SUSTIVA should not be coadministered with other NNRTIs.Refer to the full prescribing information for maraviroc for guidance on coadministration with efavirenz.Concomitant administration of boceprevir with SUSTIVA is not recommended because it may result in loss of therapeutic effect of boceprevir.Coadministration of SUSTIVA is not recommended because it may lead to reduced therapeutic effect of pibrentasvir/glecaprevir.Concomitant administration of simeprevir with SUSTIVA is not recommended because it may result in loss of therapeutic effect of simeprevir.Coadministration of SUSTIVA and sofosbuvir/velpatasvir is not recommended because it may result in loss of therapeutic effect of sofosbuvir/velpatasvir.Monitor INR and adjust warfarin dosage if necessary.Potential for reduction in anticonvulsant and/or efavirenz plasma levels; periodic monitoring of anticonvulsant plasma levels should be conducted.Increases in sertraline dosage should be guided by clinical response.Consider alternative antifungal treatment because no dose recommendation for ketoconazole can be made.Avoid concomitant use unless the benefit outweighs the risks.Consider alternatives to macrolide antibiotics because of the risk of QT interval prolongation.Increase daily dose of rifabutin by 50%. The K103N substitution was the most frequently observed. Close monitoring of immunosuppressant concentrations for at least 2 weeks (until stable concentrations are reached) is recommended when starting or stopping treatment with efavirenz.Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms.No dosage adjustment is recommended when SUSTIVA is given with the following: aluminum/magnesium hydroxide antacids, azithromycin, cetirizine, famotidine, fluconazole, lorazepam, nelfinavir, nucleoside reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, stavudine, tenofovir disoproxil fumarate, zidovudine), paroxetine, and raltegravir.Efavirenz does not bind to cannabinoid receptors. Vosevi should not be combined with Norvir (ritonavir)-boosted Aptivus (tipranavir) as the drug may lower the body’s level of the sofosbuvir and velpatasvir components of Vosevi. To report SUSPECTED ADVERSE REACTIONS, contact Bristol-Myers Squibb at 1-800-721-5072 or FDA at 1-800-FDA-1088 or Late-onset neurotoxicity, including ataxia and encephalopathy (impaired consciousness, confusion, psychomotor slowing, psychosis, delirium), may occur months to years after beginning efavirenz therapy. The concentration of efavirenz inhibiting replication of wild-type laboratory adapted strains and clinical isolates in cell culture by 90-95% (ECIn cell culture, HIV-1 isolates with reduced susceptibility to efavirenz (>380-fold increase in ECClinical isolates with reduced susceptibility in cell culture to efavirenz have been obtained. In HIV-1 infected patients (n=9) who received Sustiva 200 to 600 mg once daily for at least one month, cerebrospinal fluid concentrations ranged from 0.26 to 1.19% (mean 0.69%) of the corresponding plasma concentration. The adverse reactions observed in the three trials were similar to those observed in clinical trials in adults except that rash was more common in pediatric patients (32% for all grades regardless of causality) and more often of higher grade (ie, more severe). Store it at room temperature and away from excess heat and moisture (not in the bathroom).It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. Do not take a double dose to make up for a missed one.Sofosbuvir, velpatasvir, and voxilaprevir may cause other side effects. Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.Drugs that induce CYP3A activity (eg, phenobarbital, rifampin, rifabutin) would be expected to increase the clearance of efavirenz resulting in lowered plasma concentrations [There is limited information available on the potential for a pharmacodynamic interaction between Sustiva and drugs that prolong the QTc interval. Be careful not to spill the capsule contents or spread it in the air.Before you prepare a dose of Sustiva mixed with infant formula using the capsule sprinkle method, gather the following supplies:Then, carefully twist both ends of the Sustiva capsule in opposite directions to open it (see Figure N). [print code] Revised: October 2019ZEPATIER is a registered trademark of Merck Sharp & Dohme Corp.Read this Instructions for Use before you prepare your first dose of SUSTIVA mixed with food or infant formula using the capsule sprinkle method, each time you get a refill, and as needed. It works by decreasing the amount of hepatitis C virus in the body. Based on the concentration-QTc relationship, the mean QTc prolongation and its upper bound 90% confidence interval are 8.7 ms and 11.3 ms in subjects with CYP2B6*6/*6 genotype following the administration of 600 mg daily dose for 14 days [Peak efavirenz plasma concentrations of 1.6-9.1 μM were attained by 5 hours following single oral doses of 100 mg to 1600 mg administered to uninfected volunteers.