Would there be benefits in taking a double dose of Atripla (2 pills instead one)? I am aware there could be possible increases in side effects. But I am tempted to think that maybe that might help supress the virus in the system more quickly if one can tolerate the side effects.

Besides the doubling of the cost and increased side effects there is no data to justify using higher doses of Atripla in the setting of already good virologic control or to more rapidly decrease viral levels if just starting medications. The doses used were based on the data balancing effectiveness and toxicity from earlier studies with the individual component drugs. The high rates of success with Atripla seen in actual practice provides solid evidence that the doses of the drugs used in the fixed formulation are appropriate for the majority of patients starting treatment. In some cases (often due to drug interaction concerns or renal problems) differing doses of the individual drugs need to be given so that Atripla is not the right formulation but the drugs need to be prescribed separately. KH