Generic Name: efavirenz-emtricitabine-tenofovir, Oral tablet

Atripla

All Brands

  • Atripla
SECTION 1 of 4

Highlights for efavirenz-emtricitabine-tenofovir

Oral tablet
1

Atripla is a combination of three drugs. It’s a complete treatment for HIV. In general, people who take this drug don’t usually need to take other HIV drugs.

2

Common side effects include mood changes, stomach problems, increased cholesterol, and others.

3

Atripla has many drug interactions. To avoid interaction problems, your doctor may manage the other drugs you take.

4

Atripla can have negative effects on people with certain conditions. If you have kidney disease, liver disease, or hepatitis B, tell to your doctor before taking Atripla.

5

The normal dosage for Atripla is one tablet every day. You can take it at bedtime to reduce your reaction to its side effects.

IMPORTANT INFORMATION

FDA Warning

Atripla has a Black Box Warning. This is the most serious warning from the U.S. Food and Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous problems.

Warning:

  • Lactic acidosis can occur while taking this drug. This critical change in the body’s chemical balance can cause serious symptoms, including liver enlargement.
  • If you have hepatitis B, start taking this drug, and then stop, it may worsen your hepatitis B symptoms.

May slow kidney function

This can affect the ability of your kidneys to filter out wastes and keep you healthy. Your doctor should test your kidney function before taking Atripla.

Anti-inflammatory warning

Don’t take large doses of ibuprofen, naproxen, piroxicam, or other anti-inflammatory drugs — or take them for a long time. Taking these drugs with Atripla can slow your kidney function. Combining them may cause Atripla to stay in your body longer than it should, which can increase its side effects.

May decrease bone density

Tenofovir, one of the drugs in Atripla, may decrease your bone mineral density and increase your risk of breaking a bone. Ask your healthcare provider or pharmacist if you should take vitamin D and calcium while taking Atripla.

Drug Features

Atripla is a prescription drug. It is available in these forms: oral tablet.

This is a combination of two or more drugs in a single form. It is important to know about all the drugs in the combination because they each may have unique traits.

Why It's Used

Atripla treats HIV in adults and children ages 12 and older who weigh at least 88 pounds.

More Details

How It Works

Atripla contains three drugs: efavirenz, emtricitabine, and tenofovir disoproxil fumarate.

More Details

Why It's Used

Atripla treats HIV in adults and children ages 12 and older who weigh at least 88 pounds.

It has three drugs in one tablet. It’s a complete HIV treatment, which means most people won’t need to combine it with other HIV drugs.

Atripla is often effective in controlling HIV in people who take it every day.

How It Works

Atripla contains three drugs: efavirenz, emtricitabine, and tenofovir disoproxil fumarate.

  • Emtricitabine and tenofovir are nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs work by blocking an enzyme called reverse transcriptase, which HIV uses to multiply in your body. Blocking the enzyme helps to control the virus.
  • Efavirenz is a non-nucleoside reverse transcriptase Inhibitor (NNRTI). Efavirenz also blocks reverse transcriptase. It helps to prevent HIV from multiplying and inserting itself into your genes.
SECTION 2 of 4

efavirenz-emtricitabine-tenofovir Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with Atripla are:

  • changes in the distribution of body fat, such as an increasing amount of fat on or around the neck

  • increased cholesterol and triglyceride levels

  • diarrhea, nausea, or vomiting

  • mood changes, including depression, insomnia, anxiety, or bad dreams. These are common during the first few weeks of taking efavirenz, one of the three drugs in Atripla. If you have extreme mood changes, call your healthcare provider.

  • headaches

  • immune reconstitution syndrome. This may occur as your immune system recovers. In this condition, symptoms of infections that you may have had previously can suddenly worsen.

  • rash. If you experience a bad rash, or if it appears suddenly or gets worse, call your doctor right away. A serious rash from efavirenz is a sign that you are very ill.

