Used For:

• Treatment of HIV-1 infection

Adult Dosage:

• 1 tablet once dailyTaken at bedtime, preferably on an empty stomach

Contraindications:

• Do not use Trioday in:Known hypersensitivity to lamivudine, tenofovir, or efavirenzSevere liver diseaseSevere renal impairment (CrCl <50 mL/min – due to tenofovir)History of severe psychiatric illness (psychosis, severe depression) – efavirenz riskConcomitant use with drugs strongly interacting with efavirenz (e.g., certain sedatives, ergot derivatives)⚠️ Pregnancy:Efavirenz was previously contraindicated in 1st trimester; now can be used if benefits outweigh risks, but alternative regimens are preferred in early pregnancy when available.

Side Effects:

• Common Side EffectsEfavirenz-related (most common):DizzinessVivid dreams or nightmaresInsomniaDifficulty concentratingMood changes, anxietyGastrointestinal:Nausea, vomitingDiarrheaAbdominal discomfortGeneral:HeadacheFatigueSkin rash (usually mild)Serious (but less common) Side EffectsSevere depression, suicidal thoughts, psychosis (efavirenz)Hepatotoxicity (elevated liver enzymes)Renal toxicity (tenofovir-related)Loss of bone mineral density / osteoporosisLactic acidosis (rare but serious)Severe skin reactions (Stevens–Johnson syndrome – very rare)

Precautions:

• Strict adherence is essential (missed doses → drug resistance)Baseline and periodic monitoring of:Liver function testsKidney functionBone health (long-term use)Use cautiously in:Patients with mental health disordersHepatitis B co-infection (stopping lamivudine/tenofovir may cause HBV flare)Do not stop suddenly without medical adviceAvoid driving or operating machinery initially (due to dizziness/sedation)

Dietary Restrictions:

• Take on an empty stomach (high-fat meals ↑ efavirenz side effects)Take at bedtime to reduce CNS side effectsAvoid alcohol (↑ liver toxicity & CNS effects)Avoid recreational drugs (↑ psychiatric side effects)Maintain:Adequate hydrationCalcium & vitamin D intake (bone protection)No specific food restrictions otherwise