Atripla vs. Symfi for HIV Treatment: Important Differences and Potential Risks.

Key takeaways

Atripla (efavirenz/emtricitabine/tenofovir) and Symfi (efavirenz/lamivudine/tenofovir) are both combination HIV treatments taken once daily. Atripla includes emtricitabine, while Symfi contains lamivudine instead. Both medications have similar side effects, such as dizziness and liver problems, but Symfi also has a version called Symfi LO with a lower dose of efavirenz, which might be better for those who experience more side effects. Atripla must be taken on an empty stomach, usually at bedtime to minimize side effects, whereas Symfi can be taken at any time of day, as long as it's on an empty stomach. Both are not first-choice treatments due to their side effects, and neither is recommended during pregnancy. Both medications are available as a generic.

Atripla

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Symfi

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Summary for Atripla

Prescription only

Atripla is a combination antiviral medication used to treat human immunodeficiency virus (HIV). It's a tablet that has three active ingredients: efavirenz, emtricitabine, and tenofovir disoproxil fumarate (TDF). Atripla is for adults and children who weigh at least 88 lbs. You take it once a day by mouth on an empty stomach. Some side effects include diarrhea, nausea, and depression. The brand name Atripla isn't sold anymore, but you can still get this medication as a generic.

Indications for Atripla

HIV treatment

Pros and Cons for Atripla

Pros

Is a full HIV treatment regimen
Combines 3 HIV medications into 1 tablet for convenience
Taken once a day
Not likely to cause weight gain
Okay for children weighing at least 88 lbs to take

Cons

Must take on an empty stomach, preferably at bedtime
Might have strange dreams while taking
Interacts with other medications, including some other HIV medications and hepatitis C medications
Risk of kidney and bone problems
Not recommended for people with moderate or severe kidney or liver problems

Common Side Effects for Atripla

Tiredness (9%)
Depression (9%)
Nausea (9%)
Diarrhea (9%)
Dizziness (8%)
Upper respiratory tract infections (8%)
Sinus infection (8%)
Rash (7%)
Headache (6%)

Warnings for Atripla

Worsening of hepatitis B infection in people with HIV and hepatitis B
Liver problems
Effects on mental health
Side effects related to the nervous system (e.g., dizziness, trouble sleeping)
Kidney problems
Bone problems
Lactic acidosis
Overactive immune system
Changes in body fat
Interactions with other medications
Harm to an unborn baby

Summary for Symfi

Prescription only

Symfi is an HIV antiretroviral (ARV) combination tablet that contains 3 different medications: efavirenz, lamivudine, and tenofovir. It also comes as Symfi LO, which has a lower dose of efavirenze compared with Symfi. This once-daily medication is considered a complete HIV treatment regimen for many people. Symfi isn't a first choice treatment option because it can cause a lot of serious side effects, such as mood, liver, and kidney problems.

Indications for Symfi

Pros and Cons for Symfi

Pros

Convenient, once-a-day tablet
Comes in two different strengths, with different amounts of efavirenz
Available as a lower-cost generic
Symfi LO can be used in children who weigh at least 88 pounds

Cons

Not a first choice treatment option for HIV
Can cause more fat to appear in the belly and upper back, and less fat in the face, arms, and legs
Not a good option for people with kidney problems, liver problems, or certain heart rhythm problems
Should be avoided during pregnancy

Common Side Effects for Symfi

Common side effects for Symfi

Rash (13%)
Dizziness (9%)
Trouble sleeping (4%)
Headache (3%)
Diarrhea (3%)
Vomiting (2%)
Stomach flu (2%)
Fever (1%)
Cough, sore throat, and other cold or flu symptoms (1—2%)
Shingles (1%)

Common side effects for Symfi LO

Rash (9%)
Dizziness (6%)
Trouble sleeping (3%)
Cough, sore throat, and other cold or flu symptoms (3%)
Shingles (3%)
Diarrhea (2%)
Stomach flu (2%)
Fever (2%)
Vomiting (1%)
Headache (1%)

Warnings for Symfi

Worsening of hepatitis B
High level of acid in the blood (lactic acidosis) and liver damage (hepatomegaly with steatosis)
Kidney problems
Mental health effects
Central nervous system (CNS) side effects
Rash
Liver toxicity
Inflammation of the pancreas (pancreatitis)
Immune reconstitution syndrome (inflammation)