Atripla (emtricitabine leaflet)

Emtricitabine slows the progress of HIV infection.

It is taken once daily and can be taken before or after meals.

It is one of a number of medicines that you will need to take regularly.

Emtricitabine has been associated with some side-effects. Your doctor will discuss these with you before you start treatment.

About emtricitabine

Type of medicine An antiretroviral medicine (a nucleoside reverse transcriptase inhibitor)
Used for Human immunodeficiency virus (HIV) infection, in adults and children
Also called Emtriva®
Truvada® (emtricitabine with tenofovir)
Atripla® (emtricitabine and efavirenz with tenofovir)
Eviplera® (emtricitabine and rilpivirine with tenofovir)
Available as Capsules and oral liquid medicine.
Combination brands (Truvada®, Atripla®, Eviplera®) are available as tablets

Emtricitabine is an antiretroviral medicine. It is used for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs.

Emtricitabine belongs to a group of antiretroviral medicines known as nucleoside reverse transcriptase inhibitors (NRTIs). It is given alongside a number of other antiretroviral medicines, as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine. Some brands of emtricitabine such as Truvada®, Atripla®, and Eviplera®, contain other antiretroviral medicines also. Taking these brands helps to reduce the number of tablets you need to take each day. Some of the information in this leaflet does not apply to these combination brands - please refer to the manufacturer's printed information leaflet from inside the pack.

Emtricitabine slows down the progress of HIV infection by reducing the amount of virus in your body. This helps improve your immune system and reduces the risk of you developing the complications associated with HIV infection. It will be prescribed for you by a doctor who is a specialist.

Before taking emtricitabine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking emtricitabine it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have a kidney or liver problem.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take emtricitabine

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of emtricitabine you have been given, and a full list of side-effects which you may experience from taking it.
  • Take emtricitabine exactly as your doctor tells you to. It is taken once daily. Adults will usually be prescribed capsules/tablets to take, whereas children are likely to be supplied with liquid medicine (Emtriva® Oral Solution). Your doctor will advise you how much should be taken for each dose.
  • Try to take it at the same time of day each day, as this will help you to remember to take it. You can take emtricitabine before or after meals.
  • If you are sick within one hour of taking emtricitabine, you should take another dose. This is because the medicine will not have been absorbed by your body. If you are sick more than one hour after taking a dose, do not repeat the dose, as it will already have been absorbed.
  • If you forget to take a dose, take it as soon as you remember providing it is within 12 hours of the time you should have taken it. If when you remember it is more than 12 hours late, do not take the dose you missed, but remember to take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • Keep your regular appointments with your doctor so that your progress can be monitored. You are likely to need regular blood tests to check how well your medicines are working.
  • It is important that you continue to take emtricitabine and your other antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
  • If you develop any infection soon after you start this treatment, let your doctor know. As a result of taking emtricitabine, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
  • Follow carefully any advice your doctor gives to you about making some lifestyle changes to reduce the risk of damage to your heart and blood vessels. These may include stopping smoking, eating healthily and taking regular exercise.
  • Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
  • It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made. If you have any feelings of depression then you should speak with your doctor.
  • Emtricitabine has been associated with a serious side-effect in some people who have taken it. This is known as lactic acidosis. It is a problem where there is too much lactic acid in the blood. The symptoms associated with it are listed in the next section 'Can emtricitabine cause problems?'. If you develop any of the symptoms listed below, you must let your doctor know straightaway, as they can worsen, and may even become life-threatening.
  • Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is where some bone tissue dies because there is a reduced blood supply to it. It can cause joint aches and pains, and lead to difficulties in movement. If you notice any of these symptoms, speak with your doctor.
  • If you buy any medicines, check with a pharmacist that they are safe to take with emtricitabine and your other medicines.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Treatment for HIV is lifelong. Continue to take emtricitabine unless you are advised otherwise, even if you feel well. This is to keep your immune system healthy.

Can emtricitabine cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. You should, however, speak with your doctor if you develop any of the following side-effects. This is because some of the common side-effects of emtricitabine are similar to the symptoms of lactic acidosis - a less common but more serious problem.

Very common emtricitabine side-effects - these affect more than 1 in 10 people who take this medicine
What can I do if I experience this?
Feeling or being sick, abdominal pain, wind, indigestion Stick to simple meals - avoid rich or spicy food. If it continues, speak with your doctor
Diarrhoea Drink plenty of water
Headache Ask your doctor to recommend a suitable painkiller
Common emtricitabine side-effects - these affect less than 1 in 10 people who take this medicine What can I do if I experience this?
Feeling dizzy, tired or weak Do not drive or use tools or machines until you feel better. If this continues, speak with your doctor
Skin changes and allergic-type rashes, difficulties sleeping, abnormal dreams, muscle aches and pains, and blood disorders (your doctor will monitor you for these) If any of these become troublesome, speak with your doctor

Your doctor will discuss with you the possibility of lactic acidosis occurring. Let your doctor know straightaway if you develop any of the following symptoms:

  • Feeling or being sick, abdominal pain, loss of appetite, loss of weight, fast or gasping breathing.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store emtricitabine

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.
  • Store unopened bottles of emtricitabine liquid medicine in a refrigerator. Once a bottle has been opened it can be stored out of the refrigerator, but it must be in a cool place. Opened bottles keep for 45 days - after this time, make sure you have a fresh supply.