美国FDA最近批准生产和销售治疗艾滋病的新药物atripla

atripla是综合了三样抗爱滋病药物sustiva (efavirenz), emtriva (emtricitabine) 和 viread(tenofovir disoproxil fumarate), 一天只需服用一次的新型药物。

【别名】立普妥 , 阿托伐他汀钙
【外文名】Lipitor , Atorvastatin Calcium
【药理毒理】本品为HMG-CoA还原酶选择性抑制剂，通过抑制HMG-CoA还原酶和胆固醇在肝脏的生物合成而降低血浆胆固醇和脂蛋白水平，并能通过增加肝细胞表面低密度脂蛋白（LDL）受体数目而增加LDL的摄取和分解代谢。本品也能减少LDL的生成和其颗粒数。本品还能降低某些纯合子型家族性高胆固醇血症（FH）的低密度脂蛋白胆固醇（LDL-C）水平，而一类型的人群对其他类型的降脂药物治疗很少有应答。
本品能降低纯合子和杂合子家族性高胆固醇血症、非家族性高胆固醇血症以及混合性脂类代谢障碍患者的血浆总胆固醇（TC）、LDL-C和载脂蛋白B（ApoB），还能降低极低密度脂蛋白胆固醇（VLDL-C）和三酰甘油（TG）的水平，并能不同程度地提高血浆高密度脂蛋白胆固醇（HDL-C）和载脂蛋白A1（ApoA1）的水平。
【适应证】杂合子家族性或非家族性高胆固醇血症和混合性高脂血症，也用于纯合子高胆固醇血症。
【不良反应】本品可被较好地耐受，不良反应多为轻度和一过性，最常见的是便秘、腹胀、消化不良和腹痛⑴。因本品的不良反应而停药者＜2%。其他有ALT升高（0.7%），发生在用药16周内。
【相互作用】本品与含有炔诺酮和炔雌醇的口服避孕药合用时，能分别使诺酮和炔雌醇的AUC增加30%和20%；与红霉素合用时，本品的血浆浓度约增高40%；与地高辛合用时，多次给药后，地高辛的稳态血药浓度增加约20%，应对地高辛浓度进行监测，与考来烯胺（消胆胺）合用时，本品的血浆浓度降低约25%，但降低LDL-C的效果较单用本品或考来替泊的效果都大。本品与环孢菌素、烟酸、红霉素及吡咯类抗真菌药合用，发生肌病的危险性增加。
【用法用量】po，可在任何时间单剂量服用，进食或非进食时均可。起始剂量为10mg,qd，剂量范围为10～80mg·d-1。根据治疗目标和治疗反应采取个体化治疗方案。对肾功能不全患者，不必调整剂量。
【注意事项】活动性肝病或原因不明的转氨酶持续升高患者及对本品的任何成分过敏者、孕妇和哺乳期妇女禁用。
①使用本品治疗前、治疗6周及12周或增加药物剂量后进行肝功能检测，并在以后定期测定肝功能。
②治疗过程中出现弥漫性肌痛、肌肉触痛或无力，特别是伴有全身不适或发热时，或/和肌酸磷酸激酶（CPK）水平明显升高，应考虑肌病的可能性。如为肌病，应停止本品的治疗。
③使用本品前，应通过适当饮食、运动和减轻肥胖的体重等方法控制高胆固醇血症，并治疗其他原发疾病。
④本品过量无特殊治疗。一旦发生过量，应予以对症及相应
7、的支持疗法，血液透极不能显著增加其清除。
⑤开始治疗和/或增加剂量后2～4周应监测血脂水平，并据此对剂量进行相应的调整。⑥对纯合子高胆固醇血症患者，除非无法进行其他治疗，本品应作为其他降脂治疗措施（LDL血浆分离置换）基础上进行的治疗手段。
【规格】片剂：10mg，20mg,40mg。

【原产地英文商品名】Atripla 600-200-300MG x 30Tablets
【原产地英文药品名】EFAVIRENZ, EMTRICITABINE，and TENOFOVIR DISOPROXIL FUMARATE
【中文参考商品译名】Atripla 600-200-300毫克x30片/瓶
【中文参考药品译名】EFAVIRENZ, EMTRICITABINE，and TENOFOVIR DISOPROXIL FUMARATE
【生产厂家中文参考译名】Bristol-Myers Squibb / Gilead
【生产厂家英文名】Bristol-Myers Squibb / Gilead

Information on Atripla

Learn more about usage, cautions, and possible side effects .

