efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF)
Recommended initial regimen in certain clinical situations
One tablet once daily on an empty stomach, preferably at bedtime (food increases the risk of central nervous system, or CNS, toxicities). Tablet contains 600 mg of the NNRTI efavirenz plus 200 mg emtricitabine and 300 mg tenofovir disoproxil fumarate (TDF).
For adults and children 12 years of age and older weighing at least 88 pounds (40 kg).
Take missed dose as soon as possible, unless it is closer to the time of your next dose. Do not double up on your next dose. Do not split or crush the tablet. Dose cannot be adjusted for people with kidney problems and Atripla should not be used in people with moderate or severe kidney or liver impairment.
A similar, but not exact, off-patent medication is available (see pages for Symfi and Symfi Lo, EFV/3TC/TDF).
Gilead Sciences, Inc.
(800) GILEAD-5 (445–3235)
• See the individual drugs contained in Atripla: Sustiva and Truvada (co-formulation of Emtriva and Viread).
• See package insert for more complete information on potential side effects and interactions.
Use with caution in individuals with depression or other psychiatric issues who are not receiving mental health care. A 2014 study (reference online) reviewed four previously published AIDS Clinical Trials Group (ACTG) studies regarding efavirenz and suicidal ideation and re-emphasized the fact that efavirenz has an association with suicidality (reported suicidal ideation or attempted or completed suicide), and should be used with caution in patients with severe or uncontrolled depression and/or a history of suicidality. It is recommended for anyone on a regimen containing efavirenz to be screened for depression and suicidality. Common side effects may include dizziness, drowsiness, abnormal or vivid dreams, difficulty concentrating, rash, diarrhea, nausea, fatigue, headache, and insomnia. These side effects may go away after a few weeks. Kidney function should be assessed before initiating treatment and throughout therapy as determined by a provider. Prior to initiation, people should be tested for hepatitis B (HBV) infection. Severe exacerbations of hepatitis B have been reported in people who are co-infected with hepatitis B and have discontinued the emtri-citabine and/or tenofovir components. Monitor liver enzymes closely in people co-infected with hepatitis B and, if appropriate, initiation of anti-hepatitis B therapy may be warranted. The efavirenz component of Atripla has been associated with central nervous system (CNS) birth defects in non-human primates, and cases of neural tube defects have been reported after first trimester exposure in humans. A link between efavirenz and birth defects in humans has not been supported in meta-analyses. The recommendation is that women in their first trimester continue taking efavirenz as long as their viral load remains undetectable; however, efavirenz should only be used if the potential benefit outweighs the potential risk (as when other treatment options are not available). Because of the association with suicidality and neuropsychiatric effects, it is also recommended to screen for antenatal and postpartum depression in women with HIV who are taking a regimen containing efavirenz. The efavirenz in Atripla can cause a false positive for marijuana on certain drug tests. A more specific confirmatory test can be done.
Do not take with Epivir-HBV, Hepsera, or Vemlidy (TAF), all three used for the treatment of hepatitis B. Atripla should not be taken with voriconazole, ergot derivatives, midazolam, pimozide, triazolam, bepridil, or St. John’s wort. Atripla should also not be taken with other medications that prolong QTc interval (a heart problem) or medications with a known risk of torsades de pointes. No dose adjustment of Atripla needed with Sovaldi. Use caution when administering Atripla with Harvoni and monitor renal function closely due to possible increased tenofovir levels. Increase dose of Daklinza to 90 mg when used with Atripla. Atripla should not be taken with Epclusa, Olysio, Viekira Pak, or Zepatier. Not intended to be taken with other HIV medications, unless prescribed that way. Tell your provider or pharmacist about all medications, herbals, and supplements you are taking or thinking of taking, prescribed or not, as there are other drug interactions which are not listed here.
Atripla is listed as a “Recommended Regimen in Certain Clinical Situations” in the DHHS guidelines based on a high rate of central nervous system side effects and a possible association with suicidality. Be careful when stopping Atripla, so that you avoid the rapid development of HIV resistance to it—check with your provider or pharmacist first.
