Atripla – Fixed‑Dose Combination of Efavirenz, Tenofovir & Emtricitabine for HIV-1 Treatment | EZ Chemist Online Pharmacy
Atripla (Efavirenz/Tenofovir Disoproxil Fumarate/Emtricitabine) – Once‑Daily Single‑Tablet Regimen for HIV‑1 Infection | Buy Online at EZ Chemist
What is Atripla used for?
Atripla is a once‑daily, single‑tablet regimen combining efavirenz, tenofovir disoproxil fumarate, and emtricitabine for the treatment of HIV‑1 infection in antiretroviral‑naïve adults. It suppresses viral replication, increases CD4+ cell counts, and slows disease progression.

Product Overview
Brand Name: Atripla
Efavirenz 600 mg
Tenofovir Disoproxil Fumarate 300 mg
Emtricitabine 200 mg
Dosage Form: Film‑coated oral tablet
Strength: All three actives combined in one tablet
Pack Sizes: 30‑tablet bottles; 30‑, 90‑ and 180‑tablet blister packs
Efavirenz: Non‑nucleoside reverse transcriptase inhibitor (NNRTI)

Tenofovir DF & Emtricitabine: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

Prescription Status: Rx only

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Active Ingredients & Other Names
Component Class Other Common Names
Efavirenz NNRTI Sustiva (monotherapy brand)
Tenofovir DF NRTI Viread (brand)
Emtricitabine NRTI Emtriva (brand)
Efavirenz binds directly to HIV‑1 reverse transcriptase (RT) non‑competitively, causing conformational changes that block viral DNA polymerization.

Tenofovir is converted intracellularly to tenofovir diphosphate, which competes with deoxyadenosine 5’-triphosphate for incorporation into viral DNA, causing chain termination.

Emtricitabine is phosphorylated to emtricitabine triphosphate, competing with deoxycytidine 5’-triphosphate, also causing DNA chain termination.

Combined, they provide potent, multi‑mechanism suppression of HIV‑1 replication.
First‑line treatment of HIV‑1 infection in antiretroviral‑naïve adults

Virologic suppression in patients already virologically suppressed on stable ART regimens containing these three components

Not indicated for HIV‑2 infection
Recommended Dose: One tablet once daily, on an empty stomach at bedtime (to reduce CNS side effects).

Missed Dose: Take as soon as remembered unless within 12 hours of next dose; do not double dose.

Switching: Patients may switch to Atripla from separate components if stable and HIV‑1 RNA <50 copies/mL for at least 3 months.
Baseline Evaluation: HIV‑1 RNA, CD4+ count, renal function (eGFR), hepatic function

Ongoing Monitoring: Viral load every 3–6 months, CD4+ count, renal & liver panels, bone density in long-term use

Contraception: Efavirenz is teratogenic in animals; use effective contraception. Avoid in first trimester if possible.
Common Adverse Reactions (≥10%)
CNS: Dizziness, vivid dreams, insomnia, impaired concentration

Gastrointestinal: Nausea, diarrhea, abdominal pain

Dermatologic: Rash, pruritus

General: Fatigue, headache
CNS Toxicity: Psychiatric symptoms (depression, suicidal ideation)

Hepatotoxicity: Monitor liver enzymes, especially in hepatitis B/C co‑infection

Renal: Fanconi syndrome, acute renal failure—monitor eGFR and urinary markers

Bone Mineral Density Loss: Due to tenofovir; consider supplementation & DEXA scan

Skin Rash: Stevens-Johnson syndrome (rare)—discontinue if severe
Pregnancy & Breastfeeding: Efavirenz contraindicated in first trimester; infant exposure via breast milk—avoid breastfeeding

Psychiatric Disorders: Preexisting mental health conditions may worsen

Renal Impairment: Avoid if eGFR <50 mL/min; adjust NRTI backbone or choose alternatives

Drug Resistance: Adherence crucial to prevent resistance; baseline genotypic testing recommended

Drug Interactions: See table below
Interacting Agent Effect / Recommendation
Rifampin, Carbamazepine ↓ Efavirenz levels; avoid or adjust efavirenz dose
St. John’s Wort ↓ Efavirenz and NRTI levels; avoid
Phenytoin, Phenobarbital ↓ Efavirenz; adjust dosage
Atazanavir/Ritonavir ↑ Efavirenz levels; monitor for toxicity
Tenofovir & Didanosine ↑ Didanosine levels; monitor for pancreatitis
Methadone ↓ Methadone levels; monitor for withdrawal
Warfarin Variable effects; monitor INR
Oral contraceptives ↓ Hormone levels; use additional barrier methods

Always consult a drug interaction checker and adjust therapy accordingly.
Study 903 (Lancet, 2003): Atripla demonstrated 90% virologic suppression (HIV‑1 RNA <50 copies/mL) at 48 weeks in treatment‑naïve patients.

ECHO/THRIVE Trials: Confirmed non‑inferiority vs efavirenz + two NRTIs regimens with similar safety profiles.

Long‑Term Follow‑Up: Durable viral suppression and CD4+ increases sustained through 5 years of therapy.

Frequently Asked Questions (FAQs)
Q1: Can Atripla be taken with food?
For optimal tolerability, take on an empty stomach at bedtime. High‑fat meals increase efavirenz exposure and may worsen CNS effects.

Q2: What if I miss a dose?
Take it as soon as possible unless within 12 hours of the next dose; do not double‑up.

Q3: Is genetic testing required?
Not routinely, but perform HIV‑1 genotypic resistance testing prior to initiation.

Q4: How quickly does Atripla work?
Viral load reductions are usually seen within 2–4 weeks, with maximal suppression by 12–24 weeks.

Q5: Can Atripla be used in hepatitis B co‑infection?
Emtricitabine and tenofovir are active against HBV; monitor hepatic function closely and avoid abrupt discontinuation.

Q6: Is dose adjustment needed in liver disease?
No formal adjustment, but use with caution in severe hepatic impairment; monitor for toxicity.

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