HIVManagement.org

 
Quick Menu / Table of Contents
Introduction Principles Management NRTI Info NNRTI Info
PI Info Fusion Inhibitors Drug Summary Investigational Adherence
Lab Evaluation Resistance Tests PEP Antiretroviral Tables OI Prevention
Vaccinations TB Therapy Hepatitis Therapy OI Diagnosis OI Therapy
Bibliography Links Palliative Therapy

 

Atripla
efavirenz + emtricitabine + tenofovir

Detailed Prescribing Information

July 2006

 

Atripla
A combination of  emtricitabine + efavirenz + tenofovir
Approved 7-12-2006
Forms Available 300 mg tenofovir / 200 mg emtricitabine / 600 mg efavirenz in tablet form
Dosing 1 tablet once a day without food
Dosing at bedtime may improve tolerability to the efavirenz component.
Renal dosing Dosing interval
Ccr 30-49 cc/min
Dosing interval
Ccr < 30 cc/min
Not recommended Not recommended
Hepatic dosing: no data available
Food dependence Food increases efavirenz absorption and therefore may produce increased CNS side effects.

Take Atripla on an empty stomach.

Adverse Effects Same as tenofovir and emtricitabine and efavirenz (see above or click on the drug name)
Efavirenz may cause CNS stimulation, restlessness, nightmares, depression, exacerbation of underlying mental health problems, rash or chemical hepatitis.
Tenofovir may cause nephropathy, Fanconi-like syndrome, or loss of bone mineralization.
Emtricitabine rarely causes discoloration of palms or soles.
Interactions Same as tenofovir and emtricitabine and efavirenz (see above or click on the drug name)
If Atripla is used with didanosine, reduce the dose of didanosine EC to 250 mg daily maximum.
Atripla should be used cautiously if at all with atazanavir as the triple interaction of efavirenz, tenofovir, and atazanavir has not been well studied.
Suggested lab follow-up Monthly CBC for 3 months, then every 3 months if stable
Consider monthly creatinine measurements in lean individuals or those with renal insufficiency
Monthly liver profile for 3 months, then every 3 months and as indicated if stable
Warning

Rare lactic acidosis and hepatic steatosis.
Do not used fixed dose combination in persons with renal insufficiency.
Severe acute exacerbations of chronic hepatitis B may be observed with sudden discontinuation of lamivudine, emtricitabine, Truvada, Trizivir, Epzicom, Atripla.
Avoid use of efavirenz-containing medications in persons who require high levels of mental acuity or concentration in their work or lives, and in those with poor-controlled mental health issues such as schizophrenia or manic-depressive disorders.

Contraindication None

Suggested Usage

In general Atripla should be used in persons who are naive to treatment as most persons who are treatment experienced may harbor resistance mutations to lamivudine/emtricitabine and/or NNRTIs.
Resistance testing should be done prior to using Atripla.
Do not use in combination with Sustiva, lamivudine, emtricitabine, Epzicom, Combivir, or Trizivir due to identical mechanism of action or duplication of efavirenz or emtricitabine dosing.
Encourage exercise and calcium intake to minimize bone loss.
Advise patient to avoid dehydration.
Do not discontinue abruptly in patients with chronic hepatitis B without consideration of continuation of lamivudine or some other agent active against hepatitis B.

Complete prescribing information

Atripla Prescribing Info
Also see http://www.atripla.com for further info as it becomes available.
Patient handout for this drug HERE.

 

 

Next Page Click HERE for Antiretroviral Summary Information


 

Links to Antiretroviral Sections (click on anything)
Nucleoside & Nucleotide Reverse Transcriptase Inhibitors (NRTI)
AZT  |  ddC  |  ddI  |  d4T  |  3TC  |  ABC  |  FTC  |  TDF  |  Combivir  |  Trizivir  |  Epzicom  |  Truvada  |  Atripla
Nonnucleoside Reverse Transcriptase Inhibitors (NNRTI)
efavirenz  |  nevirapine  |  delavirdine
Protease Inhibitors (PI)  |  Boosted Protease Inhibitors
saquinavir  indinavir  |  ritonavir  |  nelfinavir  |  amprenavir  |  lopinavir + ritonavir  |  atazanavir  |  fosamprenavir  | tipranavir  |  darunavir
Fusion Inhibitors
enfuvirtide


 

Quick Menu / Table of Contents
Introduction Principles Management NRTI Info NNRTI Info
PI Info Fusion Inhibitors Drug Summary Investigational Adherence
Lab Evaluation Resistance Tests PEP Antiretroviral Tables OI Prevention
Vaccinations TB Therapy Hepatitis Therapy OI Diagnosis OI Therapy
Bibliography Links Palliative Therapy

 

Updated 7.22.2006

 


 

1. Renal dosing information from: Ian R. McNicholl & Rudolph A. Rodriguez, MD, Dosing of Antiretroviral Drugs in Renal Insufficiency and Hemodialysis, May 2004
http://hivinsite.ucsf.edu/InSite?page=md-rr-18