Atripla is usually taken as one tablet per day. That has to be taken on an empty stomach. However, it is best taken in the evening. That way, sleeping at night could minimize some of the side effects that may be caused by some components, like efavirenz, especially dizziness and sleep disorders.

• Dosage: The adult dosage is one tablet a day. Take your dosage and the time as prescribed by your doctor. Atripla must be taken persistently at any time of the day to be effective.
• Missed Dose: If a person missed a dose of Atripla, they should take the medicine as soon as they remember. However, if the next scheduled dose is due in that case, then the missed dose needs to be skipped and the following dose needs to be taken at regular time. In no way should two doses be administered together to cover for the missed dose.
• Swallow: The drug should be swallowed using water. A patient should not break, crush, or chew the tablet.

Each of the three drugs in Atripla has a slightly different mechanism of action that prevents the replication of HIV.

1.　Efavirenz (NNRTI):

　　a)　Champions through its inhibition of the reverse transcriptase enzyme. The reverse transcriptase is essential for the virus to replicate itself by converting its RNA into DNA, which then becomes integrated into the host cell’s genome. The action of efavirenz, therefore means that the virus cannot replicate and multiply itself.

2. Emtricitabine (NRTI):

o\\Emtricitabine is an NRTI. It acts upon the reverse transcriptase enzyme but like the previous drugs, functions as the DNA component’s analogue where it successfully inhibits the enzyme from adding further bases to the DNA chain of the virus. This does not allow the virus to multiply.

3.Tenofovir Disoproxil Fumarate (NRTI):

Tenofovir is another NRTI that acts by interfering with reverse transcriptase. Tenofovir exerts its action exactly like emtricitabine. It blocks the virus from converting its RNA to DNA and therefore it prevents HIV replication.

Like all medicines, Atripla may cause side effects. However, not everyone will experience them and many side effects may diminish over time as the body gets used to the drug. Common side effects include:

1.Central Nervous System (CNS) Effects, that are associated with efavirenz :

• Dizziness, headaches, insomnia, vivid dreams, or confusion
• In some patients mood swings, depression, or anxiety

2.Gastrointestinal Problems:

o Gastrointestinal: nausea, diarrhea, or abdominal pain. These can be reduced by ingesting Atripla on an empty stomach, as directed.

3. Dermatologic

o A rash may develop and often subsides with continued therapy. In some cases, severe rashes may occur. A healthcare provider must be notified.

4. Hepatic

o Elevations in liver enzymes may occur with Atripla. Liver function should be monitored regularly; this will especially be important for people who have ongoing liver disease, hepatitis B, or hepatitis C.

5. Kidney Issues:

Tenofovir may cause kidney function to lower, and the kidneys need to be considered in closer evaluation at periodic follow up. In some individuals, decreased kidney function can be expected.

6. Fat Redistribution:

Antiretroviral treatment for long term, including Atripla, has been linked with fat redistribution in which fat moves from face or arms and deposits centrally or in the back.

7. Lipodystrophy:

Some people may develop lipodystrophy, changes in how the body fat is deposited, particularly when on HIV drugs for long periods like Atripla.

8. Loss of Bone Mineral Density:

Tenofovir tends to decrease the bone mineral density and increase susceptibility to fractures. Bone density monitoring could be required.

1. Pregnancy:

Atripla is contraindicated during pregnancy, especially in the first trimester; indeed, there have been theoretical concerns that efavirenz may be teratogenic-that is, interfere with a developing fetus. Patient questions or concern about pregnancy must include discussion of alternatives for treatment.

2.Drug Interactions:

oAtripla can interact with other medications, including some anticonvulsants, antibiotics, antifungals, and some heart disease drugs. Discuss any other medications you are taking with your physician, including over-the-counter or dietary supplements.

3.Hepatic and Renal Function:

Patients with diseases of the liver or kidneys should take great caution when taking Atripla. Their function of the liver and kidney should be checked periodically.

Rifampin: Rifampin, an antibiotic, can significantly reduce the effectiveness of Atripla by increasing the metabolism of its components (efavirenz, emtricitabine, and tenofovir), leading to lower drug levels.

Methadone: Atripla can reduce methadone levels, potentially leading to withdrawal symptoms in individuals taking methadone for opioid dependence.