Tablets
Chemical Name: EFAVIRENZ (eh-FAV-er-enz), EMTRICITABINE (em-trye-SYE-ta-been), and TENOFOVIR DISOPROXIL FUMARATE (te-NOE-fo-veer dye-soe-PROX-ill FYOU-mar-ate)

Common uses
This medicine is an antiretroviral combination medicine used alone or with other medicines to treat human immunodeficiency virus (HIV) infection in adults.

Before using
WARNING: SEVERE AND SOMETIMES FATAL LACTIC ACIDOSIS (buildup of lactic acid in the blood) has occurred in some patients taking this type of medicine. The risk may be greater in women, patients who are very overweight, or patients who have been taking nucleoside medicines (such as emtricitabine) for a long time. CONTACT YOUR DOCTOR IMMEDIATELY if you develop extreme weakness or tiredness; unusual muscle pain; trouble breathing; stomach pain with nausea or vomiting; cold feeling, especially in the arms and legs; severe or persistent dizziness or lightheadedness; or fast or irregular heartbeat. SEVERE AND SOMETIMES FATAL LIVER PROBLEMS have also occurred in some patients taking this type of medicine. CONTACT YOUR DOCTOR IMMEDIATELY if you develop yellowing of the skin or eyes, dark urine, pale stools, loss of appetite, severe or persistent nausea, or stomach pain. THIS MEDICINE IS NOT APPROVED TO TREAT HEPATITIS B INFECTION. Safety and effectiveness have not been confirmed in patients who have both HIV and hepatitis B. Some patients with hepatitis B who were treated with similar medicines have had severe worsening of liver problems after they have stopped treatment. Patients with both HIV and hepatitis B who take this medicine should have medical exams and liver function tests performed for at least several months after they stop taking this medicine. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are taking any other medicines containing efavirenz, emtricitabine, or tenofovir. DO NOT TAKE THIS MEDICINE if you are taking any medicines containing lamivudine, or if you are taking astemizole, carbamazepine, cisapride, midazolam, triazolam, terfenadine, ergot medicines (such as ergotamine or ergonovine), St. John's wort, or voriconazole. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking adefovir dipivoxil, cidofovir, acyclovir, valacyclovir, ganciclovir, valganciclovir, hormonal birth control (such as birth control pills), certain antifungal medicines (such as itraconazole or ketoconazole), clarithromycin, certain medicines for high cholesterol (such as atorvastatin, pravastatin, or simvastatin), didanosine, HIV protease inhibitors (such as amprenavir, atazanavir, fosamprenavir, indinavir, lopinavir, ritonavir, or saquinavir alone), medicines for seizures (such as phenytoin or phenobarbital), methadone, rifabutin, rifampin, sertraline, or warfarin. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including a history of bone problems, diabetes, mood or mental problems, suicidal thoughts or actions, substance abuse, kidney problems, dialysis, liver problems (such as hepatitis B infection), seizures, very overweight, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of abnormal liver function tests, severe liver problems (such as enlarged liver or fatty liver), moderate to severe kidney problems, or lactic acidosis. Use of this medicine in children under age 18 is not recommended. Discuss with your doctor the risks and benefits of giving this medicine to your child. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.

Directions
Follow the directions for using this medicine provided by your doctor. An additional patient information leaflet is available with this medicine. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. TAKE THIS MEDICINE BY MOUTH ON AN EMPTY STOMACH at least 1 hour before or 2 hours after eating. TAKE THIS MEDICINE WITH water. STORE THIS MEDICINE at room temperature at 77 degrees F (25 degrees C) in the original container, away from heat and light. Brief storage between 59 to 86 degrees F (15 to 30 degrees C) is permitted. Do not use this medicine if the seal over the bottle opening is broken or missing. Take this medicine regularly to receive the most benefit from it. Taking this medicine at the same time each day will help you to remember. CONTINUE TO USE THIS MEDICINE even if you feel well. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. DO NOT take 2 doses at once.

