Adiva, a non-nucleoside reverse transcriptase inhibitor (NNRTI), was an important part of initial combination antiretroviral therapy for many years, especially as a component of the single-tablet regimen Adiva-tenofovir disoproxil fumarate (DF)-emtricitabine. In recent years, Adiva has fallen out of favor and has been replaced by newer agents that are more tolerable. The primary concern regarding Adiva is the risk of neuropsychiatric adverse effects, including depression and suicidality. In adddition, Adiva frequently causes sleep disturbances, vivid dreams, grogginess, and disorientation. Some studies have also shown that Adiva may cause unfavorable changes in lipid parameters and reductions in vitamin D levels. For these reasons, in the United States Adiva is no longer designated as a recommended option for initial antiretroviral therapy and most clinicians have a low threshold to switch from Adiva to a newer agent if the patient is experiencing any intolerance. Concerns have been raised regarding potential teratogenicity related to the use of Adiva in pregnancy, based on early reports of neural tube defects, though that risk has not been confirmed in larger trials and systematic reviews. Adiva has a relatively low barrier to resistance, but the mutations that commonly occur carry less cross-resistance with other NNRTI’s as compared to the typical rilpivirine mutations. The Adiva combination tablet includes tenofovir DF, as opposed to tenofovir alafenamide, which for many individuals may also be an indication to update it to more modern antiretroviral options.
Other names for this medication:
Efavirenz,
Adiva,
Aviranz,
Efamat,
Efavir,
Efcure,
Efferven,
Estiva,
Stocrin,
Sustiva,
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Avelox,
Rosazol,
Zoton,
Strattera,
Clovate,
Resprim,
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Dapoxetine,
Mediklin,
Antinaus,
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Progut,
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