Viraday Tablet
Manufactured By Cipla Limited
Composition Emtricitabine 200mg Tenofovir 300mg Efavirenz 600mg
RS 2875.64
MRP RS 4424.06
(35% OFF)
Includes all taxes
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( 30 tablets in 1 bottle )
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Description:
Viraday Tablet
Viraday Tablet is a fixed-dose combination (FDC) antiretroviral medicine manufactured by Cipla Limited, one of India's most trusted pharmaceutical companies. Each tablet contains three potent active ingredients: Emtricitabine 200mg (NRTI), Tenofovir Disoproxil Fumarate 300mg (NRTI), and Efavirenz 600mg (NNRTI), providing a complete once-daily regimen for the treatment of HIV-1 infection in adults. Available from Shabbir Medical Hall at the best price in India, this genuine prescription tablet is available online with fast delivery nationwide.
BENEFITS: Viraday Tablet offers a highly effective, simplified one-tablet-once-daily antiretroviral regimen that suppresses HIV-1 replication to undetectable levels, dramatically reducing viral load and preserving CD4+ T-cell counts. By combining two NRTIs (Emtricitabine + Tenofovir) with one NNRTI (Efavirenz), it attacks the virus through dual complementary mechanisms, minimising the risk of resistance development. Clinical evidence demonstrates sustained virological suppression, reduced risk of AIDS-defining illnesses, improved immune reconstitution, and significantly extended lifespan and quality of life in HIV-positive patients. It is a WHO-recommended first-line ART regimen and part of India's National AIDS Control Organisation (NACO) treatment guidelines.
USAGE OVERVIEW: Viraday Tablet is taken orally, on an empty stomach (at least 2 hours after food or at bedtime on an empty stomach), as food — especially high-fat meals — significantly increases Efavirenz absorption and risk of CNS side effects. The standard dose is one tablet once daily. Dosage and duration are strictly as directed by the treating physician / ART centre doctor.
SAFETY OVERVIEW: The most common side effects include CNS symptoms (dizziness, insomnia, vivid dreams, depression), rash, nausea, diarrhoea, and raised liver enzymes. Serious risks include hepatotoxicity, lactic acidosis, renal toxicity (Tenofovir), and severe psychiatric reactions. Regular monitoring of viral load, CD4 count, liver function, renal function, and bone density is mandatory during long-term therapy.
Uses / Indications:
- HIV-1 Infection (Treatment-Naive Adults): first-line antiretroviral therapy (ART) in combination with or as a complete regimen
- HIV-1 Infection (Treatment-Experienced Adults): as per physician assessment of prior ART history and resistance profile
- Part of WHO-recommended and NACO first-line ART regimen for adults in India
ADDITIONAL USES:
- HIV/HBV Co-infection: Tenofovir + Emtricitabine are active against both HIV-1 and Hepatitis B virus (HBV); Viraday may be prescribed in HIV/HBV co-infected patients (under specialist guidance)
- Pre-Exposure Prophylaxis (PrEP): Tenofovir + Emtricitabine component is used for HIV PrEP (specialist prescription only; not the full Viraday formulation)
NOTE:
- Viraday Tablet is NOT indicated for HIV-2 infection (Efavirenz is NOT active against HIV-2)
Interactions / Warnings:
CNS WARNING:
- Efavirenz-related CNS symptoms (dizziness, impaired concentration, vivid dreams) are most severe in the first 2–4 weeks. Bedtime dosing minimises impact. Avoid driving or operating heavy machinery until response is established.
PSYCHIATRIC WARNING:
- Use with extreme caution in patients with a history of psychiatric disorders. Monitor for depression, suicidal ideation, psychosis. Do NOT discontinue abruptly — contact physician immediately if psychiatric symptoms develop.
HEPATOTOXICITY WARNING:
- Liver function tests (ALT, AST, bilirubin) MUST be monitored at baseline and every 3–6 months. Risk is higher in patients with chronic hepatitis B or C co-infection or heavy alcohol use.
