Atripla (Efavirenz + Emtricitabine + Tenofovir)
September 8, 2012
Fact Sheet 475).
The drugs in Atripla are a non-nucleoside reverse transcriptase inhibitor (efavirenz) and two nucleoside analog reverse transcriptase inhibitors, or nukes (emtricitabine and tenofovir). These drugs block the reverse transcriptase enzyme. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This has to occur before HIV's genetic code gets inserted into an infected cell's own genetic codes.
There are no absolute rules about when to start antiretroviral therapy (ART). You and your health care provider should consider your CD4 cell count, your viral load, any symptoms you are having, and your attitude about taking ART. Fact Sheet 404 has more information about guidelines for the use of ART.
If you take Atripla, you can reduce your viral load to extremely low levels, and increase your CD4 cell counts. This should mean staying healthier longer.
Atripla provides three drugs in one pill. It can be more convenient to use Atripla than some other combinations of drugs. This could mean fewer missed doses and better control of HIV. Atripla can be an effective regimen of ARVs in one pill.
Fact Sheet 126 for more information on resistance.
Sometimes, if your virus develops resistance to one drug, it will also have resistance to other ARVs. This is called "cross-resistance."
Resistance can develop quickly. It is very important to take ARVs according to instructions, on schedule, and not to skip or reduce doses.
Atripla should be taken on an empty stomach. Taking Atripla at bedtime may help reduce side effects. If you miss your dose, you can take Atripla up to 12 hours late. Otherwise, take your next dose at the regular time.
Food with high fat content can increase levels of efavirenz and should not be eaten before taking a dose of Atripla.
The most common side effects of Atripla are the same as with the drugs it contains: efavirenz (see Fact Sheet 432), emtricitabine (see Fact Sheet 420), and tenofovir (see Fact Sheet 419). They include headache, diarrhea, nausea, vomiting, vivid dreams, anxiety, rash, dizziness, insomnia, and loss of appetite.
About 5% of patients taking efavirenz had serious psychiatric symptoms. If you are taking Atripla and experience serious depression or other psychiatric symptoms, talk to your health care provider right away.
If you have had hepatitis B or C, your liver function tests may increase significantly. These should be monitored carefully.
Studies in monkeys showed that efavirenz is likely to cause birth defects. Pregnant women should not take Atripla, especially during the first 3 months of pregnancy.
People who take Atripla may falsely test positive for marijuana use. To prove that the results are false, you would have to identify the drug that you are taking. This would mean disclosing that you have HIV infection.
Drugs to watch out for include other ARVs, drugs to treat tuberculosis (see Fact Sheet 518), for erectile dysfunction (such as Viagra), for heart rhythm (antiarrhythmics), and for migraine headaches. Interactions are also possible with several antihistamines (allergy medications), sedatives, drugs to lower cholesterol, and anti-fungal drugs.
Efavirenz decreases blood levels of methadone. Efavirenz can lower concentrations of buprenorphine. Be aware of these interactions if you take Atripla.
The herb St. John's Wort (see Fact Sheet 729) lowers the blood levels of some non-nucleoside reverse transcriptase inhibitors. Do not take it with Atripla.
This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.