Efavirenz
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Nightmares, anxiety and leg cramps: case report A 48-year-old man with HIV infection started antiretroviral therapy (ART) with efavirenz 600 mg/day, zidovudine and lamivudine. One week later, he reported dizziness, intense nightmares, anxiety and leg cramps. After more than 4 weeks of ART, his efavirenz steady-state plasma concentration was significantly higher than the recommended therapeutic range. Subsequently, efavirenz was reduced to 400 mg/day in March 2006. He reported decreased intensity and frequency of leg cramps and nightmares, as well as reduced irritability. Genotyping in May 2007 found CYP2B6 polymorphisms, which cause reduced enzymatic activity. In July 2008, his plasma concentration for efavirenz remained elevated, and efavirenz was further decreased to 200 mg/day. Considerable improvement in his symptoms was reported after 1 month, and his plasma concentration remained within the therapeutic range thereafter. Cabrera Figueroa S, et al. Long-term efficacy and safety of efavirenz dose reduction to 200 mg once daily in a Caucasian patient with HIV. Clinical Drug 801153532 Investigation 30: 405-411, No. 6, 1 Jun 2010 - Spain
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Reactions 10 Jul 2010 No. 1309
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