RENAL TOXICITY (TENOFOVIR):
- Assess renal function (serum creatinine, eGFR, urinalysis for proteinuria) at baseline and every 3–6 months. Tenofovir is CONTRAINDICATED if eGFR <30 mL/min.
BONE DENSITY:
- Tenofovir is associated with reduced bone mineral density (BMD) on long-term use. Calcium + Vitamin D supplementation and periodic DEXA scans may be recommended.
FOOD INTERACTION:
- Take on an EMPTY STOMACH or at bedtime. High-fat food significantly increases Efavirenz absorption and CNS toxicity risk.
DRIVING & MACHINERY:
- Avoid driving or operating machinery until CNS effects are established (typically 2–4 weeks).
ELDERLY USE (≥65 years):
- Use with caution; monitor renal and hepatic function closely. Limited clinical data in elderly patients.
Pregnancy interaction:
- Efavirenz was previously classified as FDA Category D (teratogenic risk in primates); evidence in humans is less conclusive but caution is required in first trimester
- WHO recommends Dolutegravir-based regimens over Efavirenz in women of childbearing potential who may become pregnant
- Viraday (EFV-based) should only be continued in pregnancy after specialist review and risk-benefit assessment by an HIV physician
- Women who are pregnant or planning pregnancy must inform their HIV physician immediately
BREASTFEEDING:
- Antiretroviral drugs are excreted in breast milk. WHO guidelines recommend either exclusive breastfeeding with maternal ART or formula feeding — strictly as advised by the HIV specialist
- Consult your HIV physician for individualised infant feeding guidance
CONTRACEPTION WARNING:
- Efavirenz is a strong CYP3A4 inducer; it significantly reduces the efficacy of hormonal contraceptives (pills, patches, rings). Use a barrier method (condom) in addition to hormonal contraception. Consult your doctor for reliable contraception options
Expert advice:
- 1. TAKE AT BEDTIME ON AN EMPTY STOMACH: Viraday Tablet (particularly Efavirenz) must be taken on an empty stomach — ideally at bedtime. Bedtime dosing allows you to sleep through the peak CNS side effects (dizziness, vivid dreams, disorientation) that are most pronounced in the first 2–4 weeks of therapy. Taking with food — especially high-fat meals — dramatically increases Efavirenz blood levels and worsens these side effects.
- 2. NEVER STOP TREATMENT WITHOUT MEDICAL ADVICE: Antiretroviral therapy must be taken every day without interruption. Missing doses or stopping abruptly leads to viral rebound, CD4 decline, and — critically — development of drug resistance that can permanently compromise treatment options. If you experience side effects, contact your HIV physician immediately — do NOT self-discontinue.
- 3. MONITOR KIDNEYS VIGILANTLY: Tenofovir Disoproxil Fumarate (TDF) can cause progressive kidney damage and, rarely, Fanconi syndrome. Report any reduction in urine output, swelling in legs, persistent fatigue, or bone pain to your doctor immediately. Kidney function tests (serum creatinine, eGFR) are mandatory every 3–6 months.
- 4. WATCH FOR PSYCHIATRIC SYMPTOMS: Efavirenz can cause or worsen depression, anxiety, and — rarely — suicidal thoughts or psychosis. These are not signs of weakness; they are drug effects. Report any persistent mood changes, sleep disturbances beyond 4 weeks, or thoughts of self-harm to your physician without delay.
- 5. CONTRACEPTION IS CRITICAL: Efavirenz significantly reduces the effectiveness of hormonal contraceptives. Always use a barrier method (condom) in addition to any hormonal contraception. Discuss reliable non-hormonal contraceptive options with your physician if needed.
