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Stribild vs. Sustiva

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Stribild (elvitegravir/cobicistat/emtricitabine/tenofovir) and Efavirenz (Sustiva) are both used to treat HIV, but they have some key differences. Stribild is a combination of four medications, including an integrase inhibitor, two nucleoside reverse transcriptase inhibitors (NRTIs), and a booster, and it is taken once daily with food. In contrast, Efavirenz (Sustiva) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that must be taken on an empty stomach at bedtime. Stribild is a single-tablet regimen, while Efavirenz (Sustiva) is taken with other antiretrovirals. Efavirenz (Sustiva) is available in generic form, making it a lower-cost option, whereas Stribild does not have a generic version. Both medications have significant side effects and interactions, but Efavirenz (Sustiva) is particularly noted for causing nerve issues and mood changes, while Stribild can cause kidney and bone problems. Neither medication is recommended during pregnancy, but Stribild is also not suitable for those with kidney or liver issues.

Stribild

 

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Efavirenz

(Sustiva)

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Summary for Stribild

Prescription only

Stribild is a single-tablet-regimen containing 3 HIV antiretrovirals (ARVs), elvitegravir (Vitekta), emtricitabine (Emtriva), and tenofovir DF (Viread), and one booster medication, cobicistat (Tybost).

Indications for Stribild

  • HIV treatment

Pros and Cons for Stribild

Pros

  • 1 tablet once a day is a full HIV regimen
  • Contains tenofovir, which is also a first-choice treatment option for hepatitis B
  • One of the few single-tablet-regimens that contains an integrase inhibitor (a preferred HIV ARV subclass)
  • In clinical trials, caused less abnormal dreams than Atripla
  • Gilead copay card available for people with commercial health plans (not for use with Medicaid and Medicare plans)

Cons

  • Must be taken with food
  • Dose can't be adjusted, so it's not recommended for people with kidney or liver problems
  • Can cause kidney and bone problems
  • Interacts with a lot of medications
  • Not a good option for people who are pregnant, or plan to become pregnant

Common Side Effects for Stribild

  • Nausea (16%)
  • Diarrhea (12%)
  • Abnormal, strange dreams (9%)
  • Headache (7%)

Warnings for Stribild

  • WORSENING OF HEPATITIS B
  • CHANGES IN KIDNEY FUNCTION
  • LIVER PROBLEMS
  • DRUG INTERACTIONS
  • BONE PROBLEMS
  • IMMUNE RECONSTITUTION SYNDROME

Summary for Sustiva

Prescription only

Efavirenz (Sustiva) is a medication that's used in combination with other antiretroviral (ARV) therapy to treat human immunodeficiency virus (HIV) infections. It comes as oral tablets and capsules that are swallowed whole. The capsules can also be opened up and sprinkled in liquid for people who have trouble swallowing. Some side effects of this medication are rash, diarrhea, and nausea. Efavirenz (Sustiva) is available as both a brand-name and generic medication.

Indications for Sustiva

  • Treatment of HIV infection in people ages 3 months and older

Pros and Cons for Sustiva

Pros

  • Only taken once a day
  • Capsule form can be opened and sprinkled on soft food or liquid, such as applesauce or milk, so convenient for people with difficulty swallowing pills
  • Available as a lower-cost generic medication
  • Can be used in young children 3 months and older who weigh over 7.7 lbs

Cons

  • Has many potentially serious side effects and risks (e.g., nerve issues, irregular heartbeat)
  • Needs to be taken on an empty stomach
  • Not recommended during pregnancy
  • Interacts with a lot of medications

Common Side Effects for Sustiva

The following side effects were reported in adults taking this medication with other HIV ARVs. Side effects might differ in children.

  • Rash (5-16%)
  • Diarrhea (3-14%)
  • Pain (1-13%)
  • Higher triglyceride (fat) levels (6-11%)
  • Low white blood cell count (2-10%)
  • Nausea (2-10%)
  • Dizziness (2-9%)
  • Feeling tired (2-8%)
  • Higher liver enzymes (5-8%)
  • Headache (2-8%)
  • Difficulty sleeping (7%)
  • Vomiting (3-6%)
  • Trouble concentrating (3-5%)

Warnings for Sustiva

  • Heart rhythm problems (QT prolongation)
  • Effects on the brain, nerves, and mental health
  • Harm to unborn baby
  • Severe skin and allergic reactions
  • Liver problems
  • Higher cholesterol levels
  • Changes in body fat
  • Overactive immune system
  • Interactions with other medications

Prices with our coupons for Stribild vs. Sustiva

Price Card Drug Icon
Stribild30 tablets / 150mg/150mg/200mg/300mg of
$4,460.07$5,696.14
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Price Card Drug Icon
Efavirenz30 tablets / 600mg of
$46.13$1,326.48
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