efavirenz + emtricitabine + tenofovir disoproxil maleate at a glance
Medicine class
One non-nucleoside and two nucleoside/nucleotide reverse-transcriptase inhibitors.
Licensed role
HIV-1 treatment for eligible adults with stable viral suppression; not licensed as PrEP or PEP.
Administration
Swallow whole with water on an empty stomach. Bedtime administration may reduce troublesome nervous-system effects.
Important checks
Kidney and liver health, viral suppression, resistance history, mental health and interactions require review.
What is efavirenz + emtricitabine + tenofovir disoproxil maleate used for?
This product has a restricted licensed role rather than being a general starting treatment for HIV.
HIV-1 treatment in adults with established viral suppression on combination antiretroviral therapy.
Use requires no previous virological failure or known clinically significant resistance to its components.
Not licensed for HIV prevention, chronic hepatitis B treatment or use in children.
How does efavirenz + emtricitabine + tenofovir disoproxil maleate work?
Efavirenz blocks HIV-1 reverse transcriptase at a non-nucleoside binding site. Activated emtricitabine and tenofovir compete with normal building blocks and terminate viral DNA chains. Together they reduce viral replication but do not remove HIV from the body.
efavirenz + emtricitabine + tenofovir disoproxil maleate preparations and strengths
Tablet
Route: Oral
Strengths: 600 mg + 200 mg + 245 mg
How to take efavirenz + emtricitabine + tenofovir disoproxil maleate
Follow the HIV specialist’s instructions and the pack leaflet.
Swallow the film-coated tablet whole with water.
Take it on an empty stomach because food can increase efavirenz exposure and adverse effects.
Bedtime administration may make dizziness, drowsiness, abnormal dreams and impaired concentration easier to tolerate.
Do not stop or change treatment without specialist advice; the components leave the body at different rates, which may encourage resistance.
If vomiting occurs soon after taking it, ask the HIV team whether replacement is needed.
efavirenz + emtricitabine + tenofovir disoproxil maleate side effects
Common or expected effects
- Dizziness, drowsiness, headache or impaired concentration
- Abnormal dreams, insomnia, anxiety or low mood
- Rash or itching
- Nausea, vomiting, diarrhoea or abdominal discomfort
- Tiredness or weakness
- Changes in liver enzymes, blood glucose, lipids or phosphate
Get urgent medical advice
- Severe rash with blistering, peeling, fever or mucosal involvement
- Suicidal thoughts, severe depression, psychosis-like behaviour or seizures
- Severe allergic reaction or angioedema
- Kidney injury or proximal renal tubulopathy, sometimes with muscle weakness or bone pain
- Severe liver injury, pancreatitis or lactic acidosis
- Abnormal heart rhythm in susceptible people
efavirenz + emtricitabine + tenofovir disoproxil maleate in pregnancy
The product information advises avoiding pregnancy during treatment and using this combination during pregnancy only when clinically required. Anyone pregnant or planning pregnancy should contact their HIV and maternity specialists promptly, without stopping treatment unless advised. Efavirenz can reduce exposure to some hormonal contraceptives.
efavirenz + emtricitabine + tenofovir disoproxil maleate while breastfeeding
The active substances pass into human milk, and the selected product information says it should not be used while breastfeeding. Formula feeding is the safest UK option because it removes postnatal HIV transmission through breast milk. Anyone wishing to breastfeed needs early specialist planning and close monitoring.
efavirenz + emtricitabine + tenofovir disoproxil maleate interactions
Efavirenz affects several metabolising enzymes, while tenofovir and emtricitabine are mainly cleared by the kidneys. The HIV team should check prescription, non-prescription, herbal and recreational substances.
St John’s wort
Contraindicated because it can lower efavirenz exposure and undermine viral suppression.
Voriconazole
Contraindicated because each medicine substantially alters the other’s exposure and the fixed combination cannot be adjusted.
Elbasvir with grazoprevir
Contraindicated because efavirenz may markedly reduce antiviral exposure and effectiveness.
Common questions about efavirenz + emtricitabine + tenofovir disoproxil maleate
Answers are fully visible for fast scanning and source review.
What is it used for?
It treats HIV-1 in selected adults whose virus is already stably suppressed and not known to be resistant to its components.
Is it PrEP?
No. The selected product is licensed for established HIV-1 treatment, not pre-exposure prophylaxis.
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.