Efavirenz (Stocrin)

[shaynesydney]

After taking this ARV for a year, I've just learned yesterday from a different doctor that I'm taking amphetamines every day. :confused:

I wonder if this might account for certain, um, 'difficulties' I experience and if anyone else has had problems with Efavirenz, particularly in relation to depressoin.

[bgf northernnick]

Hi shaynesydney ,
Stocrin certainly does knock a lot of people around m8..........I was put on to it many years ago and dumped em all down the toilet after 3 months as side effects did not subside as promised...........I found it almost imossible to sleep and ended up almost housebound as I would get extreme disorientation/anxiety attacks when in town or when driving.......these were so bad that if I was driving I would have to pull over and wait sometimes for up to a couple of hours before feeling safe to continue.......having these attacks in town were even more scary cause everyone treated me like I was having a bad time on recreational drugs......was forced to disclose my status and explain that my condition was a side effect of new Hiv meds when seeking assistance which didn't always go down well either...........In hindsight many of the symptoms were exagerated because of sleep deprevation (which has been proven to be dangerous after a few day as it adversely affects many of our functions ............... Not too sure what difficulties you are experiencing m8 as you don't say in your post.............I can say that I got very depressed at the thought that this drug was one of my only options for treatment /living with Hiv if I had to put up with the side effects to stay alive.....Luckily this was not the case and now on a different regime..............Stocrin has proven to be a very effective treatment tho for those who can tolerate any side effects........
Was blown away by a report that I saw on one of the satelite/pay tv channels a few months ago that in Africa where Stocrin is one of the main subsidised hiv drugs for distribution and treatment.........There had been a new culture of substance abuse by groups of youths/individuals who were powdering up stocrin tabs and smoking it them for a high........This was being raised as an issue cause in areas of extreme poverty plwha's were having their meds stolen or were trading them for other consumables.........To date have not been able to find anymore info about this so would be gr8 to hear from anyone here who knows/ heard about this issue in this space........... as if this info is true then maybe it would be gr8 to get some lobbying into drug companies/governments to subsidise an alternative hiv medication for wide disribution in areas of extreme poverty so the meds always go to treat hiv and not be abused/wasted.
Hopefully someone maybe able to give you more feedback m8......Have a good weekend,
Nick

[shaynesydney]

Thanks for all that, bgf northernnick. Yes it does get very compliucated. I haven't been able to find any online resource that explains that Efavirenz is an "amphetamine," but I have heard that they are sold outside nightclubs, especially in South American countries, where they are easier to get, and used in combination with other drugs.

Anyway...having seen my doctor for a follow-up, I've decided to just keep things as they are. I accept that there's a syndrome attached to being HIV+, including side effects from the meds...and the virus itself - and no point moaning about it.

My doctor went on and on and on about 'lactates and hydrates and take 3 mgs of this but don't take this with that because you will go into a coma, and 9 mgs of that and P.N. and B2 and magnesium counts and diabetes...." I felt like I'd become a commodity in some industry. I just told him he made me feel weary and sad and I didn't think I'd be changing anything in my life as it is quite manageable and I am basically quite happy with it. He gave me a fistful of scripts and told me to 'go away and think about it." :)

[gandolf69]

Think about it?
Yes maybe a new doctor as i don't like his approach and from what your saying he sounds like a asshole.

[shaynesydney]

Think about it?
Yes maybe a new doctor as i don't like his approach and from what your saying he sounds like a asshole.

Agreed. I only saw him 'cause my regular doctor was away. My regular doctor gives me hugz sometimes too. :p

[gandolf69]

I'd stick with my regular doctor Shayne as he sounds lovely and a decent doctor who knows you very well and that's what we all need.

[richyrich77]

Mate any good doctor would not have you on that ancient treatment.

Get off them A.S.A.P, They are one an old style of HAART, I have not heard about the amphetamine in them, yet would not surprise me. They do however contain a huge amount of AZT which causes major issues. Its what was in the first HAART they made.

I can remember tripping every night when I went to bed, I could hear voices and thought people were in the room, fun some nights a nightmare others.
They had me on heaps of painkillers and other things I did not know what was going on around me.

These were the tablets they first put me on when I got sick. And they do the same to most people.

I was hospitalized on these babies with severe depression, (they said I was completely unable to function in the outside world) I was a mess, went to 52 kgs, and im 6ft1 my face over the year I was on them aged 10 years, the tablets gave me Lypodystrophy(permanent) means fat cells cannot maintain themselves hence sunken in cheeks ect and I was close to ending it.
They refused to change them in hospital, so I refused all treatment and threw my tablets daily on the floor until finally they were changed.