Cautions
DO NOT TAKE THIS MEDICINE if you have had an allergic reaction to it or are allergic to any ingredient in this product. DO NOT EXCEED THE RECOMMENDED DOSE OR CHANGE THE DOSE of this medicine without checking with your doctor. Exceeding the recommended dose of this medicine may not provide additional benefits and may increase the risks of side effects. DO NOT STOP USING THIS MEDICINE without first checking with your doctor. This may cause the amount of the virus to increase or may make the virus harder to treat. Also some conditions (such as Hepatitis B infection) may become worse when the medicine is suddenly stopped. LABORATORY AND/OR MEDICAL TESTS, including liver function, kidney function, and bone density tests may be performed to monitor your progress or to check for side effects. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are taking this medicine. THIS MEDICINE MAY INTERFERE with certain laboratory tests (such as drug tests). Make sure laboratory personnel and your doctors know you use this medicine. THIS MEDICINE IS NOT A CURE FOR HIV INFECTION and will not prevent you from spreading HIV infection to others through blood or sexual contact. Use barrier methods of birth control (such as condoms) if you have HIV infection. THIS MEDICINE MAY IMPROVE IMMUNE SYSTEM FUNCTION. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (such as fever, sore throat, weakness, cough, or shortness of breath) after you start taking this medicine. THIS MEDICINE WILL ADD TO THE EFFECTS OF ALCOHOL and other depressants (such as sleep aids or tranquilizers). Ask your pharmacist if you have questions about which medicines are depressants. This medicine may cause dizziness or drowsiness. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. CHECK WITH YOUR DOCTOR to see if you should take a calcium and vitamin D supplement while you are taking this medicine. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. This includes St. John's wort. FOR WOMEN: THIS MEDICINE HAS BEEN SHOWN TO CAUSE HARM to the human fetus. Avoid becoming pregnant while you are taking this medicine. IF YOU SUSPECT THAT YOU COULD BE PREGNANT, contact your doctor immediately. FOR WOMEN USING HORMONAL BIRTH CONTROL (such as birth control pills), this medicine may decrease the effectiveness of your birth control. To prevent pregnancy, always use an additional form of birth control such as a condom or diaphragm. IT IS UNKNOWN if this medicine is excreted in the breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or this medicine to the baby. IF YOU HAVE DIABETES, this medicine may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine. MONITOR BLOOD GLUCOSE on a regular basis, as directed by your doctor.

Possible side effects
SIDE EFFECTS that may occur while taking this medicine include diarrhea, discoloration of the skin, dizziness, drowsiness, gas, headache, heartburn, stomach upset, strange dreams, tiredness, trouble sleeping, trouble concentrating, or vomiting. These side effects tend to go away after a few weeks. If they continue or are bothersome, check with your doctor. Changes in body fat may occur while you are taking this medicine (e.g., increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Check with your doctor for more information. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience agitation; anxiety; chronic back pain; a change in the frequency of urination or in the amount of urine produced; loss of appetite; loss of coordination; nervousness; muscle or joint pain; signs or infection (such as cough, fever, sore throat, or runny nose); or tingling or numbness of the hands, feet, or skin. CONTACT YOUR DOCTOR IMMEDIATELY if you experience behavior changes (such as angry or aggressive behavior); confusion; hallucinations; memory loss; symptoms of lactic acidosis (such as extreme weakness or tiredness, fast or irregular heartbeat, unusual muscle pain, severe stomach pain with nausea and vomiting, severe dizziness or lightheadedness, or feeling cold in the arms or legs); mood or mental changes (such as depression, delusions, paranoia, or suicidal thoughts or actions); symptoms of liver problems (such as yellowing of the skin or eyes, dark urine, loss of appetite, pale stool, severe or persistent nausea, or unusual fatigue); reddened, blistered or swollen skin; or seizures. An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing.

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other.