Generic Name: efavirenz, emtricitabine, and tenofovir (ef AV ir enz, em trye SYE ta been, and ten OF oh vir)Brand Names: Atripla
Efavirenz, emtricitabine, and tenofovir is an antiviral medication that prevents human immunodeficiency virus (HIV) from reproducing in your body.
Efavirenz, emtricitabine, and tenofovir treats HIV, which causes acquired immunodeficiency syndrome (AIDS). Efavirenz, emtricitabine, and tenofovir is not a cure for HIV or AIDS.
Efavirenz, emtricitabine, and tenofovir may also be used for other purposes not listed in this medication guide.What is the most important information I should know about efavirenz, emtricitabine, and tenofovir?Do not use this medication while you are pregnant. It could harm the unborn baby. Use effective birth control while you are using this medication, and for at least 12 weeks after your treatment ends. Tell your doctor if you become pregnant during treatment. Do not take this medication if you are also taking cisapride (Propulsid), midazolam (Versed), triazolam (Halcion), St. John's wort, voriconazole (Vfend), or an ergot medicine such as dihydroergotamine (D.H.E. 45, Migranal), ergonovine (Ergotrate), ergotamine (Ergomar), or methylergonovine (Methergine). Do not take this medication with other medicines that also contain efavirenz, emtricitabine, tenofovir (Sustiva, Emtriva, Truvada, or Viread), or lamivudine (Combivir, Epivir, Epzicom, or Trizivir).
There are many other medicines that can cause interactions or serious medical problems if you take them together with efavirenz, emtricitabine, and tenofovir. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.Some people have developed a life-threatening condition called lactic acidosis while taking this medication. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired. Efavirenz, emtricitabine, and tenofovir can cause severe or fatal liver problems. Call your doctor at once if you have symptoms such as nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).What should I discuss with my healthcare provider before taking efavirenz, emtricitabine, and tenofovir?Do not use this medication if you are taking any of the following drugs:
midazolam (Versed) or triazolam (Halcion);
St. John's wort;
an ergot medicine such as dihydroergotamine (D.H.E. 45, Migranal), ergonovine (Ergotrate), ergotamine (Ergomar), or methylergonovine (Methergine); or
lamivudine (Combivir, Epivir, Epzicom, or Trizivir); or
any other medicines that also contain efavirenz, emtricitabine, or tenofovir (such as Sustiva, Emtriva, Truvada, or Viread).
If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take efavirenz, emtricitabine, and tenofovir, tell your doctor if you have:
a history of mental illness, use of antipsychotic medication, or injection drug use;
epilepsy or other seizure disorder;
osteopenia (low bone mineral density); or
hepatitis B or C infection.
Your name may need to be listed on a pregnancy patient registry when you start using this medication.You should not breast-feed while you are using efavirenz, emtricitabine, and tenofovir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk. Some people have developed a life-threatening condition called lactic acidosis while taking this medication. You may be more likely to develop lactic acidosis if you are overweight or have liver disease, if you are a woman, or if you have taken certain HIV or AIDS medications for a long time. Talk with your doctor about your individual risk.
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from this medication.Take this medication on an empty stomach at bedtime.
To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.
It is important to take this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.Store this medicine at room temperature away from moisture, heat, and direct light. Keep the medicine in its original bottle with the cap tightly closed.
See also: Efavirenz, emtricitabine, and tenofovir dosage in more detail
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
signs of liver damage - nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
urinating less than usual or not at all;
fever, chills, body aches, flu symptoms;
unusual thoughts or behavior, severe depression, extreme fear, thoughts of hurting yourself or others, hallucinations;
severe blistering, peeling, and red skin rash; or
Less serious side effects may include:
dizziness, drowsiness, anxiety, depressed mood;
headache, tired feeling, ringing in your ears, vision problems;
sleep problems (insomnia), confusion, strange dreams, forgetfulness;
mild nausea, vomiting, diarrhea, loss of appetite, upset stomach;
darkened skin on the palms of your hands or the soles of your feet;
joint pain, back pain;
numbness or tingly feeling;
runny or stuffy nose, cough; or
changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for HIV Infection:
Usual dose: 1 tablet orally once a day at bedtime on an empty stomach
There are many other medicines that can cause interactions or serious medical problems if you take them together with efavirenz, emtricitabine, and tenofovir. Tell your doctor if you use any of the following:
acyclovir (Zovirax), ganciclovir (Cytovene), valacyclovir (Valtrex), or valganciclovir (Valcyte);
adefovir (Hepsera) or cidofovir (Vistide);
a blood thinner such as warfarin (Coumadin);
cholesterol medications such as atorvastatin (Lipitor), pravastatin (Pravachol), or simvastatin (Zocor);
antibiotics such as clarithromycin (Biaxin), itraconazole (Sporanox), ketoconazole (Nizoral), rifabutin (Mycobutin), rifampin (Rifater, Rifamate);
a calcium channel blocker such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nifedipine (Procardia, Adalat), verapamil (Calan, Covera, Isoptin, Verelan), and others;
seizure medicines such as carbamazepine (Tegretol, Carbatrol), phenytoin (Dilantin), phenobarbital (Luminal, Solfoton); or
certain other HIV medicines such as atazanavir (Reyataz), didanosine (Videx), indinavir (Crixivan), saquinavir (Invirase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), or ritonavir (Norvir).
This list is not complete and there may be other drugs that can interact with efavirenz, emtricitabine, and tenofovir. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.