In a two week period on Truvada, Ritonavir, and Reyataz I felt half decent.
This combo only need to take once a day..It works for me talk to your doctor re other treatments.

I stayed in that hospital for 3 months recovering, i was so skinny my body ached like I cant explain I do not want to ever feel like that again.
Im sure some day I will yet at least I will be prepared.

6 Months later the virus was undetectable and i been healthy 2 years later and never been sick since.
I weigh 75kgs and am looking ok again, face not the same, they do offer free fillers and face fixing after they stuff you up though(how kind)
Dont let it get to that stage, if you feel something is wrong your health is very important.

I found out later 2 of my friends went through the same thing.

They prescribe these tablets as they are the cheapest to make.
If you are now working they will really push them on you so gov not have to pay.

Good luck, take care of yourself.....

[richyrich77]

Sorry mate I meant if you are NOT working they will push these on you as they are the cheapest that exist. Cheaper for the Gov, and yes thats why they use them in Africa.
Sad

[bgf northernnick]

Hi guys and richyrich77 ,
Was gr8 richyrich77 that you shared your experience of Efavirenz(Stocrin) here m8:D This drug regime is not for everyone as you know and inspite of the fact that you,me an a few others have had a bad time with them there are indeed thousands of people who didn't have a bad experience with them and are doing gr8 today.........It is NOT an old and outdated regime just given to DSP recipients because it's cheap.....It is gr8 that you are now on a regime that you can handle and have responded to but please consider the damage:confused: you can do by making such wild assumptions for the many who maybe reading these posts who may have been prescribed these meds.....Do you have a medical contact/link to back up these claims?..........also it is more likely one of the other drugs you were given may have caused the Lipo too and there are sites like treatments.org.au and many others that deal with this issue...........
Think it's fantastic we have this space to assist others on their respective journeys but in this area of HIV meds ALWAYS take advice from qualified prescribers who actually know what they are doing.
regards,
Nick

[richyrich77]

Nick,
Love the positive negative positive feedback sandwich.

That was my experience with them and I suggest to anyone who is having depression issues or complications to get off them,(given that Shayne is in this category I was meaning him) not the entire world.
Consult another opinion, best would be a professor of HIV or specialist, not just a script writer as they generally have little knowledge of what they are prescribing. (of course there are exceptions to this) I would hate to make another wild assumption lol, there are some very well informed doctors, yet I would prefer to seek info from someone that educates others on the matter.

Lipo is a known side affect of this medication if you have concerns seek further information, many links on the net perhaps referring to the leaflet that came with the medication will confirm this.

My wild assumptions that they are given to anyone unemployed is a fact, they are given to nearly everyone as i first regime, as they are the cheapest to produce for the Australian Gov.
They are the most prevalent in third world countries (why would this be) because they are cheap.
They are also snorted outside clubs in poverty countries as a party drug.

Links to costs of drugs
http://www.pharmacychecker.com/Pricing.asp?DrugName=Truvada&DrugId=59317&DrugStrengthId=113886

This is the cost of Truvada 8 times that of efavarinz, generally the reason they like to keep you off them if they can.

Link to efaverinz costs
http://www.pharmacychecker.com/Pricing.asp?DrugName=Efavirenz&DrugId=59366&DrugStrengthId=107743

I call it an ancient treatment as it contains a high percentage of AZT it is this that causes lipo.

And the other tablets given to me by the docs were for pain management as I have spine damage and when 52kgs you can feel everything, morphine and prescription painkillers do not generally cause lipo, well not when you already have it within the first year of taking your meds.

Sorry I cant seem to sugercoat my posts as I am me.
Oh I could try, Thanks so much for the feedback Mike, yes I realize I could have shocked some people, my apologies to anyone who is now concerned re the information I have given.
It was my experience, I will proof read my responses in future and sensor them.
Would that be free speech or manipulated text.

[BGF-Positron]

Almost two decades ago my doctor and I started to talk in depth about whether I should take this drug or that drug for HIV. I played a very large roll in saying yes or no to his advice. I listened to my body AND my doctor. 17 years on we still both agree I do not need ANY medication for my HIV. Never have hopefully never will. Who would have thought hay...........?
Just my situation NotherthNick is correct ALWAYS take advice from qualified prescribers who actually know what they are doing.
But also keep in tune with what your body is doing, read your blood results and talk to your doctor about the results and what those results REALY mean……

[bgf northernnick]

