should be aware that weight is another factor that predisposes a patient to EFV toxicity, and it is recommended that patients weighing less than 40 kg should be prescribed a reduced dose of 400 mg.[5,9]
There are no fixed-dose combination (FDC) with a reduced EFV dose available in South Africa, and underweight patients are often over-dosed as healthcare workers often prescribe the FDC with standard doses of EFV
Summary
Efavirenz has been linked to early (two to six weeks1) transient as well as late neuropsychiatric effects, which include increased risk of suicidal ideation,[2] encephalopathy,[3] catatonia,[4] psychosis and ataxia.[5,6] All of these have been directly linked to EFV toxicity. The risk for toxicity has been associated with loss of function polymorphisms of cytochrome 2B6, the main metabolising enzyme for EFV.[7] It is estimated that about 20% of sub-Saharan Africans are genetically slow metabolisers and may be at risk of EFV toxicity.[8]
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