Starting a new medication for the first time can be scary, especially if you've heard other people talk about its side effects. When it comes to Sustiva and its potential to cause side effects – especially CNS-related problems – there are a few tips to keep in mind before starting:
1) Always remember: side effects do not always occur and vary from person to person. Your experience with Sustiva may be very different from that of another person's. At the same time, it's important to be prepared for any side effects that you may experience.
2) Be aware of other drugs or over-the-counter products that might increase the amount of Sustiva in your blood and, thus, increase the chance of experiencing side effects. For example, the protease inhibitor Norvir (ritonavir) can increase Sustiva levels in the blood by 20 percent. If your doctor has recommended that you take Sustiva and Norvir together, talk to him or her about starting either drug a few days-or even a week-apart. Also, taking Sustiva with food can also increase its levels in your blood, and make potential side effects seem worse.
3) Food can increase the blood levels of Sustiva, increasing the chance of side effects. For this reason, it is recommended that people take Sustiva on an empty stomach.
4) Don't be afraid to call your health-care provider if a particular side effect seems severe or has you worried.
5) Establish a reliable support network. If you don't feel well upon starting Sustiva, it might be helpful to have friends or family members you can rely on. They can help you if the going gets rough, and attend to things that you might not feel like doing (i.e., chores that need doing or errands than need running).
6) Avoid alcohol or drugs. Alcohol and recreational drugs, such as marijuana, cocaine, and speed, can worsen some of the CNS side effects of Sustiva.
7) Start Sustiva on a weekend and/or take a few days off from work. Sustiva can cause CNS side effects after the first dose has been taken and it may take you a few days to get used to any mental changes that occur. Not having to worry about work during this time can be helpful.
8) Take Sustiva before bedtime. Many of Sustiva's CNS side effects are strongest within a few hours after taking the drug. Thus, it is strongly recommended that people take the drug before going to bed and to "sleep off" the feelings of dizziness, impaired concentration, etc. While some people report that Sustiva actually keeps them awake, there are some potential ways to manage this insomnia (see below).
9) Avoid driving or using large machinery, especially if Sustiva causes sensations of dizziness or impaired concentration or if you haven't been sleeping well.
10) Switching from Sustiva to another anti-HIV drug is always an option. While most people are able to tolerate the side effects of Sustiva, severe side effects that last a long time can have a negative effect on a person's quality of life. Note: it is dangerous to simply stop taking Sustiva or reduce the dose without first talking with your health-care provider. This can lead to drug resistance and end up doing more harm than good.
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