Sustiva vs. Delavirdine for HIV Treatment: Important Differences and Potential Risks.

Key takeaways

Efavirenz (Sustiva) and delavirdine (Rescriptor) are both medications used to treat HIV infections and belong to the non-nucleoside reverse transcriptase inhibitor (NNRTI) class. However, they have several differences. Efavirenz (Sustiva) is still available as a generic medication and is taken orally once daily at bedtime on an empty stomach, while delavirdine (Rescriptor) is no longer available in the United States. Efavirenz can be used in children as young as 3 months old, whereas delavirdine was not specified for pediatric use. Efavirenz has a range of side effects, including dizziness, rash, and liver problems, and it interacts with many other medications, requiring careful monitoring. Delavirdine was discontinued for business reasons, not safety concerns, as newer HIV treatments became more popular. While efavirenz is still a part of current HIV treatment regimens, delavirdine is not used anymore.

Efavirenz

(Sustiva)

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Rescriptor

(delavirdine)

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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

Summary for Delavirdine

Prescription only

Rescriptor (delavirdine) was one of the first HIV antiretroviral (ARV) medications approved by the FDA. It hasn't been a first choice treatment option for many years, and is no longer available in the United States.