Hi Guys,
Thanks for posting your links richyrich77:) Please accept that my comments were in no way intended to undermine your experience with this drug .......you really have been thru the mill and have lived to tell the tale......better still you found the time to share that experience here..........side effects from meds have always been a major component in my discussions with Hiv service providers in the course of my 13 yrs as a community volunteer as like a few of us I have been around since Hiv hit sydney back in the eighties and witnessed many good m8's die while suffering debilitating side effects from early regimes during the 'guinea pig' era........Luckily we have come a long way since then eh? ............. Am sure that no one especially here should have the right to censor our real/lived experiences but would just urge all to consider that these drugs do effect everyone differently and to be mindful that everyone with Hiv do not necessarily have the same treatments options available.......There are many factors to be taken into account when tailoring a regime like.....what drugs the individual had been on before........which drugs are the patients Hiv strain resistant to......... whether someone can maintain healthy eating habits while adjusting to new meds.........counceling for depression etc.......cost is rarely an ultimately deciding factor in the end when suppression of viral load and increase in t'cells is the mark of success of a treatment regime for any individual.
Totally agree that we should be talking more with our specialists about how these
drugs effect us and our expectations .............
There are also a few lucky individuals around ( not that many)that have the 'non progressive gene' in their make up and don't ever have any major problems with Hiv.........Careful monitoring is essential for ALL especially given that one can have have this virus for 12/13 years before developing any major problems.
Wishing all a fantastic day.......It's still sunny up here....yippee!!!!!!!
Nick

[richyrich77]

Totally agree Nick,
Sorry for seeming rude,
I generally am not and I have thought about this post and realize the implications, yet they are true yet I do need to however refine my attitude.
I had a shit of a time with the health system in the beginning, yet realize some people are very happy on this combo and cheers to them, and I wish them all the best. (truly I do)

I have issues with the health system not so much with you (well none at all actually)

I will explain my experience with HIV.

I used to drink, party, and take a lot of drugs, I was a lost soul with an emptiness inside that could never be filled.
I used the gay scene and drugs ect as a way to escape the real world.

When I was around 19 I became quite successful in my work, and slightly happier with home life, partner ect.
I sorted out all my issues, drinking been one of the major ones (sober for over 5 years now) yet the HIV was an interesting one. The drugs left before that and I was pretty happy (strated partying around age of 13) yep had to dress as a girl to get into clubs once they found out how old I was.

When I got sober I had been for a full year, I had blood tests every 3 months for the period of a year (hoping and praying I did not have HIV) given the choices that I had made I was fully aware that the chances were extremely high.

A year passed and all was clear.
One day I went to work and after work had bad pains in my legs and back of neck and felt really sore.
Every year since I was 19yrs old doctors told me I had Glandular fever.
It would occur once a year like clockwork when working heaps or stressed.
I assumed it was this again.
(I also had regular HIV tests)

The next day I couldnt get up off the floor, never have I felt anything like this in my life.
I went and had tests and on fri the 13th lol doc called and asked me to come in.
He told me I had HIV shook my hand and sent me on my way (literally)
I was overwhelmed, how did I have hiv when I had not had unsafe sex for a year and taken care of myself.

To cut long story short, I met professor at Alfred ID clinic, she examined all my medical history and explained that I have carried it in my system undetected since I was around 19 years old, each year they told me I had Glandular was impossible as you only get max of twice and then it becomes Epsteen Bar Virus, she said many people can carry HIV and it will remain undetected even with HIV tests, until the time it sero converts and then it takes over.
I was 27 by this stage.
Why is the real truth about HIV not out there.?
Thousands, millions of people could have it and not know, is this why they cant say this. Perhaps I shouldnt either but it is true and it happened to me and no doubt lots of others.
Do not think for a minute I am not happy now with my life, I am very much so in a good place (have some bad days as we all do) yet my past created a future in which I can have had a world of experiences and come through the other side, been a humble happy individual, I appreciate and respect myself and life and am surrounded by normality the type I could only envy and have hatred towards when I was young as I could not achieve it.
I also cannot say HIV has been a bad thing for me, if anything a good one, it helped me search for a real existence in this world.
I long for nothing, I seek no material gain, completely non scene, non labels money has no relevance to me, once you have had all that and are still empty you begin to question the importance of things.

I apologize this post has nothing to do with original, it may however be interesting reading lol.

Good day to all
A book is to come one day, this may be why I have no issue sharing intimate personal things, as I think more people should be honest and themselves could make for a better world.

[BGF Admin]

Hi all,
Just wanted to clarify a few points from this thread following consultation with a specialist in this field:

• Efavirenz contains amphetamines:

This is not the case, it has a completely different chemical structure, and bears no chemical similarity to amphetamine or methamphetamine.

• Efavirenz contains "a huge amount of AZT ":

This is not the case, Stocrin® tablets contain no AZT, but rather 600mg of efavirenz plus the inactive ingredients sodium lauryl sulfate, lactose, magnesium stearate, and sodium starch glycollate.