Atripla is a once-a-day single-tablet regimen that has been used to treat HIV infection for quite some time. It was the favorite for initial therapy due to its potency and relative safety. The medicines contained in Atripla are efavirenz, emtricitabine, and tenofovir disoproxil. Efavirenz is known for its neurotoxicity. Individuals taking it have reported vivid dreams, depression, fatigue, and insomnia. For some time people believed these side effects would go away while others believe that you just get used to them. Watch out for any liver, kidney, bone, or mental problems while taking this regimen. Make sure your doctor monitors you closely.
Our pharmacists are experts in managing HIV/AIDS, medication therapy and finding valuable treatment resources. We always keep Atripla in stock so you never have to wait to receive your medication. If you have any issues with your insurance plan or coverage, we’ll find a solution so you don’t miss a dose. You can rest assured that you have picked a partner who will work with you and your doctor to achieve your treatment goals.
Yes. Drug Mart pharmacy stocks all of the latest HIV/AIDS medications, including Atripla.
Drug Mart offers free prescription delivery to any location (home or office) in New Jersey, New York or Pennsylvania.
Drug Mart is licensed in New Jersey, New York and Pennsylvania. If you live in one of these States, complete the form at Get Started, and our pharmacy team will handle the rest.
Yes. Drug Mart offers the blister pack, multi-dose medication packaging to any patient who take more than 5 medications per day. Each pack is made up of 28 individual blisters containing a person’s prescribed medication for a specific time and date. This service is completely free-of-charge.
Gilead, the maker of Atripla has a prescription copay assistance program. Our staff is trained to find these savings and help lower the price you pay for your prescription. In most cases, patients pay zero dollar out-of-pocket for their Atripla prescription.
ATRIPLA® is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults.
According to the U.S. Department of Health and Human Services, many patients can get to undetectable in 24 weeks, when taking their treatment as prescribed.
Most Medicare Part D plans cover Atripla. Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Atripla.
You should take Atripla on an empty stomach. This means having a two-hour gap between eating and taking your medication. You should then wait at least one hour before eating again.
It is recommended to take Atripla at bedtime to help avoid certain side effects.
If you miss a dose of Atripla within 12 hours of the time you usually take it, take your dose with food as soon as possible. Then take your next dose at the regularly scheduled time. If you miss a dose by more than 12 hours of the time you usually take it, wait and then take the next dose at the regularly scheduled time. Do not take more than your prescribed dose to make up for a missed dose.
No. Note that Atripla tablets should be administered whole.
Atripla should not be taken with voriconazole, ergot derivatives, midazolam, pimozide, triazolam, bepridil, or St. John’s wort. Atripla should also not be taken with other medications that prolong QTc interval (a heart problem) or medications with a known risk of torsades de pointes.
Yes, you may take a multivitamin. No interactions were found between Atripla and multivitamins. This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Yes. Always consult your healthcare provider.
Medicines that may interact with Atripla include: Some anti-inflammatory pain medicines (“NSAIDS”) such as ibuprofen (Advil®) or naproxen (Aleve®) may increase the risk of kidney problems
There is no direct interaction between alcohol and Atripla. However, there can be an indirect interaction between alcohol and adherence. Drinking alcohol occasionally with your treatment will not affect the efficacy of Atripla. Drinking alcohol in moderation should not have an effect on your health or treatment. This is also dependent on not having other liver related problems like hepatitis B or C.
- dizziness, drowsiness, tired feeling
- nausea, diarrhea
- headache, depressed mood, trouble concentrating
- sleep problems (insomnia), strange dreams
- changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist)
Dizziness, trouble sleeping, drowsiness, unusual dreams, and trouble concentrating may frequently occur. These side effects may begin 1-2 days after starting this medication and usually go away in 2-4 weeks.
Depression was a common side effect in clinical trials of Atripla. It occurred in 9 percent of the people taking the drug. Tell your doctor right away if you have symptoms of depression. These can include feelings of sadness, hopelessness, and loss of interest in daily activities.
If you stop taking Atripla, even for a short time, the amount of virus in your blood may increase. The virus may become harder to treat.
Women should not become pregnant while taking Atripla and for 12 weeks after stopping it. It is not known if Atripla will cause birth defects.
Tell your doctor if you are breastfeeding. You should not breastfeed if you are HIV-positive because of the chance of passing the HIV virus to your baby.
Call us at the pharmacy and we’ll be glad to answer any questions. You can reach us at (800) 877-0337.