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Viread vs. Sustiva

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

Key takeaways

Tenofovir disoproxil fumarate (Viread) and Efavirenz (Sustiva) are both medications used to treat HIV, but they have some key differences. Tenofovir (Viread) is a nucleoside reverse transcriptase inhibitor (NRTI) that also treats hepatitis B (HBV), while Efavirenz (Sustiva) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) and is not used for HBV. Tenofovir (Viread) can be taken as a tablet or powder mixed with food, whereas Efavirenz (Sustiva) comes as tablets and capsules that can be sprinkled in liquid. Efavirenz (Sustiva) must be taken on an empty stomach at bedtime to reduce side effects like dizziness and trouble sleeping, while Tenofovir (Viread) does not have this requirement. Efavirenz (Sustiva) is not recommended during pregnancy due to the risk of birth defects, but Tenofovir (Viread) is generally considered safe. Both medications have generic forms available, making them more affordable. Common side effects for Tenofovir (Viread) include rash, diarrhea, and headache, while Efavirenz (Sustiva) can cause rash, diarrhea, and nausea, along with more serious side effects like mood changes and heart rhythm problems.

Tenofovir disoproxil fumarate

(Viread)

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Efavirenz

(Sustiva)

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Summary for Viread

Prescription only

Tenofovir disoproxil fumarate (Viread), also known as TDF, is a first-choice medication that's used as part of an antiretroviral (ARV) regimen for treating human immunodeficiency virus (HIV) infections. It's also a preferred medication used for treating hepatitis B virus (HBV). Tenofovir disoproxil fumarate, the active ingredient in Viread, is also found in Truvada, a combination medication commonly used for HIV PrEP. Tenofovir disoproxil fumarate (Viread) is available as both an oral tablet and a powder that's mixed with soft food. Common side effects include rash, diarrhea, and headache.

Indications for Viread

  • Treatment of HIV infection - people ages 2 years and older
  • Treatment of chronic (long-term) hepatitis B - Brand Viread for people ages 2 years and older; generic for people ages 12 years and older

Pros and Cons for Viread

Pros

  • Can treat both HIV and HBV infections
  • Only taken once a day
  • Available in a powder form that can be mixed with soft foods for people who have difficulty swallowing pills
  • Tablet form is available as a lower-cost generic medication

Cons

  • Requires regular blood work and lab tests to make sure your liver and kidneys are healthy
  • Can worsen hepatitis B if stopped all of a sudden
  • More likely to cause bone problems compared to similar medications
  • Interacts with certain medications for hepatitis C and HIV, such as atazanavir (Reyataz) and Harvoni (ledipasvir / sofosbuvir)

Common Side Effects for Viread

  • Higher cholesterol levels (19-22%)
  • Rash (5-18%)
  • Diarrhea (9-16%)
  • Headache (5-14%)
  • Pain (3-13%)
  • Higher creatine kinase (CK) levels, suggesting muscle damage (9-12%)
  • Feeling depressed (4-11%)
  • Nausea (8-11%)
  • Lack of energy (6-11%)

Please note: The side effects above were reported by people taking this medication for HIV infection.

Warnings for Viread

  • Worsening of hepatitis B infection
  • Kidney problems
  • Overactive immune system
  • Bone problems
  • Liver problems and lactic acidosis
  • Interaction with other medications

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 Viread vs. Sustiva

Price Card Drug Icon
Tenofovir90 tablets / 300mg
$44.51$2,384.99
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Price Card Drug Icon
Efavirenz30 tablets / 600mg of
$46.13$1,326.48
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