Key takeaways
Atripla (efavirenz/emtricitabine/tenofovir) and Biktarvy (bictegravir/emtricitabine/tenofovir) are both combination medications used to treat HIV, but they have some key differences. Atripla includes efavirenz, which is a non-nucleoside reverse transcriptase inhibitor (NNRTI), while Biktarvy contains bictegravir, an integrase inhibitor. Atripla must be taken on an empty stomach, preferably at bedtime to avoid side effects like dizziness and abnormal dreams, whereas Biktarvy can be taken with or without food. Atripla is available as a generic, making it more affordable, but it is no longer a first-choice treatment due to its side effects and the need for dose adjustments in people with kidney problems. Biktarvy, on the other hand, is a first-choice treatment option and is effective for both new and replacement therapy, but it is only available as a brand-name medication, which can be expensive. Both medications can cause worsening of hepatitis B if stopped suddenly.
