efavirenz + emtricitabine + tenofovir disoproxil fumarate at a glance
Medicine class
Combination antiretroviral containing one NNRTI and two nucleoside or nucleotide reverse transcriptase inhibitors.
Licensed role
Maintaining viral suppression in appropriately selected adults with HIV-1.
Food
Take on an empty stomach; food can increase efavirenz exposure and adverse effects.
Practical point
Swallow the film-coated tablet whole with water, preferably at bedtime to make dizziness or drowsiness less troublesome.
What is efavirenz + emtricitabine + tenofovir disoproxil fumarate used for?
This product has a restricted maintenance indication rather than a general first-treatment indication.
Licensed for adults with HIV-1 who have maintained viral suppression on combination antiretroviral therapy, without previous virological failure or known significant resistance to any component.
It is not licensed as HIV pre-exposure prophylaxis. NHS PrEP contains emtricitabine with tenofovir disoproxil, without efavirenz.
How does efavirenz + emtricitabine + tenofovir disoproxil fumarate work?
HIV uses reverse transcriptase to copy its genetic material. Efavirenz inhibits this enzyme at a separate binding site, while activated emtricitabine and tenofovir compete with normal building blocks and terminate the growing viral DNA chain. This suppresses viral replication but does not eliminate HIV.
efavirenz + emtricitabine + tenofovir disoproxil fumarate preparations and strengths
Tablet
Route: Oral
Strengths: 600 mg + 200 mg + 245 mg
How to take efavirenz + emtricitabine + tenofovir disoproxil fumarate
Follow the HIV clinic’s instructions. Take the tablet on an empty stomach, preferably at bedtime, and swallow it whole with water. Do not stop or change treatment without specialist advice, particularly if you also have hepatitis B.
Food can increase efavirenz exposure and adverse effects.
Avoid driving or hazardous work if dizziness, drowsiness or impaired concentration occurs.
If you vomit soon after taking the tablet, seek medicine-specific advice because replacement may be needed.
efavirenz + emtricitabine + tenofovir disoproxil fumarate side effects
Common or expected effects
- Dizziness or headache
- Difficulty sleeping, abnormal dreams, drowsiness or impaired concentration
- Nausea, vomiting, diarrhoea or abdominal discomfort
- Rash or itching
- Tiredness or weakness
- Anxiety or low mood
- Reduced appetite
Get urgent medical advice
- Severe or blistering skin reaction, or swelling of the face, lips, tongue or throat
- Severe depression, suicidal thoughts, psychosis, hallucinations or marked behavioural change
- Seizures, severe confusion, speech disturbance or loss of coordination
- Jaundice or other signs of significant liver injury
- Severe abdominal pain suggesting pancreatitis
- Deep rapid breathing, vomiting, abdominal pain or profound drowsiness suggesting lactic acidosis
- Marked thirst, increased urination, muscle weakness or bone pain suggesting renal tubular injury
efavirenz + emtricitabine + tenofovir disoproxil fumarate in pregnancy
The product information advises avoiding pregnancy and using this combination during pregnancy only when the woman’s clinical condition requires it. Anyone who is pregnant, planning pregnancy or becomes pregnant should contact their HIV and maternity specialists promptly. Do not stop antiretroviral treatment without advice because maintaining HIV control is important for both parent and baby.
efavirenz + emtricitabine + tenofovir disoproxil fumarate while breastfeeding
This product is not recommended during breastfeeding because its components enter breast milk and their effects on infants are insufficiently defined. Formula feeding is the safest option for avoiding postnatal HIV transmission. NHS information recognises that breastfeeding may sometimes be considered with an undetectable viral load and intensive specialist support; this requires review of the antiretroviral regimen.
efavirenz + emtricitabine + tenofovir disoproxil fumarate interactions
Efavirenz affects several drug-metabolising enzymes, while tenofovir can add to renal toxicity. Check prescription, non-prescription and herbal products with the HIV team.
St John’s wort
Contraindicated because it can lower efavirenz exposure and risk loss of HIV control.
Voriconazole
Contraindicated because each medicine substantially alters the other’s exposure and the fixed combination cannot be adjusted.
Elbasvir with grazoprevir
Contraindicated because efavirenz can reduce hepatitis C antiviral concentrations and cause treatment failure.
Common questions about efavirenz + emtricitabine + tenofovir disoproxil fumarate
Answers are fully visible for fast scanning and source review.
Is this combination used for PrEP?
No. It is licensed for treatment of controlled HIV-1 in selected adults. NHS PrEP uses emtricitabine with tenofovir disoproxil without efavirenz.
Does it cure HIV?
No. It suppresses HIV replication but does not remove HIV from the body.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.