Say hello to Eviplera, the latest, once-a-day, multiple combination pill.
Available on the PBS[Pharmaceutical Benefits Scheme] The federal government program which subsidises medication costs in Australia. Anti-HIV drugs are part of a special part of the PBS called Section 100 (S100) which is used for expensive, highly specialised drugs. in Australia since 1 June, Eviplera (called Complera overseas) contains tenofovir and emtricitabine — the two NRTIs also found in Atripla. But instead of efavirenz, Eviplera contains rilpivirine, a new NNRTI which has been shown to be a valid and safe alternative to efavirenz for people who are just starting on treatment as well as for others who need to change regimens.
Rilpivirine is also safe for women of child-bearing age to take and it also appears to have a better lipidA fat. (fat) profile than efavirenz.
US regulators still place efavirenz as their preferred option for commencing treatment as people with a high viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. (above 100,000 copies) are more likely to experience virological failure and resistanceHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. to treatment on rilpivirine.
Adherence is also a big issue with this drug as fewer missed doses may result in developing a resistance not only to it but to the whole family of NNRTIs.
Plus you do need to take it with a good, solid meal.
But the big bonus is that rilpivirine is more easily tolerated than efavirenz and has fewer central nervous system problems.
Multiple-combination pills like this are proving to be a popular option for PLHIVPerson (or people) Living with HIV. This term is now preferred over the older PLWHA.. The idea of one pill once a day is attractive, plus you only have to pay one copayment at the pharmacy.
There are other all-in-one pills on the horizon, too.
The long-awaited QUAD pill will likely be available in Australia next January. QUAD contains an integrase inhibitor, elvitegravir, plus tenofovir, emtricitabine and a novel boosting agent called cobicistat.
The pill is as effective as the widely used Atripla combination but with fewer neuro psychiatric side-effects, researchers reported at the 19th Conference on Retroviruses and Opportunistic Infections in Seattle in March.
Further on the horizon is a protease inhibitor-based single combo tablet containing darunavir, emtricitabine, cobicistat plus a new potent version of tenofovir currently dubbed GS 7340.
GS 7340 is a ‘prodrug’ of tenofovir. Prodrugs are typically inactive chemical compounds that turn into an active drug when they interact with the body’s metabolic system. GS 7340’s mechanism of action is the same as tenofovir, but it requires a dose that is ten times lower than Viread.
QUAD2 is also there in the distance. Identical to QUAD, except it will come with the more potent GS 7340 replacing tenofovir.