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Atripla

Other Names: ATP, emtricitibine/tenofovir/efavirenz
Manufacturer: Gilead

What is it?

Atripla® is the combination of three antiretroviral drugs (emtricitabine, tenofovir and efavirenz) used to treat HIV, a retrovirus. Retroviruses use the genetic material in the body’s cells to produce more virus which can infect other cells. Because emtricitabine and tenofovir may also decrease the amount of Hepatitis B Virus (HBV) found in the bloodstream, it may also be studied as a treatment to prevent liver damage that is caused by HBV.

How does it work?

Atripla® interferes with the life cycles of HIV and HBV to stop them from producing more virus. Specifically, this combination inhibits the enzyme called reverse transcriptase so HIV and HBV cannot build the genetic material needed to make more virus and infect more cells. Two of these drugs are often called nucleoside (emtricitabine) or nucleotide (tenofovir) reverse transcriptase inhibitors (NRTI). Efavirenz is a non-nucleoside reverse transcriptase inhibitors (NNRTI).

How do I take it?

  • Atripla® is available as a single tablet containing 200mg of emtricitabine (FTC), 300mg of tenofovir (TDF) and 600mg of efavirenz (EFV)
  • The usual dose of Atripla® is one tablet daily.
  • Because it is recommended that efavirenz be taken on an empty stomach, you should take Atripla® without food.

It is extremely important that you take Atripla and your other antiretroviral medications exactly as directed. You should set up a system that will help you remember to take your medicines so that you do not miss any doses. If you miss a dose, take it as soon as possible; however, if you skip a dose, do not take two doses at once. Do not stop taking the medication for any reason at any time unless you are directed to do so by your study clinician. If you are unable to continue taking your medication due to side effects, you should contact your provider immediately

Special Considerations

  • Atripla® should be stored at controlled room temperature in a dry place, out of the reach of children.
  • Taking efavirenz with food may increase the amount of drug in the bloodstream; this may lead to more frequent or more severe side effects.

Interactions

Some drugs taken together may have interactions that cause illness or impair the effectiveness of the drugs. It is a good idea to always check with your provider before taking any other medications, prescription or otherwise, to be sure it will not interact with Atripla®.

Tenofovir, one component of Atripla®, increases the levels of didanosine (Videx®) in the blood stream. This interaction may lead to side effects associated with didanosine. If you take didanosine, please talk with your provider or pharmacist about how to limit the development of possible side effects.

Side Effects

Not everyone experiences side effects. When they do occur, they may be mild, moderate or severe. Some side effects cannot be felt by the patient but can be found through laboratory tests, so it is important to see your provider regularly for checkups so that side effects can be detected early and treated.

The most common side effects of emtricitabine are: headache, asthenia (weakness or lack of energy), nausea, diarrhea, rhinitis (inflammation in the nose), cough and rash. Other side effects that have been reported when emtricitabine is used in combination with other antiretrovirals include changes in liver function, changes in pancreas function, and neutropenia (low white blood cell count). Symptoms of neutropenia that you may notice include any sign of infection. If you begin to have these symptoms, please contact your provider. Hyperpigmentation (dark coloring) of the palms of the hands and the soles of the feet has been reported in study subjects who received emtricitabine.

The most common side effects of tenofovir are: headache, weakness, diarrhea, nausea, and vomiting. In addition, please inform your provider if you have ever had any history of kidney problems. Your provider may need to monitor your kidney function.

During the first weeks of therapy with efavirenz, the most common side effects of efavirenz are dizziness, drowsiness or insomnia, impaired concentration, and abnormal dreams. Other possible side effects of efavirenz include skin rash, headache, nausea or vomiting, depression, and changes in liver function tests. Notify your provider if rash occurs.

Emtricitabine and Tenofovir are being studied as possible treatments for Hepatitis B virus (HBV). Patients infected with both HIV and HBV may experience a worsening of HBV symptoms if these medications are stopped.

Nucleoside/nucleotide reverse transcriptase inhibitors such as Atripla® have been associated with a condition called lactic acidosis. Lactic acidosis is a build-up of lactic acid, a byproduct of muscle metabolism, in the blood. Early symptoms can be vague and non-specific and can include nausea, vomiting, fatigue, abdominal pain, sudden unexplained weight loss, and shortness of breath. If you are experiencing these symptoms and they cannot be explained by other causes, please contact your provider immediately. Although lactic acidosis is a rare condition, it can be life-threatening if not treated.

 

 

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