  • skin discolorations, such as the appearance of small freckles or spots

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • symptoms of liver disease, such as fatigue, light-colored stool, pain in the upper right part of abdomen, or yellowing of the eyes or skin

  • symptoms of reduced kidney function

  • broken bones

  • severe or sudden rash

  • severe mood problems

  • depression

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Atripla does not cause drowsiness.

In many cases, Atripla produces predictable side effects that occur after a dose such as: 

  • bad dreams
  • depression
  • anxiety
  • insomnia

These effects occur due to the drug efavirenz, which is one of the three drugs in Atripla.

These side effects may disappear within several weeks. Contact your healthcare provider if you have severe mood changes.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

efavirenz-emtricitabine-tenofovir May Interact with Other Medications

Oral tablet

Atripla can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol Interaction

Avoid alcohol when taking this drug combination. Alcohol can cause you to be unpredictably sleepy and sedated.

Medications That Might Interact with This Drug

HIV Drugs

Don’t take other antiretroviral HIV drugs with Atripla. Most people won’t need other drugs to treat their HIV. If you’ve taken efavirenz in the past and had an allergic reaction or rash, don’t take Atripla. One of its ingredients is efavirenz. Taking efavirenz again after having a rash the first time could be very serious or even fatal.

Other Drugs

Do not combine these drugs with Atripla:

  • astemizole (available only in Canada)
  • bepridi
  • cisapride
  • ergotamine and other ergot-related migraine drugs
  • pimozide
  • St. John’s wort
  • terfenadine (available only in Canada)
  • triazolam
  • voriconazole

Drugs with Increased Effects

Atripla may increase the effects of some drugs. Your healthcare provider may need to adjust your dose or change to another drug.

Certain HIV drugs may have increased effects if taken with Atripla. These include:

  • didanosine
  • ritonavir
  • lamivudine
  • lopinavir / ritonavir
  • ritonavir

Other drugs that may have increased effects if combined with Atripla include:

  • adefovir
  • antidepressants, including paroxetine, sertraline, and others
  • darunavir
  • ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs). Avoid taking these for a long time or at high doses while taking Atripla.
  • vancomycin and other aminoglycoside antibiotics
  • zolpidem

Drugs with Decreased Effects

Atripla may decrease the effects of other drugs. Your doctor may need to change the dose.

Certain HIV drugs may have decreased effects if taken with Atripla. These include:

  • atazanavir
  • fosamprenavir
  • indinavir
  • raltegravir
  • saquinavir

Other drugs that have decreased effects if combined with Atripla include:

  • atorvastatin
  • boceprevir, used to treat hepatitis B
  • bupropion
  • clarithromycin
  • cyclosporine
  • diltiazem
  • felodipine
  • itraconazole
  • ketoconazole
  • methadone
  • nicardipine 
  • nifedipine
  • posaconazole
  • pravastatin
  • maraviroc
  • oral contraceptives
  • phenobarbital
  • rifampin
  • rifabutin
  • sertraline
  • simvastatin
  • sirolimus, and other related drugs
  • tacrolimus
  • telaprevir, used to treat hepatitis C
  • verapamil

Drugs with Unpredictable Results

Some drugs may have unpredictable results when combined with Atripla. Your healthcare provider will monitor them and change the dose as needed:

  • carbamazepine
  • phenytoin
  • phenobarbital
  • warfarin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with kidney disease

If you have kidney disease and your creatinine clearance is less than 50 mL per minute, talk to your healthcare provider before taking Atripla. This drug is not recommended for those with slower kidney function, because the drug can pile up in your body and slow your kidneys. This would lead to worsened side effects.

People with liver disease

If you have any liver disease, talk to your healthcare provider before taking Atripla. Atripla is processed through the liver. If your liver isn’t working well, you might not be able to take the drug. Your doctor should check your liver function before starting you on Atripla.

People with hepatitis B

This drug is not approved to treat HIV in people with hepatitis B. If you have hepatitis B, start this drug, and then stop, your hepatitis can get much worse. Your doctor will need to perform liver function tests and may need to treat the hepatitis.

