AIDS and HIV Information
What is Atripla Used For?
Atripla is a single-tablet regimen (STR) approved for the treatment of HIV-1 infection. It contains three medications from the NRTI and NNRTI class of anti-HIV drugs. It was approved by the FDA in 2006 and became the first complete, single-tablet, once-daily regimen for adults and children 12 years of age and older. It is currently listed in the US Department of Health and Human Services (HHS) HIV treatment guidelines as an alternative regimen for treatment-naïve patients or those starting HIV treatment for the first time.
How it works
- 600mg of efavirenz (EFV)
- 200mg of emtricitabine (FTC)
- 300mg of tenofovir (TDF)
Emtricitabine and tenofovir belongs to the antiretroviral (ARV) HIV drug class called Nucleoside/Nucleotide Reverse Transcriptase Inhibitors or NRTI, while efavirenz is an active ingredient from the Non-NRTI class. Both group of drugs work together to block the conversion of HIV RNA to HIV DNA. The enzyme reverse transcriptase is an important component of HIV’s life cycle. By blocking reverse transcriptase and the process of reverse transcription, the virus won’t be able to multiply and proliferate in your immune system.
Things to know before taking Atripla
Safety and efficacy
Atripla was the only combination treatment in one pill for years, until the introduction of Complera in 2011. They contain the same drugs and share the same side effects, but Complera is somewhat better tolerated than Atripla. According to the Star study, patients reported significant improvement in their physical health using Atripla, but experienced better mental health with Complera. One study showed that people on a stable HIV regimen can safely switch to Atripla; 87% of 300 participants remain undetectable after 48 weeks. However, side effects were also more common and nervous system-related effects are often the reason for discontinuance. A small, but interesting, study showed that a reduced dosing of three days a week for Atripla is effective in maintaining viral suppression among patients on a stable and suppressive regimen for more than two years.
Warnings and contraindications
- Do not take this regimen if you are allergic to any of the three active ingredients (efavirenz, emtricitabine, and tenofovir) in this medication.
- You should not take this drug if you have the following medical conditions: severe liver disease, heart disorders (i.e., QT interval prolongation), low levels of electrolytes, and moderate to severe kidney disease.
- You should be closely monitored if you have hepatitis B infection, as emtricitabine is not approved for this condition and your symptoms may worsen after discontinuation of Atripla.
- Inform your doctor if you have a history of mental illness, convulsions or seizures, and liver disease.
- Efavirenz causes serious birth defects in unborn animals and babies of pregnant women treated with Atripla. You should avoid getting pregnant or breastfeeding your baby while taking Atripla.
- Taking alcohol with this medication may worsen side effects such as drowsiness.
- Atripla may cause serious adverse events, including but not limited to, liver impairment, lactic acidosis, psychiatric problems (e.g., depression, vivid dreams, and suicidal thoughts), changes in bone mineral density, kidney problems, and flare ups of hepatitis B infections.
- The efavirenz component of Atripla may cause a false positive for cannabis drug test.
Some common medicines and herbal supplements may cause serious interactions with Atripla.
- Medicines that contain emtricitabine, efavirenz, tenofovir, and other anti-HIV drugs.
- Pain relievers or non-steroidal anti-inflammatory drugs like Ibuprofen and Aspirin.
- Antibiotics (aminoglycosides, vancomycin)
- Antivirals (ganciclovir, cidofovir)
- Antifungals (pentamidine, amphotericin B)
- Chemotherapy medications (interleukin 2)
- St. John’s wort and Ginkgo biloba extract
- Statins or blood fat lowering medicines
- Anticonvulsants (carbamazepine, phenytoin, phenobarbital)
- Anti-TB drugs (rifampicin, rifabutin)
- Birth control pills
- Anti-blood clot medications (warfarin)
How to take Atripla?
Always read the package insert or patient information included with every pack of Atripla, as there may be updates about the drug. The recommended dose for this regimen is one tablet once daily by mouth. It should be taken on an empty stomach, at least one hour before or two hours after meal. Doctors usually advise to take Atripla at bedtime to make side effects, such as dizziness or drowsiness, less bothersome. Do not stop treatment abruptly or alter the dose without consulting your medical provider. Refill your prescription in advance when your supply starts to run low. Stopping treatment, even for a short time, may result to drug resistance.