An Overview of Atripla (Efavirenz/Tenofovir/FTC)

ef-FAH-ver-enz / em-tri-SIT-uh-bean / te-NOE-fo-veer

Brand Name: Atripla
Other Name(s): EFV/FTC/TDF
Drug Class: Combination Drugs

What is efavirenz/emtricitabine/tenofovir disoproxil fumarate?

Efavirenz/emtricitabine/tenofovir disoproxil fumarate is a combination of three antiretroviral drugs, which are taken together in one tablet that is a fixed dose. Efavirenz (Sustiva) is a non-nucleoside reverse transcriptase inhibitor (NNRTI). Emtricitabine (Emtriva) and tenofovir DF (Viread) are nucleoside reverse transcriptase inhibitors (NRTIs).

The three drugs in combination work together to disrupt one of the early steps in the HIV life cycle, called reverse transcription. During normal reverse transcription, HIV's reverse transcriptase enzyme (a type of protein) converts HIV's RNA -- a single strand of genetic information -- into DNA -- a double strand of genetic information. It does this by recoding the RNA building blocks into complementary DNA building blocks. As the HIV life cycle proceeds, the newly formed DNA is used to make more copies of HIV virus.

When the efavirenz/emtricitabine/tenofovir disoproxil fumarate drug combination is present, however, efavirenz attaches directly to reverse transcriptase, blocking the conversion of RNA into DNA. Emtricitabine and tenofovir DF compete with available DNA building blocks called deoxycytidine 5′-triphosphate and deoxyadenosine 5′-triphosphate. By replacing these DNA building blocks in the newly developing HIV DNA, emtricitabine and tenofovir DF are able to stop reverse transcriptase from completing its job. This prevents the HIV DNA strand from being formed. The actions of efavirenz, emtricitabine, and tenofovir DF halt the HIV life cycle.

Is the combination of efavirenz/emtricitabine/tenofovir disoproxil fumarate known by any other names?

Yes. Efavirenz/emtricitabine/tenofovir disoproxil fumarate is marketed under the brand name Atripla. It was originally approved by the U.S. Food and Drug Administration (FDA) on July 12, 2006. The tablet containing the three drugs is currently approved for use alone as a complete regimen and in combination with other antiretroviral agents to treat HIV-1 infection in adults.

Does Atripla cure HIV or AIDS?

No. This medicine does not cure or prevent HIV infection or AIDS and does not reduce the risk of passing the virus to other people.

Who should not take Atripla?

• Atripla is not recommended for use in patients less than 18 years old.
• Because Atripla is a fixed-dose combination, it should not be used in patients who require dosage adjustment, such as those with moderate or severe renal (kidney) impairment.
• Women who are pregnant should not take Atripla.
• Women who are breastfeeding should not take Atripla.
• Depending on certain factors, Atripla may not be right for you. Your doctor will determine if it is appropriate for you to take this medicine.

What should I tell my healthcare provider before I take Atripla?

• Tell your doctor and pharmacist if you are allergic to Atripla, efavirenz, emtricitabine, tenofovir DF, or any other medications.
• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medication or monitor you more carefully for side effects.
• Tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking Atripla, call your doctor.
• Tell your doctor if you are breastfeeding. You should not breastfeed if you are infected with HIV or if you are taking Atripla.
• Tell your doctor about any medical conditions you may have had or currently have, including kidney problems, bone problems, liver problems (such as hepatitis B virus [HBV] infection), mental illness, seizures, drug or alcohol use.

How should I take Atripla?

• Always take this medication as your doctor instructs. Atripla is taken by mouth, without food (on an empty stomach).
• Unless your doctor tells you otherwise, continue your normal diet.
• Taking Atripla at bedtime may reduce certain side effects, such as dizziness, headache, trouble sleeping, drowsiness, trouble concentrating, and unusual dreams.
• Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
• Keep a written list of all the prescription medicines (such as Atripla) and nonprescription (over-the-counter) medicines you are taking, and any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important to carry this information with you in case of emergencies.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.