Estiva

Estiva belongs to antiretroviral medication and contain as active constituent like Efavirenz. Estiva tablet in combination with other drugs to treat the infection caused by HIV. Estivawithhold the HIV multiplication of virus cell and drug despitethe destruction of the immune system. Estiva may help to delay the problems arises from AIDS/HIV diseases. Estiva will not curable or preventable HIV/AIDS. The drug is prescription medicine provided under the supervision of medical practioners

Efavirenz

Estiva

600mg

Hetero





USAGE OF ESTIVA

Estiva tablets is indicated for the treatment of HIV infection, by combining with other anti-retroviral drugs used in adult and children’s 3 months old / weight of 3.5kg

PHARMACOLOGY OF ESTIVA

The pharmacology of Efavirenz is similar to lamivudine. Efavirenz is presentaction by prohibiting the activity of viral RNA directed DNA polymerase enzyme which is a reverse transcriptase.The intracellular alteration to active triphosphorylated form which is essential for the activity of efavirenz.Depending up on the cell type, the phosphorylation occurs.

The production of DNA copies of viral RNA is interceded by inhibition of reverse transcriptase. This generation is necessary for production of new viral assembly. Finally the inhibition causes cell division termination.




PHARMACOKINETIC

The maximum plasma concentration of efavirenz is attained at 5 hours. The time to maximum plasma concentration time is relatively 3 to 5 hours. The steady state of efavirenz is reached within 6 to 10 days.

Efavirenz is highly bound to human plasma protein nearly 99.5 to 99.7%.

The metabolism of efavirenz is majorly occurred by cytochrome P450 enzymes to hydrolyzed metabolites. The major isoenzymes are CYP3A & CYP2B6.

The terminal mean half life period of efavirenz is 52 to 76 hours. 14 to 34% of radiolabel should be eliminated through urine and 16-61% eliminated via feces.





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estiva
Brand Estiva
Ingredients Efavirenz
Strength 600mg
Manufactured Hetero
Rating


The usual dose of Estiva in adults is 600mg of tablet should be given orally as a one dose by together with protease inhibitors or nucleoside analogue reverse transcriptase inhibitors. The Efavirenz concentration of should be elevated when the Estiva tablet should be administered with food which leads to increase the adverse effects associated to Estiva. The up-take drug at bed time should elevate the tolerability of nervous system symptoms.

Dose alteration

Concomitant use of Estiva with voriconazole, the continuance dose of voriconazole should be elevated to 400mg for every 12 hours and the Estiva dose should be depletes to 300mg as a single dose.

Estiva tablets should not be broke, chew or crush. In combination with rifampin, the dose of Estiva is 800mg

In pediatrics:
The dose of Estiva should be suggested for the pediatric patients with the age of 3 years.

10 to < 15kg: given 200mg of Efavirenz
15 to <20kg: given 250mg of Efavirenz
20 to <25kg: given 300mg of Efavirenz
25 to <32.5kg: given 350mg of Efavirenz
32.5 To <40kg: given 400mg of Efavirenz
At least 40kg: given 600mg of Efavirenz

SIDE EFFECTS

Psychiatric symptoms, Nervous system symptoms, Rash

The common side effects of Efavirenz are

Anorexia, Nausea, Vomiting, Diarrhea, Dyspepsia, Abdominal pain, Anxiety, Fatigue, Pain, Dizziness, Headache, Insomnia, Abnormal dreams, Depression

Check the patients with these problems and inform the healthcare providers

Cholesterol and triglycerides Redistribution/accumulation of body fat, including central obesity, dorsocervical fat enlargement, peripheral wasting, facial wasting, breast enlargement.

LFTs in patients with history of hepatitis B and/or C.HepaticFunction Use Immune reconstitution syndrome. Lipids Increases in total cholesterol and triglycerides have been checked, Monotherapy Resistant virus may emerge rapidly. Convulsions Use with caution in patients with history of seizures.

CNS symptoms Liver enzymes in patients with suspected past of hepatitis B or C infection and liver toxicity. Psychiatric symptoms psychiatric disorders may be at greater risk. Some occasional reports of death by suicide, delusions, and psychosis-like behavior. Skin rash Reported in 26% of adults and 46% of children. Over dosage Symptoms Increased CNS symptoms, involuntary muscle contractions.

CONTRAINDICATION

Hypersensitivity reactions are produced due to patients may contraindicate to the components present in the Estiva tablets. Contraindicated drugs like, Due to this effect, patients may affect with severe life threatening conditions.

Avoid the combinational therapy. Some of the drugs are given: Anti-migraine like ergot derivatives Benzodiazepines Calcium channel blockers GI motility agents Neuroleptics St John’s wort

Estiva Drug interaction




  • Interaction with HIV integrase inhibitors (dolutegravir), other HIV NNRTIs ( etravirine), HMG-CoA reductase inhibitors ( simvastatin) reduce plasma concentration
  • Serious, life-threatening events (e.g. cardiac arrhythmias, respiratory depression) may produce when Estiva given with terfenadine, astemizole, cisapride, midazolam, triazolam, pimozide, bepridil or ergot alkaloids (ergotamine)
  • Estiva with psychoactive drugs leads to additive CNS effects and change plasma warfarin concentrations with warfarin.
  • Estiva with voriconazole, plasma concentrations of Efavirenz is high and voriconazole is decreased when given continuity.



Efavirenz has category D: Based on adverse effects by investigation and experience studies in humans a positive identification of human fetal risk is reported.

Estiva store at room temperature 25°C. Keep from freezing and reach of children. Kept away the medicine (Estiva) from heat, moisture, and direct light. Do not uses after expiry date Ask your consultant about how should dispose of any medicine you do not use.

If missed to take a dose, leave the dose and take your next dose at the normal time or take it as soon as you remember and take your next dose at the normal time. Do not have the extra dose to make up for a missed dose. Please consult with the doctor.

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