Pregnant women

Atripla is a pregnancy category D drug. This means studies of the drug in pregnant animals have shown harm to offspring. But, despite the potential for problems, this drug may still be prescribed if the possible benefits outweigh the risks.

Pregnancy testing is recommended before you start Atripla. If you’re a woman who is able to become pregnant, you should use effective pregnancy prevention during treatment and for 12 weeks afterward.

There may be other HIV drugs that are safer during pregnancy than this drug combination. If you’re pregnant or plan to become pregnant, talk to your doctor before taking Atripla.

Women who are nursing

It’s not recommended to breastfeed infants while you’re taking Atripla. Emtricitabine, one of the three drugs in Atripla, can be passed to the baby through breast milk.

If an infant is exposed to Atripla, the drug may become an ineffective treatment for them later in life.

For Children

Atripla can be given to children ages 12 and older who weigh at least 88 pounds.

Children should have their kidney function tested before treatment. Atripla can be hard on the kidneys, and it may also affect bone density. Lab tests may be needed to see if Atripla affects the bones of children or adults. Children should also be tested for hepatitis B before starting Atripla because their hepatitis can become much worse.

Allergies

Atripla can cause a sudden, life-threatening rash in some people. The rash is a sign that your immune system is reacting poorly to the Atripla and you should stop taking it right away. This reaction can lead to wheezing and breathing problems.

A worsening rash can be a sign that the reaction is growing worse. Call your doctor right away if you experience a serious or sudden rash.

SECTION 4 of 4

How to Take efavirenz-emtricitabine-tenofovir (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

HIV

Brand: Atripla

Form: Oral Tablet
Strength: Efavirenz 600 mg/emtricitabine 200 mg/enofovir disoproxil fumarate 300 mg
Adult Dosage (ages 18-64 years)

Take one tablet every day on an empty stomach.

Child Dosage (ages 12-17 years and ≥ 88 pounds)
  • Take one tablet every day on an empty stomach.
  • Since this medicine is a fixed dose, it cannot be used in patients who are younger than 12 and < 88 pounds.
Senior Dosage (ages 65 years and older)
  • There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal.
  • If you’re a senior, you may need a lower dose or you may need a different schedule.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug controls the HIV virus by stopping the virus’s growth process. It also can prevent HIV from entering your healthy cells. Atripla can work well if you take it every day.

If You Miss a Dose or Stop the Drug

If you skip doses or stop taking it, the virus may start multiplying again, which can make your HIV symptoms worse.

If You Stop and Start Again

If you stop the drug and start again, you could experience worse side effects. The drug could become less effective.

If You Miss a Dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before it’s time for the next dose, wait to take it as scheduled. Don’t try to catch up by taking two tablets at once.

How Can I Tell if the Drug is Working?

Your doctor will need to run lab tests to see if this drug is working well for you. 

They will check your:

  • viral load
  • CD4 count
  • other indicators of controlled infection

Atripla is a long-term drug.

Store Atripla at room temperature: 68 – 77°F (20 – 25°C)

Keep the medication tightly closed and in its original container, and away from heat and light.

Clinical Monitoring

This drug will require occasional lab tests. Tests can monitor both the effectiveness of the drug and whether it’s causing side effects or potential changes to your kidneys or liver.

These tests could include:

  • CD4 counts (for effectiveness of treatment)
  • kidney function tests
  • liver function tests
  • bone density tests

Not every pharmacy stocks this drug, so call ahead

If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can’t dispense only part of a bottle.

This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail order pharmacies and ship the drug to you.

In larger cities, there will often be HIV pharmacies where you can have your prescriptions filled. Ask your doctor if there’s a local HIV pharmacy in your area.

Insurance

Many insurance companies will require a prior authorization (P.A.) before approving and paying for Atripla.

Are There Any Alternatives?

There are many drugs and combinations that can treat HIV. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

Content developed in collaboration with Susan J. Bliss, RPh, MBA

Medically reviewed by Alan Carter, PharmD and Stacey Boudreaux, PharmD on January 22, 2015

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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