Transitory severe CNS adverse effects after accidental efavirenz overdose during post-exposure HIV prophylaxis.

摘要

A 45 year-old nurse reported a needlestick injury from an unknown source. A three-drug anti-HIV post-exposur.e prophylaxis (PEP) regimen with Combivir (azidotimidine/lamivudine) 1 pill plus nelfi-navir (250 mg) 5 pills twice daily was prescribed, but efavirenz pills (200 mg) were erroneously supplied instead of nelfinavir; consequently she took 5 pills (1000 mg) of efavirenz. Shortly thereafter she experienced dizziness, Hghtheadedness, irritability, impaired concentration, anxiety and insomnia. Nevertheless, the morning after she continued to take all the medications at breakfast. Her central nervous system (CNS) symptoms worsened and she also experienced mental confusion and had an unsteady gait.