Atripla

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Atripla
Combination of
Tenofovir	Nucleotide analogue reverse transcriptase inhibitor
Emtricitabine	Nucleoside reverse transcriptase inhibitor
Efavirenz	Non-nucleoside reverse transcriptase inhibitor
Identifiers
CAS number	?
ATC code	J05AR06
PubChem	?
Therapeutic considerations
Pregnancy cat.	D(US)
Legal status	POM(UK) ℞-only(US)
Routes	Oral

Atripla is a fixed dose combination drug for the treatment of HIV infection. It combines Gilead Sciences's tenofovir and emtricitabine (already available in the anti-HIV combination Truvada) with Bristol-Myers Squibb's efavirenz into a fixed-dose pill. Combining the three drugs into a single, once-daily pill reduces pill burden and simplifies dosing schedules, and therefore has the potential to increase adherence to antiretroviral therapy.

Atripla is the first multi-class antiretroviral drug available in the United States and represents the first collaboration between two U.S. pharmaceutical companies to combine their patented anti-HIV drugs into one product. The drug costs approximately $1,150 USD for a one-month supply. As of 2007, in India it costs $1,344 USD per year and in Africa $528 USD. It was approved by the U.S. FDA on July 12, 2006.

Atripla is a fixed dose combination of 600 mg Efavirenz, 300 mg Tenofovir, and 200 mg Emtricitabine. In adults, it is taken once daily on an empty stomach. Dosing at bedtime is recommended to improve tolerability of nervous system symptoms. Atripla is not recommended for patients under 18 years of age.

Atripla is a pink, capsule-shaped tablet with "123" impressed on one side.

In North America and Europe, Atripla is marketed jointly by Gilead Sciences and Bristol-Myers Squibb, but in much of the developing world, marketing and distribution is handled by Merck & Co.^[1] In India, Cipla has released its own copy of Atripla, called Viraday.

[edit] Side Effects and Medical Interactions

Common side effects of Atripla are tiredness, dizziness, stomach and intestinal upset, and skin discoloration. More severe side effects are hallucinations and sleeplessness.^[2]

According to the official Atripla website, medications that should not be taken with Atripla are "Hismanal (astemizole), Vascor (bepridil), Propulsid (cisapride), Versed (midazolam), Orap (pimozide), Halcion (triazolam), or ergot derivatives (for example, Wigraine and Cafergot)." Discuss any other HIV or hepatitis medications you are taking with your doctor to avoid complications. Additionally, St. John’s wort is known to reduce the effectiveness of Atripla, resulting in increased viral load and possible resistance to Atripla.^[3]

[edit] References

[edit] External links

Atripla.com managed by Gilead Sciences and Bristol-Myers Squibb
Atripla article on The Body, an HIV reference site

v • d • e Antivirals used against HIV (HAART) (primarily J05)

Nucleoside & Nucleotide Reverse Transcriptase Inhibitors (NRTI)	Abacavir (ABC)° • Emtricitabine° • Lamivudine (3TC)° • Tenofovir° • Didanosine • Zidovudine (AZT) • Apricitabine^† • Stampidine^† • Elvucitabine^† • Racivir^† • Amdoxovir^† • Stavudine^‡ • Zalcitabine^‡

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)	Efavirenz° • Nevirapine • Etravirine • Rilpivirine^† • Loviride^‡ • Delavirdine^‡

Protease Inhibitors (PI)	Atazanavir° • Brecanavir^§ • Fosamprenavir° • Lopinavir° • Darunavir • Nelfinavir • Ritonavir • Saquinavir • Tipranavir • Amprenavir^‡ • Indinavir^‡

Entry/fusion inhibitors	Enfuvirtide • Maraviroc • Vicriviroc^† • PRO 140^† • Ibalizumab^†

Integrase inhibitors	Raltegravir • Elvitegravir^†

Maturation inhibitors	Bevirimat^† • Vivecon™^†

Combined formulations	Combivir • Atripla • Trizivir • Truvada • Kaletra • Epzicom

Other & experimental agents	Foscarnet • Hydroxyurea • Synergistic enhancers • Epigallocatechin gallate • Portmanteau inhibitors • Globoidnan A • Griffithsin • Diarylpyrimidines • Calanolide A • Cyanovirin-N • Miltefosine • R-roscovitine^†

°DHHS preferred first-line agent. ^†Undergoing clinical trials, not FDA approved. ^‡Formerly or rarely used agent. ^§Development terminated.