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The following information outlines essential safety considerations and warnings related to the use of Atripla. It is crucial to understand these risks and take necessary precautions. Consult your healthcare provider if you have any questions or concerns.

• Hepatitis B Worsening: Discontinuing Atripla can lead to a severe exacerbation of hepatitis B. Do not stop taking the medication unless directed by your healthcare provider. If discontinuation or a switch to another antiviral is necessary, ensure regular lab testing to monitor liver function and hepatitis B virus levels.

• Liver Concerns and Toxicity: Although infrequent, nucleoside reverse transcriptase inhibitors (NRTIs) like emtricitabine and tenofovir can induce a life-threatening liver condition known as lactic acidosis with hepatic steatosis. Efavirenz may alter liver function tests after initiating Atripla, especially in individuals with existing liver disease or infection. Atripla is unsuitable for those with moderate to severe liver conditions. Liver function should be assessed prior to starting Atripla and monitored during treatment. Symptoms such as loss of appetite, abdominal pain, muscle pain, rapid breathing, fatigue, and sudden weakness warrant immediate medical attention.

• Mental Health Impacts: Atripla may cause depression, suicidal thoughts, aggression, and psychosis. Notify your healthcare provider of any mood alterations. Engaging friends or family to monitor for changes in mood or behavior can be beneficial. Seek urgent medical help if experiencing self-harm thoughts or aggression.

• Central Nervous System (CNS) Effects: Some users may encounter CNS side effects like dizziness, insomnia, concentration difficulties, drowsiness, and unusual dreams, particularly in the initial weeks. If these persist or hinder daily medication adherence, consult your provider.

• Birth Defects: Use of Atripla during the first trimester of pregnancy may harm the unborn child. Discuss safe HIV antiretroviral options with your healthcare provider if pregnant or planning a pregnancy. If avoiding pregnancy while on Atripla, consider discussing birth control options with your provider.

• Kidney Issues: Atripla might lead to kidney problems soon after starting treatment or over time. Avoid combining it with other medications that can damage the kidneys, such as high-dose NSAIDs (e.g., Motrin, Aleve). Regular lab tests are recommended to monitor kidney health.

• Bone Health: Atripla can reduce bone mineral density, potentially leading to osteoporosis and increased fracture risk. Calcium and vitamin D supplements may help prevent this. Additional bone density tests might be necessary if you have fractures or other risk factors.

• Immune Reconstitution Syndrome: As Atripla reduces viral load, it aids in immune system recovery, which may cause inflammation due to fighting existing infections. Your healthcare provider might check for underlying infections before starting Atripla, especially if it’s your first HIV treatment. Contact your provider if you experience fever, breathing difficulties, or sudden health changes.

• Fat Redistribution: Atripla, like other HIV antiretrovirals, may cause changes in body fat distribution, such as increased fat in the abdomen and upper back with decreased fat in the face, arms, and legs. The cause of these changes remains unclear.

When taking this medication, some common side effects may occur, though they are generally mild and manageable. These include tiredness or fatigue, mood changes such as depression, nausea, diarrhea, dizziness, symptoms resembling a common cold or flu, a runny nose, skin rash, and headaches. If these symptoms persist or worsen, it's advisable to reach out to a healthcare provider.

Other side effects that some patients experience are difficulty sleeping, abnormal dreams, anxiety, and vomiting. While these are less common, they should be monitored, and medical advice should be sought if they become troublesome.

There are rare but serious side effects that demand immediate medical attention. These include allergic reactions characterized by skin rash, itching, or swelling, heart rhythm changes such as a fast or irregular heartbeat, and symptoms of high lactic acid levels like muscle pain and general discomfort. Additionally, signs of infection, kidney injury, or liver injury, mood and behavior changes including thoughts of self-harm, and severe skin reactions are critical to watch for. If you experience symptoms such as pain, numbness, changes in vision, or difficulty walking, or if you notice any unusual changes in your health, seek urgent medical care.