Generic Name: efavirenz + tenofovir disoproxil fumarate + emtricitabine
Drug Class: Complete Regimens
Company: Bristol-Myers Squibb and Gilead Sciences
Approval Status: Approved
Generic Version Available: Yes
An alternative treatment regimen for antiretroviral-naive people living with HIV, as indicated by the U.S. Department of Health and Human Services (DHHS) Panel on Antiretroviral Guidelines for Adults and Adolescents. Visit https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/0 for the full DHHS guidelines.
Atripla is a single-tablet regimen for HIV. It contains two different types of HIV drugs: one non-nucleoside reverse transcriptase inhibitor and two nucleoside reverse transcriptase inhibitors. Atripla was approved by the U.S. Food and Drug Administration for use by people living with HIV in July 2006. A generic version became available in the U.S. in October 2020.
Atripla is a combination of three drugs: Sustiva (efavirenz), Viread (tenofovir disoproxil fumarate) and Emtriva (emtricitabine). All three drugs can be purchased individually for use in combination with other HIV drugs.
Adult Dose: One tablet once a day. Each tablet contains 600mg efavirenz + 300mg tenofovir disoproxil fumarate + 200mg emtricitabine.
Pediatric Dose: Age 12 to 18 years, and weighing at least 88lbs (40kg): one tablet once a day.
Dosing Info: This is a complete one-pill, once-daily drug regimen. Take on an empty stomach. Dose should be taken at bedtime to minimize dizziness, drowsiness and impaired concentration.
Many patients have dizziness, headache, trouble sleeping, drowsiness, trouble concentrating, and/or unusual dreams after starting treatment with Atripla. These feeling may be less noticeable if you take Atripla at bedtime on an empty stomach. They also tend to go away after you’ve taken the medicine for a few weeks. Tell your doctor promptly if any of these side effects continue or if they bother you.
A small number of patients have had severe depression, strange thoughts, or angry behavior while taking Sustiva, one of the drugs in Atripla. Some patients have had thoughts of suicide and a few patients have actually committed suicide. These problems tend to occur more often in patients with a history of mental illness. You should contact your doctor immediately if you think you are having these symptoms, so your doctor can decide whether you should continue to take Sustiva.
Rash is another common side effect of Atripla. These rashes usually go away without any change in treatment. In a small number of patients, rash may be serious. If you develop rash, call your doctor as soon as possible.
Atripla may lead to new or worsening kidney problems, including kidney failure. Your healthcare provider may do blood tests to check your kidneys before and during treatment with Atripla. If you develop kidney problems, your healthcare provider may need to make changes to your treatment regimen.
Atripla may lead to bone problems, including bone pain or bones getting soft or thin, which may lead to fractures. Your healthcare provider may do tests to check your bones.
If you also have hepatitis B virus (HBV) and take Atripla, your hepatitis may become worse if you stop taking it. Do not stop taking Atripla without first talking to your healthcare provider.
The following medications should not be taken while you are being treated with Atripla:
Antibiotics: Priftin (rifapentine)
Antifungals: Standard doses of Vfend (voriconazole)
Antihistamines: Hismanal (astemizole) or Seldane (terfenadine)
Antipsychotics: Orap (pimozide)
Acid reflux/heartburn medications: Propulsid (cisapride)
Heart medications: Vascor (bepridil)
Sedatives: Versed (midazolam) and Halcion (triazolam)
Antimigraine medications: Wigraine and Cafergot (ergot medications)
Antivirals: Hepsera (adefovir)
Atripla should not be used at the same time as Vfend (a voriconazole), a medication used for certain fungal infections. The efavirenz in Atripla can significantly decrease the effectiveness of Vfend; Vfend can significantly increase the risk of efavirenz side effects.
Atripla should not be combined with any HIV medications that contain any of the active ingredients in Atripla. These include: Complera, Emtriva, Genvoya, Stribild, Sustiva, or Viread. Combining Atripla with HIV medications containing active ingredients similar to those in Atripla should also be avoided. These include: Combivir, Epivir, Epzicom, Rescriptor, Triumeq, Trizivir, and Viramune.
Other medications that may be best avoided while being treated with Atripla: Fortovase, Invirase (saquinavir), Biaxin (clarithromycin), Noxafil (posaconazole), and Sporanox (itraconazole).
Important hepatitis C treatment drug-drug interactions: Can be combined with Sovaldi (sofosbuvir), Harvoni (ledipasvir/sofosbuvir), ribavirin, and pegylated interferon alfa. Do not use with Olysio/Sovriad (simeprevir) or Viekira Pak (ombitasvir/paritaprevir/ritonavir/dasabuvir).
Dose modifications may be required for the following medications, if combined with Atripla: calcium channel blockers such as Cardizem or Tiazac (diltiazem), Covera HS or Isoptin (verapamil) and others; Crixivan (indinavir), Selzentry (maraviroc); the immunosuppressant medicines cyclosporine (Gengraf, Neoral, Sandimmune, and others), Prograf (tacrolimus), or Rapamune (sirolimus); Methadone; Mycobutin (rifabutin); Rifampin; cholesterol-lowering medicines such as Lipitor (atorvastatin), Pravachol (pravastatin), and Zocor (simvastatin); or the anti-depressant medications bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban) or Zoloft (sertraline).
Other drug interactions are possible. Consult the Atripla package insert for more details: http://packageinserts.bms.com/pi/pi_atripla.pdf
Before taking this medication, tell your doctor if you have kidney disease, liver disease (including hepatitis B), or a history of depression/suicidal thoughts. In addition, tell your doctor if you are pregnant or planning to become pregnant, if you are breastfeeding, and all your medical conditions, including all prescription and over-the-counter medications and supplements you are taking.
For More Info: http://packageinserts.bms.com/pi/pi_atripla.pdf
Co-Pay Program Info: https://www.poz.com/basics/hiv-basics/drug-assistance-programs
Patient Assistance Program Info: https://www.poz.com/basics/hiv-basics/drug-assistance-programs
Last Reviewed: October 12, 0020