Trioday Tablet (Tenofovir Disoproxil Lamivudine and Efavirenz Tablets)

Trioday Tablet is a once-daily fixed-dose antiretroviral combination containing efavirenz 600 mg, lamivudine 300 mg and tenofovir disoproxil fumarate 300 mg. Efavirenz Tablet is an NNRTI; lamivudine and tenofovir are NRTIs. The three medicines suppress HIV at complementary points in reverse transcription. Efavirenz-based single-tablet regimens were widely used as first-line ART for many years. Current international guidelines often prefer integrase-inhibitor-based regimens such as dolutegravir because of improved tolerability and resistance profile, but efavirenz-based therapy remains an established alternative in selected settings.

This fixed-dose regimen is used for treatment of HIV-1 infection in patients for whom the component doses are appropriate. It should not be used as PrEP because it contains efavirenz and is a full treatment regimen. Before initiation or switching, clinicians review HIV resistance history, renal function, hepatitis B status, pregnancy considerations, and interacting medicines. Both tenofovir and the companion NRTI have HBV activity, so stopping the combination in HBV coinfection can trigger a hepatitis flare.

Efavirenz Tablet binds HIV-1 reverse transcriptase at an allosteric site and inhibits it non-competitively. Tenofovir diphosphate and lamivudine triphosphate act as nucleotide/nucleoside analogues that terminate viral DNA chains.

Efavirenz-based ART trials: Large trials established potent viral suppression with the efavirenz tablet plus two NRTIs and made this a historical global first-line standard.

Modern comparative trials: Dolutegravir-based regimens have generally shown better resistance/tolerability profiles, informing current guideline preference.

Just like any other medication, the Trioday Tablet is also associated with some side effects. Most of the side effects are minor and usually go away within some time. Here are some of the symptoms, including:

Common side effects

• Dizziness
• Vivid dreams or sleep disturbance
• Headache
• Nausea
• Rash
• Fatigue
• Difficulty concentrating

Serious side effects

• Severe psychiatric symptoms
• Severe skin reactions
• Hepatotoxicity
• Renal toxicity from TDF
• HBV flare after discontinuation
• QT prolongation in susceptible patients

Important: Dose and regimen must be prescribed by the treating specialist. Tablet/vial strength is not necessarily the patient dose. Do not start, stop, split, combine, or substitute treatment based on website information.

Take a missed dose when remembered unless close to the next dose. Do not double. Maintaining daily adherence is critical to avoid viral rebound and resistance.

• HIV viral load
• CD4 count as clinically indicated
• Renal function
• Liver function
• HBV status
• Mental health/CNS tolerability
• Adherence and drug-interaction review​
  

• Current efavirenz/tenofovir fixed-dose prescribing information as applicable. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/219804Orig1s000lbl.pdf
• Current WHO/DHHS/IAS-USA HIV treatment guidelines. https://www.iasusa.org/fellow-student-resources/guidelines/
• ADVANCE and other modern ART comparative trials for current regimen context.https://www.mdpi.com/1999-4915/16/8/1205.
• MDPI. Relationship between modern ART and Immunosenescene Marker in Patients in HIV. https://www.mdpi.com/1999-4915/16/8/1205​
• Science Direct. Trioday tablet for people with HIV infection,https://www.sciencedirect.com/science/article/pii/S1198743X2400168X