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Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors

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Hyperhidrosis in association with efavirenz.

Aurelio Fuertes¹, Aurelio Fuertes Martín, Salvador Cabrera

¹Infectious Disease Service, University Hospital of Salamanca, Salamanca, Spain.

AIDS Patient Care and Stds

|October 30, 2009

Summary

This summary is machine-generated.

Excessive sweating in patients taking efavirenz (EFV) may be a dose-dependent adverse drug event. Reducing the EFV dose controlled severe nocturnal sweating, suggesting a link to drug concentration.

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Area of Science:

Pharmacology and Toxicology
Neuroscience
Clinical Medicine

Background:

Hyperhidrosis, or excessive sweating, can be an adverse drug event (ADE) affecting thermoregulation.
Efavirenz (EFV) is an antiretroviral medication known to cross the blood-brain barrier.

Observation:

A patient on a 600 mg nightly dose of EFV experienced severe nocturnal sweating.
This patient had elevated EFV plasma concentrations and a CYP2D6 genetic deficiency.
The sweating resolved within 15-20 days after reducing the EFV dose to 400 mg/day.

Findings:

Nocturnal hyperhidrosis in this case was episodic, dose-dependent, and linked to elevated EFV plasma levels.
EFV's ability to reach the central nervous system may impact thermoregulation, causing sweating.
Hyperhidrosis is not listed as an EFV side effect, potentially leading to underdiagnosis.

Implications:

Hyperhidrosis could serve as a clinical indicator of supratherapeutic EFV plasma concentrations.
Reducing the EFV dose appears to effectively manage this specific adverse drug event.
Further investigation into EFV-induced hyperhidrosis incidence and its underlying mechanisms is warranted.