St. John’s Wort: This herbal supplement can decrease the levels of Atripla’s active ingredients, reducing its effectiveness in treating HIV.

Midazolam: The use of midazolam, a sedative, with Atripla can increase the sedative effects, potentially causing excessive drowsiness or respiratory depression.

Adult Dosage: One tablet of Atripla that contains 600 mg efavirenz, 200 mg emtricitabine, and 300 mg tenofovir disoproxil fumarate once daily.

• Pediatric Dosage: Children under 12 years of age and weighing less than 35 kg (77 pounds) should not take Atripla.

Atripla is a prescription product. Patients should have a prescribing provider for follow-up appointments to monitor their HIV, possibly viral load, liver and kidney function tests, and monitoring of adverse effects.

1. What is Atripla?

   • Atripla is an antiretroviral medication used to treat human immunodeficiency virus (HIV) infection. It combines three active ingredients: efavirenz, emtricitabine, and tenofovir disoproxil fumarate.

2. How does Atripla work?

   • Atripla works by inhibiting reverse transcriptase, an enzyme crucial for the replication of HIV. This helps to lower the viral load in the body and maintain immune function.

3. Who can take Atripla?

   • Atripla is typically prescribed to adults and children weighing at least 40 kg who are diagnosed with HIV. It is not recommended for those with a known hypersensitivity to any of its components.

4. What is the usual dosage of Atripla?

   • The standard dose is one tablet taken orally once daily, preferably on an empty stomach, to enhance absorption.

5. What are the side effects of Atripla?

   • Common side effects include dizziness, insomnia, and rash. Some individuals may experience more serious side effects, such as liver problems or lactic acidosis.

6. Can Atripla be taken with other medications?

   • Atripla may interact with various medications. It’s crucial to inform your healthcare provider about all drugs you are taking, including over-the-counter medications and supplements.

7. What should I do if I miss a dose of Atripla?

   • If you miss a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at once.

8. Is Atripla safe during pregnancy?

   • Atripla should be used during pregnancy only if clearly needed and under the guidance of a healthcare provider, as it may pose risks to the developing fetus.

9. What should I avoid while taking Atripla?

   • Avoid alcohol, as it can exacerbate side effects. It’s also important to avoid taking other medications that may interact or affect liver enzymes.

10. How should Atripla be stored?

    • Atripla should be stored at room temperature, away from moisture and heat, and out of reach of children.

11. What lifestyle changes should I make when taking Atripla?

    • It’s essential to maintain a healthy lifestyle, including a balanced diet, regular exercise, and stress management, to support overall health while managing HIV.

12. Can Atripla cure HIV?

    • No, Atripla does not cure HIV. It helps manage the infection and reduces viral load, but ongoing treatment is necessary.

13. How often should I see my healthcare provider while on Atripla?

    • Regular follow-up appointments are essential, usually every 3 to 6 months, to monitor treatment efficacy, viral load, and side effects.

14. What should I do if I experience severe side effects?

    • Seek immediate medical attention if you experience severe side effects such as chest pain, severe rash, or signs of liver problems, including jaundice.

15. Can Atripla affect my mental health?

    • Some patients have reported mood changes or depressive symptoms when taking Atripla, particularly due to efavirenz. Discuss any mental health concerns with your doctor.

16. Is Atripla effective for all strains of HIV?

    • Atripla is effective against many strains of HIV but may not work against resistant strains. Resistance testing may be conducted before starting treatment.

17. What are the symptoms that indicate I need to stop taking Atripla?

    • Symptoms like severe rash, liver enzyme elevation, or psychiatric symptoms that are concerning should prompt a discussion with your healthcare provider about discontinuing use.

18. How does Atripla compare to other HIV medications?

    • Atripla is often chosen for its once-daily dosing and the convenience of a single tablet. However, individual responses and side effects can vary, making tailored treatment important.

19. Can I take Atripla with food?

    • Atripla should be taken on an empty stomach to improve absorption. It’s best taken at bedtime to minimize side effects.

20. What resources are available for support while taking Atripla?

    • Numerous support groups and resources are available, including HIV-focused organizations and online forums. Your healthcare provider can also recommend support services.