AIDS Home > Atripla Warnings and Precautions

Before taking Atripla, warnings and precautions for the drug should be reviewed with your healthcare provider. It is important to know that the medication may cause psychiatric problems, skin rashes, and changes in body fat distribution in some people. When reviewing Atripla warnings and precautions, tell your healthcare provider about all existing medical conditions you have and all other medications you are currently taking.

Atripla: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Atripla™ (efavirenz, emtricitabine, and tenofovir disoproxil fumarate) if you have:
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Atripla Warnings and Precautions

Warnings and precautions to be aware of prior to taking Atripla include the following:
  • The medication can cause psychiatric problems, including anxiety, depression, aggressiveness, and suicidal thoughts or behavior. Tell your healthcare provider immediately if you are experiencing any psychiatric Atripla side effects.
  • Atripla can cause dizziness, drowsiness, and problems with concentration. Make sure you know how the medication affects you before driving, operating heavy machinery, or consuming alcoholic beverages.
  • Atripla often causes harmless skin rashes. However, if you have a rash with blisters, loss of skin, a fever, or mouth sores, be sure to tell your healthcare provider immediately, as this may be a sign of a life-threatening reaction to the drug.
  • If you have liver disease (especially hepatitis), your healthcare provider should monitor your liver function (using regular blood tests) to make sure Atripla is not causing further liver damage. Also, you may need a lower Atripla dosage, since the liver helps to remove the medication from the blood.

Because some cases of serious liver damage associated with Atripla occurred in people without previous liver problems (or other risk factors for liver damage), some healthcare providers choose to monitor liver function in all people taking Atripla.

  • Atripla may increase the risk of seizures. Make sure your healthcare provider knows if you have epilepsy or a history of seizures.
  • Stopping Atripla may make a hepatitis B infection worse. This may become quite serious. You should be tested for hepatitis B before taking Atripla. If you have hepatitis B and stop taking Atripla, your healthcare provider should monitor your liver very carefully for several months. 


  • In rare cases, the medication can cause a condition called lactic acidosis and hepatic steatosis. It is caused by damage to the liver and can be very dangerous. You are at higher risk for this side effect if you have liver disease.
  • Atripla can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
  • The kidneys help remove Atripla from the blood, and the drug can damage the kidneys. Let your healthcare provider know if you have any kidney problems prior to beginning treatment, as you may need a lower Atripla dosage, and you may be at a higher risk for kidney damage due to Atripla.
  • Atripla can decrease bone density, which increases the risk of osteoporosis and broken bones. Your healthcare provider should check your bone density while you are taking the medication, especially if you have had a broken bone in the past. Ask your healthcare provider if you should take calcium and vitamin D during treatment, as this may help strengthen your bones.
  • Atripla is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, whether or not you are taking medications.
  • As with all HIV medications, it is important that you take Atripla exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
  • Atripla can interact with a number of different medications (see Atripla Drug Interactions).
  • Atripla is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy, although the full risks are not known (see Atripla and Pregnancy).
  • Atripla passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Atripla and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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