MONITORING ADVICE:
- HIV Viral Load: Every 6 months (goal: undetectable, <50 copies/mL)
- CD4+ T-cell count: Every 6 months
- Liver Function Tests (ALT, AST, bilirubin): Baseline, then every 3–6 months
- Renal Function (serum creatinine, eGFR, urine protein): Baseline, then every 3–6 months
- Full Blood Count (FBC): Periodically — monitor for anaemia (Emtricitabine)
- Bone Mineral Density (DEXA): Consider at baseline and periodically on long-term TDF therapy
- Fasting lipid profile & blood glucose: Periodically (Efavirenz can affect lipid levels)
COMPLIANCE TIPS:
- Set a daily phone alarm at a consistent bedtime for your dose
- Keep a medication diary with dose times and any side effects noted
- Carry your HIV physician prescription and a medication alert card at all times
- Do NOT crush, split, or chew tablets — swallow whole with a full glass of water
- Store in original sealed bottle away from heat and moisture
SAFETY TIPS:
- Do NOT share this medication — it is prescribed specifically for you
- Maintain all scheduled blood tests and HIV clinic appointments without delay
- Inform all treating doctors (GP, dentist, specialist) that you are on antiretroviral therapy
- Before any surgical procedure, inform the surgeon and anaesthetist about all ART medications
- Avoid alcohol — it worsens Efavirenz CNS effects and increases hepatotoxicity risk
- Calcium and Vitamin D supplements may be recommended by your physician to protect bone density during long-term Tenofovir use
Side Effects:
- Dizziness, lightheadedness, impaired concentration
- Insomnia, abnormal dreams / vivid dreams
- Somnolence (drowsiness) — avoid driving or operating machinery, especially in first 2–4 weeks
- Headache, fatigue
COMMON SIDE EFFECTS — GENERAL (>1 in 10 people):
- Nausea, diarrhoea, vomiting, flatulence
- Skin rash (Efavirenz-related; usually mild and self-limiting in first 2 weeks)
- Elevated liver enzymes (ALT, AST)
- Asthenia (weakness), myalgia
SERIOUS SIDE EFFECTS (contact your doctor immediately):
- Severe psychiatric reactions: severe depression, suicidal ideation, psychosis, mania — especially in patients with prior psychiatric history
- Hepatotoxicity: jaundice, dark urine, severe upper abdominal pain — DISCONTINUE and seek urgent review
- Lactic acidosis / severe hepatomegaly with steatosis: rare but life-threatening — nausea, vomiting, abdominal pain, weakness, respiratory distress
- Renal toxicity (Tenofovir): declining kidney function, Fanconi syndrome (proximal renal tubular dysfunction) — monitor renal function regularly
- Severe skin reactions: Stevens-Johnson Syndrome, toxic epidermal necrolysis (very rare)
- Immune Reconstitution Inflammatory Syndrome (IRIS): worsening of pre-existing opportunistic infections in first weeks of ART
EMERGENCY SIGNS — SEEK IMMEDIATE MEDICAL HELP:
- Severe rash with blistering, peeling, or mucosal involvement
- Jaundice or severe abdominal pain
- Extreme weakness, difficulty breathing, persistent vomiting (lactic acidosis)
- Suicidal thoughts or severe mood change
How to use:
- ADULT DOSAGE: 1 tablet (Emtricitabine 200mg + Tenofovir 300mg + Efavirenz 600mg) ONCE DAILY
- Preferably taken at BEDTIME on an EMPTY STOMACH
- Taking with food (especially high-fat meals) significantly increases Efavirenz plasma levels and CNS side effects
ROUTE OF ADMINISTRATION:
- Oral (film-coated tablet) — swallow whole with water
- Do NOT crush, split, or chew tablets
TIMING:
- Take at the same time each day for consistent drug levels
- Bedtime dosing minimises CNS side effects (dizziness, vivid dreams) as patient sleeps through peak Efavirenz levels
MISSED DOSE:
- If remembered within 12 hours: take immediately
- If more than 12 hours have passed: skip missed dose and take the next scheduled dose
- NEVER double up — this increases side effect risk without benefit
DURATION:
- Long-term / lifelong treatment as directed by physician; NEVER stop without medical advice — abrupt discontinuation causes viral rebound and resistance
STORAGE:
- Store below 30°C in a dry place, away from moisture and sunlight
