efavirenz + emtricitabine + tenofovir

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Atripla is a fixed-dose combination tablet containing three antiretroviral medications. One tablet of Atripla is equivalent to one tablet of efavirenz 600mg, a non-nucleoside reverse transcriptase inhibitor (NNRTI), and one tablet of Truvada. Truvada is a fixed-dose combination tablet of two nucleoside reverse transcriptase inhibitors (NRTIs), emtricitabine 200mg and tenofovir disoproxil fumarate 300mg.

Atripla is the first licensed combination pill that provides all the drugs needed for an anti-HIV regimen. It is approved for use as a first line regimen as well as for those who are treatment experienced.

Basic info


Generic name efavirenz + emtricitabine + tenofovir
Brand name Atripla
Also known as
Drug class Fixed Dose Combinations
Pediatric dosing? Available in doses suitable for children and/or young people.
Availability in Australia Available on the Pharmaceutical Benefits Scheme (PBS) through S100 prescribers since 2010
You may be able to import this drug from overseas for your personal use.
Formulation 600mg efavirenz; 200mg emtricitabine; 300mg tenofovir disoproxil fumarate
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Taking it

Like most anti-HIV drugs, efavirenz + emtricitabine + tenofovir must be taken in combination with other drugs to be completely effective. Commonly, efavirenz + emtricitabine + tenofovir is combined with one other nucleoside (NRTI) drug and either a protease inhibitor or non-nucleoside, although other combinations are sometimes used. Your doctor will advise you on the right combination of drugs to suit your circumstances.


Dosage

The normal adult dose is one tablet once a day preferably at bedtime.

Regardless of what you read on this website or elsewhere, you should always take your medications according to your doctor's instructions. If you're unsure, speak to your doctor or pharmacist.


With or without food

efavirenz + emtricitabine + tenofovir must be taken on an empty stomach

Side effect

All drugs can produce side effects in some people. These may be mild, moderate or severe, so you should be aware of potential side effects before starting any drug, and speak to your doctor if you experience side effects that concern you.


  • Common side effects may include nausea (upset stomach, feeling sick to the stomach), diarrhoea, headache, fatigue, vivid dreams, dizzyness.
  • Less common side effects may include nervous system symptoms, psychiatric symptoms, rash..
  • It's unlikely you will experience all of these side effects, and you may not experience any side effects at all. Before starting any new drug, ask your doctor about side effects you might experience and discuss strategies for dealing with side effects if they do occur. If you experience any significant side effect you should continue taking your medicine and see your doctor as soon as possible.

Interactions with other drugs

Atripla should not be taken with midazolam, triazolam, or ergot derivatives because competition for CYP3A4 liver enzymes by efavirenz could result in the inhibition of metabolism of these drugs and could create the potential for serious adverse events, including cardiac arrhythmias, prolonged or increased sedation and respiratory depression. Atripla should not be co-administered with voriconazole, because efavirenz significantly decreases voriconazole plasma concentrations. Atripla use is contraindicated with pimozide and St. John's wort. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination with other antiretrovirals. The safety of Atripla has not been established in patients coinfected with HIV and hepatitis B virus (HBV). Severe acute exacerbations of HBV have been reported in patients who have discontinued emtricitabine or tenofovir DF. Hepatic function should be monitored closely for at least several months in patients who discontinue Atripla and are coinfected with HIV and HBV. If appropriate, initiation of HBV therapy may be warranted. Atripla is not indicated for use in patients coinfected with HIV and chronic HBV. Because of the nature of the fixed-dose combination tablet, Atripla should not be used in combination with the individual component medications efavirenz, emtricitabine, and tenofovir DF. In addition, because of similarities between emtricitabine and lamivudine, Atripla should not be co-administered with drugs containing lamivudine, including the brand medications Combivir, Epivir, Epzicom, or Trizivir.