Atripla (tenofovir disoproxil leaflet)

Take one tablet daily.

It is important to take the tablets regularly every day, preferably at the same time each day.

Common side-effects are feeling sick, feeling dizzy, diarrhoea, and skin rash.

About tenofovir disoproxil

Type of medicine An antiviral medicine (a nucleoside reverse transcriptase inhibitor)
Used for Human immunodeficiency virus (HIV) infection
Hepatitis B
Also called Viread®
Combination brands are: Truvada® (tenofovir disoproxil with emtricitabine), Atripla® (tenofovir disoproxil with emtricitabine and efavirenz), Eviplera® (tenofovir disoproxil with emtricitabine and rilpivirine)
Available as Tablets

Tenofovir disoproxil is an antiviral medicine. It is used to treat to treat two types of infection caused by viruses - human immunodeficiency virus (HIV) infection, and hepatitis B infection.

In HIV infections, it slows the progress of the 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. Tenofovir disoproxil belongs to a group of medicines known as nucleoside reverse transcriptase inhibitors (NRTIs). It is given alongside a number of other similar medicines, as part of a combination therapy for HIV infection. Some brands of tenofovir disoproxil tablets contain these other medicines. Taking one of these combination brands helps to reduce the number of tablets you need to take each day.

Hepatitis B is a virus which is carried in your bloodstream to your liver, where it can cause inflammation and damage. Following infection with hepatitis B, a few people develop a persistent infection called chronic hepatitis B, and will usually need treatment to reduce the activity of the virus. Treatment for chronic hepatitis B may continue for several years and may include a combination of antiviral medicines.

Tenofovir disoproxil works by stopping the virus from multiplying, this reduces the amount of virus in your body. This helps to improve your immune system if you have HIV, and your liver if you have hepatitis B. It also reduces the risk of you developing complications associated with the infection. It will be prescribed for you by a doctor who is a specialist.

Before taking tenofovir disoproxil

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 tenofovir disoproxil 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 tenofovir disoproxil

  • 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 tenofovir disoproxil you have been given, and a full list of side-effects which you may experience from taking it.
  • Take tenofovir disoproxil exactly as your doctor has told you to. The usual dose is one tablet daily. Your dose will also be on the label of the pack to remind you.
  • It is recommended that you swallow the tablets whole with a drink of water. If you are taking either Viread® or Truvada® and have difficulty swallowing the tablets, you may crush them and add them to half a glass of water, orange or grape juice, providing you swallow it straightaway. Most brands of tenofovir disoproxil tablets should be taken with or just after a meal. However, if you have been prescribed Atripla®, these tablets should be taken when your stomach is empty, which means taking them one hour before any food or waiting until two hours afterwards.
  • If you are taking Viread®, Truvada®, or Atripla® and are sick within one hour of taking a tablet, 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 it, as the medicine will already have been absorbed. If you are taking Eviplera®, you should take another tablet if you are sick within four hours of taking a dose.
  • Try to take the tablets at the same time of day each day, as this will help you to remember to take them.
  • If you forget to take a dose, take it as soon as you remember, providing it is within the next 12 hours. If it is more than 12 hours later when you remember, skip the missed dose 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 the tablets are working for you, and also to see how well your liver and kidneys are working.
  • It is important that you continue to take the tablets regularly. Treatment for hepatitis B can be long-term, and for HIV it is usually lifelong. Continue to take the tablets unless you are advised otherwise, even if you feel well.
  • Tenofovir disoproxil has been associated with a serious side-effect in some people who have taken it for HIV infection. This is known as lactic acidosis. It is a problem where there is too much lactic acid in the blood. It has also occurred in a very few people who have taken it for hepatitis B. The symptoms associated with it are listed in the next section 'Can tenofovir disoproxil cause problems?'. You must let your doctor know straightaway, if you develop any of the symptoms listed below.
  • If you buy any medicines, check with a pharmacist that they are suitable to take with this medicine.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

Further information for if you are being treated for hepatitis B:

  • Treatment with this medicine does not stop you from passing the infection on to others through sexual contact, sharing needles to inject drugs, or from mother to baby. A vaccine is available which protects against hepatitis B and can be offered to your sexual and household contacts who are at risk of being infected. Do not have sex with anyone (especially any sex without using a condom) until they have been fully immunised and have had their blood checked to see that the immunisation has worked.
  • Most people with chronic hepatitis B will be advised to eat a normal healthy balanced diet. However, it is likely you will be advised not to drink alcohol. Alcohol will increase the risk and speed of you developing liver damage.

Further information for if you are being treated for HIV:

  • If you develop any infection soon after you start this treatment, let your doctor know. As a result of taking the tablets, 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.
  • Treatment with tenofovir disoproxil does not stop the risk of you passing HIV to others through sexual contact. 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.
  • Some people who have taken similar medicines for HIV (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.

Can tenofovir disoproxil 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 tenofovir disoproxil are similar to the symptoms of lactic acidosis - a much less common but more serious problem.

Common tenofovir disoproxil side-effects - these affect around 1 in 10 peopl who take this medicine
What can I do if I experience this?
Feeling dizzy, weak or tired Do not drive or use tools or machines until you feel better. If this continues, speak with your doctor
Feeling or being sick, abdominal pain, wind Stick to simple meals - avoid rich or spicy food. If it continues, speak with your doctor
Diarrhoea Drink plenty of water to replace lost fluids
Headache Ask your doctor or pharmacist to recommend a suitable painkiller
Skin rash If this becomes troublesome, speak with your doctor
Changes to some blood tests Your doctor will check for this

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 tenofovir disoproxil

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.