• Efavirenz is an "ancient treatment" and "an old style of HAART" and that it "an ancient treatment as it contains a high percentage of AZT it is this that causes lipo"

This is incorrect: Efavirenz was first introduced into the PBS in 1999, it is a safe and efficacious HIV drug in good standing throughout the world.
It is listed as one of two drugs (Nevirapine or Efavirenz) in the non-nucleoside reverse transcriptase inhibitor (NNRTI) class to effectively suppress HIV-1 viral replication.
See: World Health Organisation Antiretroviral therapy for HIV infection in adults and adolescents 2006 guidelines
http://www.who.int/hiv/pub/guidelines/artadultguidelines.pdf, and
the European guidelines: European AIDS Clinical Society (EACS) Guidelines for the Clinical Management and Treatment of HIV Infected Adults in Europe
http://www.europeanaidsclinicalsociety.org/guidelinespdf/1_Treatment_of_HIV_Infected_Adults.pdf (http://www.europeanaidsclinicalsociety.org/guidelinespdf/1_Treatment_of_HIV_Infected_Adults.pdf)

It does cause some disturbances to the way sugars and fats are processed in the body, but it does not cause lipodystrophy.

• Efavirenz tablets "are given to nearly everyone as a first regime, as they are the cheapest to produce for the Australian Gov.".

This is incorrect:
Firstly the recommended retail prices of Nevirapine and Efavirenz as listed in the PBS are: Nevirapine $271.58, and Efavirenz $452.64 per 30-day supply. Nevirapine is cheaper for the government, but can't be prescribed for some males who have a moderate CD4+ count (>400 cells/mm3) because of concerns about its liver toxicity.

Secondly, that a range of first-line HIV drugs are recommended and actually used in Australia (not just one). Some doctors prefer NNRTI regimes others prefer protease inhibitor (PI) regimes. The 'backbone' is normally two nucleoside (or nucleotide) reverse transcriptase inhibitors (usually Truvada® or Kivexa®) plus either an NNRTI (Efavirenz or Nevirapine) or a PI boosted with Ritonavir.
See: Australasian Society for HIV Medicine Guidelines for the use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. November 3, 2008. Incorporating commentary to adapt the guidelines to the Australian setting. Page 30 onwards http://www.ashm.org.au/images/publications/guidelines/dhhsadult_04_03_09%20-%20final.pdf (http://www.ashm.org.au/images/publications/guidelines/dhhsadult_04_03_09%20-%20final.pdf)

• "The cost of Truvada is 8 times that of Efavirenz, generally the reason they like to keep you off them if they can"

Incorrect, Truvada® has a recommended retail price of $765.10, this is about 1.7 more costly than the same 30-day supply of Efavirenz.
In addition Efavirenz and Truvada® are not mutually excluded: In fact they are often prescribed together in combination.
The argument that clinicians prescribe Efavirenz instead of Truvada® because it is cheaper is incorrect: they are in different drug classes.

The ACON website has a news item about the new drug in the NNRTI class which has recently been listed in the PBS.
http://www.acon.org.au/hiv/news/etravirine (http://www.acon.org.au/hiv/news/etravirine)

Etravirine is a possible substitute drug for people who find that they cannot tolerate Efavirenz.

If people have intractable problems in managing the side effects of Efavirenz they should request their HIV doctor to consider switching them to another NNRTI (Nevirapine or Etravirine) or switching them to a protease inhibitor containing regime: for example Atazanavir (Reyataz®) or Darunavir (Prezista®) or Kaletra®.

The reality is that all these HIV drugs have side effects, however, after a period of settling into a new treatment most people can manage them. Consider it preferable to have to cope with side effects than slide into a compromised immune system and the risk of opportunistic infections, or other AIDS-defining conditions. There is increasing medical evidence that untreated HIV, even with moderate CD4+ counts, exposes people to a risk of early non-AIDS medical conditions such as cancers, cardio-vascular disease and neurological damage.

Help is available from both local AIDS councils and People With HIV organisations on managing side effects and adjusting to new treatments.

As in all these things, people should feel comfortable speaking with their HIV doctors: all S100 prescribers have to attended a prescriber's course on HIV medicine and clinical care, and be accredited by the Australasian Society for HIV Medicine. Most are highly skilled and well informed about advances in HIV medicine.

We hope that this information is useful.

[bgf northernnick]

Thanks guys for getting that last post together!:D
Very refreshing to see this forum being able to correct some points regarding these meds and with such gr8 links for further info too.
Hiv meds are crucial to long term survival living with Hiv so very happy here to know we can call on experts to help us out with latest info..........
Hope you are all doing well and looking forward to being able to offer any help with anyone elses issues around meds,
have a gr8 week all,
Nick