- Keep in original bottle with lid tightly closed
- Keep out of reach of children
- Do not use after expiry date on the label
How it works:
- A cytidine analogue that is phosphorylated intracellularly to emtricitabine-5'-triphosphate
- Inhibits HIV-1 reverse transcriptase by competing with natural cytidine-5'-triphosphate and causing chain termination
- Also active against Hepatitis B virus (HBV)
MECHANISM OF ACTION — TENOFOVIR DISOPROXIL FUMARATE (300mg) — Nucleotide Reverse Transcriptase Inhibitor (NtRTI):
- A prodrug of tenofovir; converted intracellularly to tenofovir diphosphate
- Inhibits HIV-1 reverse transcriptase through chain termination after incorporation
- Also active against HBV; long intracellular half-life supports once-daily dosing
MECHANISM OF ACTION — EFAVIRENZ (600mg) — Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI):
- Binds directly and non-competitively to HIV-1 reverse transcriptase at an allosteric site
- Disrupts the enzyme's catalytic activity, blocking conversion of viral RNA into DNA
- NOT active against HIV-2 or HIV-1 group O
COMBINED PHARMACOLOGIC ACTION:
- The dual NRTI backbone (TDF+FTC) combined with an NNRTI (EFV) creates a 3-drug regimen that suppresses HIV replication from multiple points, reducing viral load to undetectable levels and preserving immune function
Faq for medicine:
Viraday Tablet (Emtricitabine 200mg + Tenofovir 300mg + Efavirenz 600mg) is used for the treatment of HIV-1 infection in adults as a complete once-daily antiretroviral regimen, as directed by an HIV physician.
2. How does Viraday Tablet work?
Viraday combines two NRTIs (Emtricitabine + Tenofovir) and one NNRTI (Efavirenz) to block HIV-1 reverse transcriptase through dual mechanisms. This suppresses HIV replication, reduces viral load to undetectable levels, and preserves CD4+ immune cells.
3. What is the dose of Viraday Tablet?
Standard dose: 1 tablet (Emtricitabine 200mg + Tenofovir 300mg + Efavirenz 600mg) ONCE DAILY on an empty stomach, preferably at bedtime. Bedtime dosing minimises CNS side effects. Always follow your HIV physician's prescription exactly.
4. What are the side effects of Viraday Tablet?
Most common: dizziness, vivid dreams, insomnia (Efavirenz-related; usually resolve in 2–4 weeks), nausea, rash. Serious but rare: hepatotoxicity, lactic acidosis, renal toxicity, severe psychiatric reactions. Regular monitoring is mandatory.
5. Can I buy Viraday Tablet online at the best price in India?
Yes. Buy Viraday Tablet online from Shabbir Medical Hall at 35% OFF MRP (Rs 2,875.64 vs Rs 4,424.06 per bottle of 30 tablets). Valid HIV physician prescription required. Fast delivery across Hyderabad, Bangalore, Mumbai, Delhi, and Chennai.
Medicine interaction:
- Rifampicin (TB treatment): significantly reduces Efavirenz levels — dose adjustment may be required under specialist guidance
- Hormonal contraceptives (pills, patches, implants): markedly reduced contraceptive efficacy — always add barrier contraception
- Methadone: Efavirenz reduces methadone levels significantly — withdrawal symptoms possible; dose adjustment required
- Warfarin / anticoagulants: Efavirenz induces CYP2C9 — monitor INR closely
- Statins (simvastatin, atorvastatin): reduced statin levels — may need dose adjustment
- Antifungals (voriconazole): markedly reduced voriconazole levels — avoid combination or use alternative
- Protease inhibitors (lopinavir, atazanavir, indinavir): complex interactions; specialist consultation required
- St John's Wort: strong CYP3A4 inducer — CONTRAINDICATED; may cause virological failure
- Nephrotoxic drugs (NSAIDs, aminoglycosides, vancomycin): combined with Tenofovir increases renal toxicity risk — avoid or monitor renal function closely
VACCINE INTERACTIONS:
- No specific vaccine interactions listed; consult your HIV physician before receiving any live attenuated vaccines during ART
SUPPLEMENT INTERACTIONS:
- St John's Wort: CONTRAINDICATED
- Calcium & Vitamin D supplements: may be co-prescribed to counter Tenofovir-related bone density loss — discuss with physician
